Journal of Clinical and Aesthetic Dermatology

FEB 2018

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

Issue link: http://jcadonline.epubxp.com/i/934167

Contents of this Issue

Navigation

Page 52 of 62

50 JCAD JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY February 2018 • Volume 11 • Number 2 O R I G I N A L R E S E A R C H unattractive, worrying about how other people react to rosacea, and perceptions related to their success, confidence, shyness, or health, the burden of disease in ETR participants was also important. Most participants in the current study with ETR and PPR had mild or moderate rosacea, which correlates with RosaQoL severity scores of "very good" or "good" in the validation study for this instrument described by Nicholson et al. 18 Those authors demonstrated that there was a roughly linear relationship between the severity of rosacea and scores on the three main domains of the RosaQoL questionnaire, suggesting that QoL was worse for participants with severity scores of very good or good compared with participants with severity scores of excellent, so that even mild rosacea could be associated with an important impact on QoL. 18 Others have demonstrated that clinical improvement in disease severity is associated with improved QoL as measured by changes in RosaQoL scores. 20 Thus, the goal of treatment for patients with moderate-to-severe rosacea should be the safe, effective improvement of clinical symptoms, as well as improvements in QoL. The primary symptom of facial erythema had a negative effect on individuals in the ETR and PPR cohorts for all domains of the IA-RFR. Interestingly, for the PPR cohort, the data from the IA-RFR and IA-RFB suggested that facial erythema had a greater negative impact on the overall score and the Self-perception and Grooming domains than did facial bumps and pimples, whereas bumps and pimples had a greater negative impact on the Emotional and Social Domains. This study also indicates that rosacea has broad negative impact on patient well-being in both physical and emotional domains. SF-36 is a general, validated QoL instrument that not only allows assessment of the physical and emotional impact of a disease state but also allows comparison with other diseases and within population norms for healthy individuals. 21 Findings from the SF-36 showed that the ETR and PPR cohorts achieved poorer scores than the general US population on multiple domains. With most researchers indicating that a difference of 5 to 10 points is clinically significant, 21 only scores in the Energy/Fatigue domain approached clinical significance for the ETR cohort compared with the general population. 19 For PPR, scores in the FIGURE 3. Mean Rosacea-Specific QoL questionnaire scores in the ETR and PPR cohorts. Responses were based on a five-point adjectival scale from 1 to 5, with higher domain scores indicating a greater level of burden (1, never; 2, rarely; 3, sometimes; 4, often; 5, all the time). Within each domain, scores were the average of all responses to the items in the domain scale. Similarly, the total score was the average of all responses with individual scale scores weighted equally. The recall period was four weeks. ETR: erythematotelangiectatic rosacea; PPR: papulopustular rosacea. FIGURE 2. Mean Impact Assessment for Rosacea Facial Bumps or Pimples scores in the PPR cohort (n=191). Individual items (8 in each domain) were rated on a five-point adjectival scale from 0 to 4; scores were then transformed to a scale of 0 to 100 with higher scores indicating higher negative impact. The recall period for each item was 7 days. FIGURE 1. Mean Impact Assessment for Rosacea Facial Redness scores in the ETR and PPR cohorts. Individual items (8 in each domain) were rated on a 5-point adjectival scale from 0 to 4; scores were then transformed to a scale of 0 to 100 with higher scores indicating higher negative impact. The recall period for each item was 7 days. ETR: erythematotelangiectatic rosacea; PPR: papulopustular rosacea.

Articles in this issue

Archives of this issue

view archives of Journal of Clinical and Aesthetic Dermatology - FEB 2018