Prognosis of 234 rosacea patients according to clinical subtype: The significance of central facial erythema in the prognosis of rosacea

Abstract

Rosacea has a wide spectrum of clinical features, which include persistent facial redness, flushing, telangiectasia, inflammatory papules/pustules, hypertrophy and/or ocular features. The prognosis of rosacea according to clinical subtype has not been evaluated. We analyzed the prognosis of rosacea in 234 patients, which included 120 patients with mixed subtype, 75 with the erythematotelangiectatic rosacea subtype and 39 with the papulopustular rosacea (PPR) subtype. The prognosis of rosacea was classified as: (i) no improvement; (ii) partial remission; and (iii) complete remission. The frequencies of complete remission, time to complete remission and 1-year complete remission rate were compared between subtypes. Follow-up periods ranged 2-72 months (median follow-up, 17.5). Aggravation of the disease was found in 50.4% of patients during follow up. Partial or complete remission was noted in 61.5% and 20.9% of patients, respectively. The median time to complete remission was 56.0 months. The prognosis of disease was more favorable for patients with the PPR subtype than for patients with other subtypes with respect to the frequency of complete remission, median time to complete remission and the 2-year complete remission rate. In conclusion, papulopustular rosacea without remarkable centrofacial erythema showed a more favorable prognosis than other subtypes. Erythematotelangiectatic lesions in rosacea patients present a challenge for the treatment of rosacea.

Integrative concepts of rosacea pathophysiology, clinical presentation and new therapeutics

“…Additional therapeutics include pharmacologically distinct topical and oral agents, administered alone or in combination. A favourable prognosis exists for patients with papulopustular presentation, while patients with underlying persistent erythema or phymata, with or without inflammatory lesions, are much more refractory to treatment . Approved systemic and topical therapies are discussed below; additional experimental therapies are summarized in Table .…”

Systemic comorbidities associated with rosacea: a multicentric retrospective observational study

“…1,7 It is characterized by a chronic course, symptoms exacerbate over time in >50% of patients, and progression from one subtype to another can occur. 1,8 A small percentage of patients (20.9%) experience complete remission (primarily those with the papulopustular subtype) within 6 years of diagnosis. 8 Once considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders.…”

“…1,8 A small percentage of patients (20.9%) experience complete remission (primarily those with the papulopustular subtype) within 6 years of diagnosis. 8 Once considered a disorder limited to the skin, rosacea is now known to be associated with systemic disorders. Rosacea is significantly associated with allergies, respiratory and gastrointestinal tract disorders, metabolic and cardiovascular diseases, major depression, Parkinson's disease, and some cancers.…”

DOMINO, doxycycline 40 mg vs. minocycline 100 mg in the treatment of rosacea: a randomized, single-blinded, noninferiority trial, comparing efficacy and safety

“…As a chronic condition with remissions and exacerbations, rosacea requires long‐term treatment: not only to improve signs and symptoms, but also to maintain remission for as long as possible. Besides, little is known about the duration of remission after rosacea treatment …”

“…Besides, little is known about the duration of remission after rosacea treatment. [22][23][24] Furthermore, patient-reported outcomes, including Patient's Global Assessment (PaGA) (Appendix S1; see Supporting Information) and patient's health-related quality of life (HRQoL) (measured with RosaQoL; Appendix S2; see Supporting Information), are often not assessed in clinical trials. The objective of this study was to compare the efficacy and safety, including investigators' reported outcomes and patientreported outcomes, of doxycycline 40 mg vs. minocycline 100 mg, in papulopustular rosacea over a 16-week treatment period, with 12-week follow-up.…”