The National Rosacea Society has introduced the first standard grading system for the study and clinical assessment of rosacea, developed by a consensus committee and review panel of 17 rosacea experts worldwide and recently published in the Journal of the American Academy of Dermatology.1
"The new standard grading system should be useful to both researchers and practicing dermatologists in addressing this often complex disorder," said Dr. Jonathan Wilkin, chairman of the consensus committee. In addition to the previously developed standard classification system, standard grading system is often essential to perform research, analyze results and compare data from different sources. This in turn provides a common reference for comprehensive patient evaluation, appropriate treatment and assessment of results in clinical practice."
The new system provides grading criteria and guidelines for the primary and secondary features of rosacea as defined in the standard classification system, and establishes a global assessment for rosacea patients by standard subtype that includes the physician's scoring of severity as well as the patient's own assessment. In most cases, some rather than all of these potential manifestations of the disorder appear in any given patient.
The primary signs and symptoms of rosacea are transient erythema (flushing), nontransient erythema (redness), papules (bumps) and pustules (pimples), and telangiectasia (visible blood vessels). For clinicians, the grading system recommends rating these signs as absent, mild, moderate or severe. Researchers are encouraged to provide more detailed measurements.
Clinicians may similarly rate the secondary signs and symptoms of rosacea -- ocular manifestations (eye irritation) and skin manifestations such as burning or stinging, plaques (raised red patches), dry appearance and phymatous changes (thickening of the skin) -- as absent, mild, moderate or severe, and are advised to note whether edema (swelling) and peripheral location of signs and symptoms are present or absent.
In addition, the system calls for a global assessment of the patient's condition according to the severity of signs and symptoms grouped into the four standard subtypes outlined in the standard classification system.
Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F. Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. Journal of the American Academy of Dermatology. 2004;50:907-912.