With the use of a reliable and validated patient self-assessment tool, rosacea has been shown to be more severe in younger patients and in men, with the relationship between disease severity and demographics being an important consideration for clinicians who treat and study rosacea, according to the results of a survey administered to adult patients with rosacea from 2011 to 2014, which was published in Dermatologic Clinics.
The investigators developed a validated self-assessment tool that has the ability to provide a more accurate assessment of rosacea severity in survey studies. In the past, the determination of rosacea severity had been based on costly in-person clinic visits. A total of 195 surveys of the 442 surveys delivered or administered in the office were completed and analyzed. All of the participants who completed the survey by mail had completed a previously validated self-assessment tool as well.
Mean age of the survey responders was 58±13 (range, 20 to 87). There were more women (n=155; 81.2%) than men (n=36; 18.8%) among the responders. Average disease duration was 11.5±10.5 years (range, 3 months to 58 years). The majority (95.3%) of the participants were white.
Severity scores were between 2 and 4 out of 8 (the most severe) in the majority of participants. Ocular symptoms were reported in 86.4% of participants. Mild nasal involvement was reported in 75.5% of participants, moderate nasal involvement in 22.8%, and severe nasal involvement in 1.6%. Nasal involvement was significantly more likely in men than in women (39% vs 20%, respectively; P =.03). Overall, 96.3% of participants had not had their rosacea surgically treated.
Age and disease severity were negatively correlated (P =.01). Self-assessment severity scores were significantly higher in participants age <60 compared with patients age ≥60 (P =.04). Participants age <60 also reported spending a median time of 5 minutes (range, 0 to 120 minutes) on the management of their rosacea symptoms vs a median of 5 minutes (range, 0 to 40 minutes) in patients age ≥60 (P =.01). Age was not significantly associated with the presence of eye symptoms, nasal involvement, or the use of light therapy.
Self-assessment severity scores were significantly higher in men than in women (3.6±1.3 vs 3.2±1.0, respectively; P =.04). It should be noted that although only 44.1% of patients responded to the survey, nonresponders matched responders with respect to age and gender.
The investigators concluded that although the current study utilized a validated, reliable self-assessment tool to demonstrate that rosacea severity is worse in younger patients and men, one of the major limitations was that the population comprised university dermatology clinic patients who may not necessarily be representative of patients in the general population.
Alinia H, Tuchayi SM, James SM, et al. Measurement of disease severity in a population of rosacea patients. Dermatol Clin. 2018;36(2):97-102.