Advances in scientific knowledge have allowed for the first update into the disease process of rosacea.
The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on the current understanding of this often life-disruptive condition, according to a press release from the group.
It is now understood that a consistent multivariate disease process underlies the various clinical manifestations of rosacea, and these are now well understood, Richard Gallo, MD, chairman of dermatology, University of California-San Diego, said in the release.
Recent studies have shown that the initial redness appears to be the start of an inflammatory continuum initiated by neurovascular dysregulation and the innate immune system, according to the release.
The role of the innate immune system has been a focus of research funded by the NRS.
The original standard classification of rosacea identified the most common presentations morphologically as subtypes. Given new knowledge of its pathology, the consensus committee emphasized that it is more appropriate to focus on the individual characteristics, called phenotypes, that may result from the consistent disease process, according to the release.
“Observing the respective phenotypes in clinical practice not only encourages consideration of the full range of potential signs and symptoms, but the assessment of severity and selection of treatment may also be more precisely tailored to each individual,” the NRS wrote.
According to the new standard system, the presence of one of two phenotypes – persistent redness of the facial skin or, less commonly, phymatous changes where the facial skin thickens – is considered diagnostic of rosacea. Other major signs include papules and pustules, flushing, telangiectasia and certain ocular manifestations.
The presence of two or more major phenotypes independent of the diagnostic features is also considered diagnostic of rosacea, according to the release.
The NRS consensus committee also emphasized the psychosocial effects of rosacea. Multiple patient surveys have documented rosacea’s adverse impact on emotional, social and occupational well-being.
Based on surveys conducted by the NRS, more than 90% of rosacea patients said the disorder had lowered their self-confidence and self-esteem, and 41% reported that it had caused them to avoid public contact or cancel social engagements.
The newly published updated classification and pathophysiology of rosacea will provide standard criteria essential for performing research, analyzing results and comparing data from different sources, as well as serve as a diagnostic reference in clinical practice, according to the release.
The committee summarized the many recent studies that have found associations between rosacea and increased risk for a growing number of potentially serious systemic disorders. These include: cardiovascular disease, gastrointestinal disease, neurological and autoimmune diseases, and certain cancers.
During Rosacea Awareness Month and throughout the year, the NRS will conduct public education activities to reach the millions of rosacea sufferers who may not realize they have a medical condition that can be treated, emphasizing the warning signs and urging those who suspect they may have rosacea to see a dermatologist.