Erythematotelangiectatic, papulopustular rosacea most common of four major subtypes

Erythematotelangiectatic and papulopustular rosacea were found to be the chronic skin condition’s most common subtypes, according to a systematic review and meta-analysis.

“Four distinct rosacea subtypes have traditionally been recognized, but the frequency of these subtypes among patients with rosacea remains unknown,” Yousef A. Barakji, MS, of the department of dermatology at Bispebjerg Hospital at the University of Copenhagen in Denmark, and colleagues wrote.

In the systematic review and meta-analysis of PubMed and Embase findings from inception through Nov. 2, 2021, the researchers assessed the frequency of four rosacea subtypes: erythematotelangiectatic, papulopustular, phymatous and ocular rosacea.

Studies with at least 25 human participants published in English, French and German were included. The final analysis included 9,190 participants from 39 data sets.

The proportion of patients with each of the four major rosacea subtypes as defined by the 2002 National Rosacea Society classification system served as the primary outcome measure.

Pooled proportion results showed that erythematotelangiectatic rosacea was reported in 56.7% (95% CI, 51.4%-62%) of the cohort, while papulopustular rosacea occurred in 43.2% (95% CI, 38.8%-47.6%), phymatous rosacea in 7.4% (95% CI, 6.1%-8.9%) and ocular rosacea in 11.1% (95% CI, 6.7%-16.3%).

Three of the four subtypes were equally distributed between men and women. However, based on the results of five studies, phymatous rosacea was reported in 28.6% (95%CI, 10.3%-51.8%) of men compared with 3.6% (95%CI, 0.007%-13.4%) of women.

While erythematotelangiectatic rosacea was observed in 80.4% (95% CI, 66.7%-91.1%) of the population in North America, it occurred in just 21.1% (95% CI, 7.9%- 38.6%) of patients from studies conducted in Africa.

Patterns of rosacea changed over time, according to the researchers. Specifically, rates of papulopustular rosacea decreased while rates of erythematotelangiectatic rosacea increased.

“In this systematic review and meta-analysis, differences were found in rosacea subtypes by patient sex and by continent of origin and publication year of included studies,” the researchers wrote. “Erythematotelangiectatic and papulopustular rosacea were the most prevalent subtypes, but data should be interpreted with caution.”