Standard Grading System Introduced on Rosacea Signs and Symptoms

BARRINGTON, Illinois (September 24, 2004) -- 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.

"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, a 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 by standard subtype that includes the physician's scoring of severity as well as the patient's own evaluation. In most cases, some rather than all of the 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), 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 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. These include subtype 1 (erythematotelangiectatic) rosacea, characterized by flushing, persistent central facial erythema and in some cases telangiectasia; subtype 2 (papulopustular) rosacea, characterized by persistent erythema with papules or pustules; subtype 3 (phymatous) rosacea, characterized by thickening skin and enlargement, most commonly of the nose; and subtype 4 (ocular) rosacea, which may include eye irritation, blepharitis (swelling of the eyelids), watery or bloodshot appearance, and other ocular manifestations.

In addition to Dr. Wilkin, the consensus committee included Dr. Mark Dahl, chairman of dermatology, Mayo Clinic Scottsdale; Dr. Michael Detmar, associate professor of dermatology, Harvard Medical School; Dr. Lynn Drake, department of dermatology, Harvard Medical School; Dr. Matthew H. Liang, professor of medicine, Harvard School of Public Health; Dr. Richard Odom, professor of dermatology, University of California at San Francisco; and Dr. Frank Powell, consultant dermatologist, Mater Misericordiae Hospital, Dublin, Ireland. In addition, 10 leading experts in the United States and Europe reviewed and contributed to the standard system, which is expected to be updated as new research discoveries are made.

Reprints of the published standard grading system are available by writing the National Rosacea Society, 800 S. Northwest Highway, Suite 200, Barrington, Illinois 60010, calling toll-free at 1-888-662-5874, or via e-mail at

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Publication Date: 
Friday, September 24, 2004

Press contacts:
Mary Erhard, Emma Terhaar

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The National Rosacea Society is a 501(c)(3) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace

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