Key points Ask What are the proportions of the 4 major subtypes of rosacea among rosacea patients? Findings In this systematic review and meta-analysis of 39 studies including more than 9000 patients, the proportion of erythematotelangiectatic rosacea was 57%, papulopustular rosacea 43%, phymatous rosacea 7%, and ocular rosacea 11%. The distribution of subtypes occurred equally between men and women, except for phymatous rosacea, which was more common in men. Meaning These findings suggest that erythematotelangiectatic and papulopustular rosacea are the most common subtypes of rosacea based on global data. |
Importance
Four distinct subtypes of rosacea have traditionally been recognized , but the frequency of these subtypes among rosacea patients remains unknown.
Aim
To evaluate the frequency of 4 subtypes of rosacea.
Data sources
This systemic review and meta-analysis included a search of 2 databases, PubMed and Embase, from the inception of the databases to November 2, 2021. The search was filtered to include only studies of human participants published in English, French and German.
Study selection
Studies were independently selected by 2 of the authors and were included if they were original with a sample size of 25 or more patients and reported absolute numbers or frequency of patients affected by rosacea subtypes.
Studies that did not report sufficient data to calculate subtype proportions were excluded .
Data extraction and synthesis
Data extraction was performed independently and in duplicate by 2 of the authors, using the search term rosacea, according to the Preferred Reporting items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
The search term, objectives, and methods of the study protocol were defined before starting the study. A total of 292 studies were included for full-text evaluation. Due to the heterogeneity of the included studies, a random effects model was used.
Main result and measures
The primary outcome was the proportion of patients with rosacea in each of the 4 major subtype groups defined by the 2002 National Rosacea Society classification system. Measures were absolute numbers or frequency of patients affected by each of the subtypes. 4 subtypes of rosacea.
Results
A total of 39 studies examining 9190 rosacea patients were included. The pooled proportion of erythematotelangiectatic rosacea was 56.7% (95% CI, 51.4%-62.0%), papulopustular rosacea 43.2% (95% CI, 38.8% %-47.6%), phymatous rosacea was 7.4% (95% CI, 6.1%-8.9%), and ocular rosacea was 11.1% (95% CI, 6.7%). %-16.3%).
The distribution of subtypes occurred equally between men and women, except for phymatous rosacea, which was more common in men.
Studies from Africa showed the lowest proportion of erythematotelangiectatic rosacea. Differences in the frequency of subtypes were observed when stratification was performed by year of publication.
Conclusion and relevance
In this systematic review and meta-analysis, differences were found in the subtypes of rosacea by patient sex and by continent of origin and year of publication of the included studies. Erythematotelangiectatic and papulopustular rosacea were the most prevalent subtypes, but the data should be interpreted with caution. Future studies should use the phenotype-based approach to rosacea.
