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BackgroundA transition from a subtyping to a phenotyping approach in rosacea is underway, allowing individual patient management according to presenting features instead of categorization by predefined subtypes. The ROSacea COnsensus (ROSCO) 2017 recommendations further support this transition and align with guidance from other working groups.ObjectivesTo update and extend previous global ROSCO recommendations in line with the latest research and continue supporting uptake of the phenotype approach in rosacea through clinical tool development.MethodsNineteen dermatologists and two ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and management. Voting was electronic and blinded.ResultsDelphi statements on which the panel achieved consensus of ≥ 75% voting 'Agree' or 'Strongly agree' are presented. The panel recommends discussing disease burden with patients during consultations, using four questions to assist conversations. The primary treatment objective should be achievement of complete clearance, owing to previously established clinical benefits for patients. Cutaneous and ocular features are defined. Treatments have been reassessed in line with recent evidence and the prior treatment algorithm updated. Combination therapy is recommended to benefit patients with multiple features. Ongoing monitoring and dialogue should take place between physician and patients, covering defined factors to maximize outcomes. A prototype clinical tool (Rosacea Tracker) and patient case studies have been developed from consensus statements.ConclusionsThe current survey updates previous recommendations as a basis for local guideline development and provides clinical tools to facilitate a phenotype approach in practice and improve rosacea patient management. What's already known about this topic? A transition to a phenotype approach in rosacea is underway and is being recommended by mu

BackgroundA transition from a subtyping to a phenotyping approach in rosacea is underway, allowing individual patient management according to presenting features instead of categorization by predefined subtypes. The ROSacea COnsensus (ROSCO) 2017 recommendations further support this transition and align with guidance from other working groups.ObjectivesTo update and extend previous global ROSCO recommendations in line with the latest research and continue supporting uptake of the phenotype approach in rosacea through clinical tool development.MethodsNineteen dermatologists and two ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and management. Voting was electronic and blinded.ResultsDelphi statements on which the panel achieved consensus of ≥ 75% voting 'Agree' or 'Strongly agree' are presented. The panel recommends discussing disease burden with patients during consultations, using four questions to assist conversations. The primary treatment objective should be achievement of complete clearance, owing to previously established clinical benefits for patients. Cutaneous and ocular features are defined. Treatments have been reassessed in line with recent evidence and the prior treatment algorithm updated. Combination therapy is recommended to benefit patients with multiple features. Ongoing monitoring and dialogue should take place between physician and patients, covering defined factors to maximize outcomes. A prototype clinical tool (Rosacea Tracker) and patient case studies have been developed from consensus statements.ConclusionsThe current survey updates previous recommendations as a basis for local guideline development and provides clinical tools to facilitate a phenotype approach in practice and improve rosacea patient management. What's already known about this topic? A transition to a phenotype approach in rosacea is underway and is being recommended by mu

Background: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient‐centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. Objectives: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. Methods: A review of the literature and consolidation of rosacea expert experience. Results: We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. Conclusions: These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea. What's already known about this topic?: Rosacea diagnosis and classification have evolved from a subtype to a phenotype approach. Adoption of the phenotype approach has begun, but more widespread adoption and support across the field are required to ensure a complete transition. What does this study add?: We offer practical guidance for clinical practice, interventional and epidemiological research, and basic science, to help overcome challenges and facilitate comprehensive uptake of the phenotype approach in rosacea.

Background: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient‐centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. Objectives: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. Methods: A review of the literature and consolidation of rosacea expert experience. Results: We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. Conclusions: These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea. What's already known about this topic?: Rosacea diagnosis and classification have evolved from a subtype to a phenotype approach. Adoption of the phenotype approach has begun, but more widespread adoption and support across the field are required to ensure a complete transition. What does this study add?: We offer practical guidance for clinical practice, interventional and epidemiological research, and basic science, to help overcome challenges and facilitate comprehensive uptake of the phenotype approach in rosacea.

Background: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient‐centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. Objectives: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. Methods: A review of the literature and consolidation of rosacea expert experience. Results: We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. Conclusions: These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea. What's already known about this topic?: Rosacea diagnosis and classification have evolved from a subtype to a phenotype approach. Adoption of the phenotype approach has begun, but more widespread adoption and support across the field are required to ensure a complete transition. What does this study add?: We offer practical guidance for clinical practice, interventional and epidemiological research, and basic science, to help overcome challenges and facilitate comprehensive uptake of the phenotype approach in rosacea.

Background: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient‐centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. Objectives: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. Methods: A review of the literature and consolidation of rosacea expert experience. Results: We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. Conclusions: These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea. What's already known about this topic?: Rosacea diagnosis and classification have evolved from a subtype to a phenotype approach. Adoption of the phenotype approach has begun, but more widespread adoption and support across the field are required to ensure a complete transition. What does this study add?: We offer practical guidance for clinical practice, interventional and epidemiological research, and basic science, to help overcome challenges and facilitate comprehensive uptake of the phenotype approach in rosacea.

Background: Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient‐centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. Objectives: To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. Methods: A review of the literature and consolidation of rosacea expert experience. Results: We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. Conclusions: These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea. What's already known about this topic?: Rosacea diagnosis and classification have evolved from a subtype to a phenotype approach. Adoption of the phenotype approach has begun, but more widespread adoption and support across the field are required to ensure a complete transition. What does this study add?: We offer practical guidance for clinical practice, interventional and epidemiological research, and basic science, to help overcome challenges and facilitate comprehensive uptake of the phenotype approach in rosacea.