Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Hi, I found the article below in the June 2002 issue of Skin and Allergy News. It may be similar to the article posted on Dr. Sy's website http://www.lindasy.com, but in case this one has more info I thought I'd post it here. Take care, Matija Four subtypes, one variant identified Guidelines Help Standardize cea Diagnosis Jeff Senior Writer A new, standard classification system for rosacea describes four subtypes and one variant that have features that may be found together or independent of each other, reported an expert committee of the National cea Society. Primary and secondary features of rosacea were combined to create the subtypes, said the committee, led by Dr. Wilkin of the Food and Drug Administration, Rockville, Md. The primary features include transient and persistent erythema, papules and pustules, and telangiectasia, but these are often accompanied by secondary features. Secondary features are edema, plaques, dry appearance, ocular manifestations, phymatous changes, burning or stinging sensations, and symptoms peripheral to the face (J. Am. Acad. Dermatol. 46[4]:584-87, 2002). " Our goal was to provide all physicians with a common terminology and a common foundation on how to diagnose and classify rosacea, " committee member Dr. Lynn Drake of Harvard Medical School, Boston, told SKIN & ALLERGY NEWS. With such information, physicians will be able to make quicker and better diagnoses, and in turn improve epidemiologic statistics that will create a firmer foundation on which to base research, she said. The subtypes and variant are defined as follows: Erythematotelangiectatic rosacea (subtype 1). This subtype is defined primarily by flushing and persistent central facial erythema. Telangiectases are common but are not essential. It is common for a patient with this subtype to have a history of transient erythema alone. Edema of the central face, stinging, burning, and roughness or scaling are often present. Papulopustular rosacea (subtype 2). This subtype may look like acne vulgaris without comedones. Patients will have persistent central facial erythema accompanied by transient papules and/or pustules that can occur in the perioral, perinasal, or periocular areas. A burning or stinging sensation also may be present. Papulopustular rosacea can appear after or along with erythematotelangiectatic rosacea, making any telangiectases difficult to spot until treatment has cleared the other features. Phymatous rosacea (subtype 3). The thickening skin, irregular surface nodularities, and enlargement present in phymatous rosacea most commonly develop on the nose (rhinophyma), but may occur on the chin, forehead, cheeks, and ears. These phymatous areas may have patulous follicles. This subtype is often observed after or in combination with subtypes 1 or 2. Ocular rosacea (subtype 4). Skin signs and symptoms do not have to be present for a diagnosis of ocular rosacea, as a limited number of studies have suggested that ocular problems may occur before cutaneous manifestations of the disease in up to 20% of patients. For this diagnosis, a patient's eyes should have one or more of the following: watery or bloodshot appearance, foreign body sensation, burning or stinging, dryness, itching, light sensitivity, blurred vision, telangiectases of the conjunctiva and lid margin, or lid and periocular erythema. Chalazia and hordeolums may also be present. Some patients may have corneal complications that decrease visual acuity. Granulomatous rosacea (variant). Patients with this variant of rosacea have hard, yellow, brown, or red cutaneous papules or nodules that sit upon fairly normal-looking skin of the cheeks and periorificial areas. All of the papules and nodules on a particular patient will have the same shape and size. Unlike the subtypes, granulomatous rosacea can be diagnosed without the presence of other rosacea signs. The experts found insufficient evidence to include rosacea fulminans, steroid-induced acneiform eruption, and perioral dermatitis as types of rosacea. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Matija, Do you have a link for that journal article? Thanks. > Hi, > > I found the article below in the June 2002 issue of Skin and Allergy > News. It may be similar to the article posted on Dr. Sy's website > http://www.lindasy.com, but in case this one has more info I thought > I'd post it here. > Take care, > Matija > > Four subtypes, one variant identified > Guidelines Help Standardize cea Diagnosis > > Jeff > Senior Writer > > > A new, standard classification system for rosacea describes four > subtypes and one variant that have features that may be found > together or independent of each other, reported an expert committee > of the National cea Society. > > Primary and secondary features of rosacea were combined to create the > subtypes, said the committee, led by Dr. Wilkin of the Food > and Drug Administration, Rockville, Md. The primary features include > transient and persistent erythema, papules and pustules, and > telangiectasia, but these are often accompanied by secondary > features. Secondary features are edema, plaques, dry appearance, > ocular manifestations, phymatous changes, burning or stinging > sensations, and symptoms peripheral to the face (J. Am. Acad. > Dermatol. 46[4]:584-87, 2002). > > " Our goal was to provide all physicians with a common terminology and > a common foundation on how to diagnose and classify rosacea, " > committee member Dr. Lynn Drake of Harvard Medical School, Boston, > told SKIN & ALLERGY NEWS. With such information, physicians will be > able to make quicker and better diagnoses, and in turn improve > epidemiologic statistics that will create a firmer foundation on > which to base research, she said. The subtypes and variant are > defined as follows: > > Erythematotelangiectatic rosacea (subtype 1). This subtype is > defined primarily by flushing and persistent central facial erythema. > Telangiectases are common but are not essential. It is common for a > patient with this subtype to have a history of transient erythema > alone. Edema of the central face, stinging, burning, and roughness or > scaling are often present. > > Papulopustular rosacea (subtype 2). This subtype may look like acne > vulgaris without comedones. Patients will have persistent central > facial erythema accompanied by transient papules and/or pustules that > can occur in the perioral, perinasal, or periocular areas. A burning > or stinging sensation also may be present. Papulopustular rosacea can > appear after or along with erythematotelangiectatic rosacea, making > any telangiectases difficult to spot until treatment has cleared the > other features. > > Phymatous rosacea (subtype 3). The thickening skin, irregular > surface nodularities, and enlargement present in phymatous rosacea > most commonly develop on the nose (rhinophyma), but may occur on the > chin, forehead, cheeks, and ears. These phymatous areas may have > patulous follicles. This subtype is often observed after or in > combination with subtypes 1 or 2. > > Ocular rosacea (subtype 4). Skin signs and symptoms do not have to > be present for a diagnosis of ocular rosacea, as a limited number of > studies have suggested that ocular problems may occur before > cutaneous manifestations of the disease in up to 20% of patients. > > For this diagnosis, a patient's eyes should have one or more of the > following: watery or bloodshot appearance, foreign body sensation, > burning or stinging, dryness, itching, light sensitivity, blurred > vision, telangiectases of the conjunctiva and lid margin, or lid and > periocular erythema. Chalazia and hordeolums may also be present. > Some patients may have corneal complications that decrease visual > acuity. > > Granulomatous rosacea (variant). Patients with this variant of > rosacea have hard, yellow, brown, or red cutaneous papules or nodules > that sit upon fairly normal-looking skin of the cheeks and > periorificial areas. All of the papules and nodules on a particular > patient will have the same shape and size. Unlike the subtypes, > granulomatous rosacea can be diagnosed without the presence of other > rosacea signs. > > The experts found insufficient evidence to include rosacea fulminans, > steroid-induced acneiform eruption, and perioral dermatitis as types > of rosacea. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Hi, I found the article below at http://www.eskinandallergynews.com You have to register to read the articles, but registration is free. About the entire journal article, several of us have wanted to get our hands on it. Unfortunately, J. Am. Acad. Dermatol. is a journal sponsored by the AMA. They don't seem to want to place the entire article online. I live in a city with a medical school, but it's a bit of a hike with public transportation from where I work and live. As well, parking is atrocious. They do let civilians like myself photocopy journal articles. Does anyone live near a medical school where you can go to the library and do this? Or perhaps someone is a student at a university or college where there is an affiliated medical school. If you want to photocopy the article and send it to me to be scanned, I'll be happy to upload the article to the group. Take care, Matija > > Hi, > > > > I found the article below in the June 2002 issue of Skin and > Allergy > > News. It may be similar to the article posted on Dr. Sy's > website > > http://www.lindasy.com, but in case this one has more info I > thought > > I'd post it here. > > Take care, > > Matija > > > > Four subtypes, one variant identified > > Guidelines Help Standardize cea Diagnosis > > > > Jeff > > Senior Writer > > > > > > A new, standard classification system for rosacea describes > four > > subtypes and one variant that have features that may be found > > together or independent of each other, reported an expert > committee > > of the National cea Society. > > > > Primary and secondary features of rosacea were combined to > create the > > subtypes, said the committee, led by Dr. Wilkin of the > Food > > and Drug Administration, Rockville, Md. The primary features > include > > transient and persistent erythema, papules and pustules, and > > telangiectasia, but these are often accompanied by secondary > > features. Secondary features are edema, plaques, dry > appearance, > > ocular manifestations, phymatous changes, burning or > stinging > > sensations, and symptoms peripheral to the face (J. Am. Acad. > > Dermatol. 46[4]:584-87, 2002). > > > > " Our goal was to provide all physicians with a common > terminology and > > a common foundation on how to diagnose and classify > rosacea, " > > committee member Dr. Lynn Drake of Harvard Medical School, > Boston, > > told SKIN & ALLERGY NEWS. With such information, > physicians will be > > able to make quicker and better diagnoses, and in turn > improve > > epidemiologic statistics that will create a firmer foundation on > > which to base research, she said. The subtypes and variant > are > > defined as follows: > > > > Erythematotelangiectatic rosacea (subtype 1). This subtype is > > defined primarily by flushing and persistent central facial > erythema. > > Telangiectases are common but are not essential. It is > common for a > > patient with this subtype to have a history of transient erythema > > alone. Edema of the central face, stinging, burning, and > roughness or > > scaling are often present. > > > > Papulopustular rosacea (subtype 2). This subtype may look > like acne > > vulgaris without comedones. Patients will have persistent > central > > facial erythema accompanied by transient papules and/or > pustules that > > can occur in the perioral, perinasal, or periocular areas. A > burning > > or stinging sensation also may be present. Papulopustular > rosacea can > > appear after or along with erythematotelangiectatic rosacea, > making > > any telangiectases difficult to spot until treatment has cleared > the > > other features. > > > > Phymatous rosacea (subtype 3). The thickening skin, irregular > > surface nodularities, and enlargement present in phymatous > rosacea > > most commonly develop on the nose (rhinophyma), but may > occur on the > > chin, forehead, cheeks, and ears. These phymatous areas > may have > > patulous follicles. This subtype is often observed after or in > > combination with subtypes 1 or 2. > > > > Ocular rosacea (subtype 4). Skin signs and symptoms do not > have to > > be present for a diagnosis of ocular rosacea, as a limited > number of > > studies have suggested that ocular problems may occur > before > > cutaneous manifestations of the disease in up to 20% of > patients. > > > > For this diagnosis, a patient's eyes should have one or more of > the > > following: watery or bloodshot appearance, foreign body > sensation, > > burning or stinging, dryness, itching, light sensitivity, blurred > > vision, telangiectases of the conjunctiva and lid margin, or lid > and > > periocular erythema. Chalazia and hordeolums may also be > present. > > Some patients may have corneal complications that decrease > visual > > acuity. > > > > Granulomatous rosacea (variant). Patients with this variant of > > rosacea have hard, yellow, brown, or red cutaneous papules or > nodules > > that sit upon fairly normal-looking skin of the cheeks and > > periorificial areas. All of the papules and nodules on a > particular > > patient will have the same shape and size. Unlike the > subtypes, > > granulomatous rosacea can be diagnosed without the > presence of other > > rosacea signs. > > > > The experts found insufficient evidence to include rosacea > fulminans, > > steroid-induced acneiform eruption, and perioral dermatitis as > types > > of rosacea. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Hi, I found the article below at http://www.eskinandallergynews.com You have to register to read the articles, but registration is free. About the entire journal article, several of us have wanted to get our hands on it. Unfortunately, J. Am. Acad. Dermatol. is a journal sponsored by the AMA. They don't seem to want to place the entire article online. I live in a city with a medical school, but it's a bit of a hike with public transportation from where I work and live. As well, parking is atrocious. They do let civilians like myself photocopy journal articles. Does anyone live near a medical school where you can go to the library and do this? Or perhaps someone is a student at a university or college where there is an affiliated medical school. If you want to photocopy the article and send it to me to be scanned, I'll be happy to upload the article to the group. Take care, Matija > > Hi, > > > > I found the article below in the June 2002 issue of Skin and > Allergy > > News. It may be similar to the article posted on Dr. Sy's > website > > http://www.lindasy.com, but in case this one has more info I > thought > > I'd post it here. > > Take care, > > Matija > > > > Four subtypes, one variant identified > > Guidelines Help Standardize cea Diagnosis > > > > Jeff > > Senior Writer > > > > > > A new, standard classification system for rosacea describes > four > > subtypes and one variant that have features that may be found > > together or independent of each other, reported an expert > committee > > of the National cea Society. > > > > Primary and secondary features of rosacea were combined to > create the > > subtypes, said the committee, led by Dr. Wilkin of the > Food > > and Drug Administration, Rockville, Md. The primary features > include > > transient and persistent erythema, papules and pustules, and > > telangiectasia, but these are often accompanied by secondary > > features. Secondary features are edema, plaques, dry > appearance, > > ocular manifestations, phymatous changes, burning or > stinging > > sensations, and symptoms peripheral to the face (J. Am. Acad. > > Dermatol. 46[4]:584-87, 2002). > > > > " Our goal was to provide all physicians with a common > terminology and > > a common foundation on how to diagnose and classify > rosacea, " > > committee member Dr. Lynn Drake of Harvard Medical School, > Boston, > > told SKIN & ALLERGY NEWS. With such information, > physicians will be > > able to make quicker and better diagnoses, and in turn > improve > > epidemiologic statistics that will create a firmer foundation on > > which to base research, she said. The subtypes and variant > are > > defined as follows: > > > > Erythematotelangiectatic rosacea (subtype 1). This subtype is > > defined primarily by flushing and persistent central facial > erythema. > > Telangiectases are common but are not essential. It is > common for a > > patient with this subtype to have a history of transient erythema > > alone. Edema of the central face, stinging, burning, and > roughness or > > scaling are often present. > > > > Papulopustular rosacea (subtype 2). This subtype may look > like acne > > vulgaris without comedones. Patients will have persistent > central > > facial erythema accompanied by transient papules and/or > pustules that > > can occur in the perioral, perinasal, or periocular areas. A > burning > > or stinging sensation also may be present. Papulopustular > rosacea can > > appear after or along with erythematotelangiectatic rosacea, > making > > any telangiectases difficult to spot until treatment has cleared > the > > other features. > > > > Phymatous rosacea (subtype 3). The thickening skin, irregular > > surface nodularities, and enlargement present in phymatous > rosacea > > most commonly develop on the nose (rhinophyma), but may > occur on the > > chin, forehead, cheeks, and ears. These phymatous areas > may have > > patulous follicles. This subtype is often observed after or in > > combination with subtypes 1 or 2. > > > > Ocular rosacea (subtype 4). Skin signs and symptoms do not > have to > > be present for a diagnosis of ocular rosacea, as a limited > number of > > studies have suggested that ocular problems may occur > before > > cutaneous manifestations of the disease in up to 20% of > patients. > > > > For this diagnosis, a patient's eyes should have one or more of > the > > following: watery or bloodshot appearance, foreign body > sensation, > > burning or stinging, dryness, itching, light sensitivity, blurred > > vision, telangiectases of the conjunctiva and lid margin, or lid > and > > periocular erythema. Chalazia and hordeolums may also be > present. > > Some patients may have corneal complications that decrease > visual > > acuity. > > > > Granulomatous rosacea (variant). Patients with this variant of > > rosacea have hard, yellow, brown, or red cutaneous papules or > nodules > > that sit upon fairly normal-looking skin of the cheeks and > > periorificial areas. All of the papules and nodules on a > particular > > patient will have the same shape and size. Unlike the > subtypes, > > granulomatous rosacea can be diagnosed without the > presence of other > > rosacea signs. > > > > The experts found insufficient evidence to include rosacea > fulminans, > > steroid-induced acneiform eruption, and perioral dermatitis as > types > > of rosacea. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 > If you want to photocopy the article and send it to me to be > scanned, I'll be happy to upload the article to the group. Matija, that's not legal. The article is copyright protected, so it can't be distributed to the public without prior approval from the publisher. Individual copies can be xeroxed if they are for educational purposes only, which is why a person can xerox the article in a medical library. But even that xeroed copy cannot then be publicly distributed. Why don't you email the publishers and ask permission? It's certainly a reasonable request, esp if its posted in a members only access area. Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 > If you want to photocopy the article and send it to me to be > scanned, I'll be happy to upload the article to the group. Matija, that's not legal. The article is copyright protected, so it can't be distributed to the public without prior approval from the publisher. Individual copies can be xeroxed if they are for educational purposes only, which is why a person can xerox the article in a medical library. But even that xeroed copy cannot then be publicly distributed. Why don't you email the publishers and ask permission? It's certainly a reasonable request, esp if its posted in a members only access area. Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 > If you want to photocopy the article and send it to me to be > scanned, I'll be happy to upload the article to the group. Matija, that's not legal. The article is copyright protected, so it can't be distributed to the public without prior approval from the publisher. Individual copies can be xeroxed if they are for educational purposes only, which is why a person can xerox the article in a medical library. But even that xeroed copy cannot then be publicly distributed. Why don't you email the publishers and ask permission? It's certainly a reasonable request, esp if its posted in a members only access area. Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
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