• There are no specific lab tests to confirm diagnosis; hence, the diagnosis is based on clinical characteristics

Presence of ≥1 of the primary features:

• Transient erythema (flushing)
• Nontransient erythema
• Papules & pustules
• Telangiectasia

One or more of the following secondary features may also be present:

• Dry appearance
• Burning or stinging sensation
• Edema
• Plaque
• Ocular manifestations
• Phymatous features (eg rhinophyma)
• Peripheral location of lesions

• Rosacea clinical scorecard is used to determine the severity of rosacea
  
  • Primary signs & symptoms may be graded as absent, mild, moderate or severe (scores of 0-3)
  • Secondary features may be graded as absent or present 

• Physicians give global assessment for each subtype based on severity of signs & symptoms; duration & extent of disease at the time of examination may also be considered in the evaluation
• Patient participates in the grading by giving global assessment of his/her condition considering the physical manifestations & its impact on quality of life (psychological, occupational & social effects)

• Primary & secondary features often occur together
• In most patients, a particular manifestation of rosacea is more predominant
• Patient may have characteristics of >1 subtype

Erythematotelangiectatic

• Flushing & persistent central facial erythema w/ or w/o telangiectasia
• Central facial edema, rough or scaly skin, stinging & burning sensation may be present

Papulopustular

• Persistent central facial erythema w/ transient central facial papules, pustules, or both
• Burning or stinging sensation & telangiectasias may be present

Phymatous

• Irregular surface nodularities, enlargement & thickening of the skin
• Typically occurs on the nose, chin, forehead, cheeks, or ears

Ocular

• Conjunctival hyperemia, burning or stinging sensation, foreign body sensation in the eye, dryness, pruritus, photosensitivity, blurred vision, telangiectasia of the sclera or other parts of the eye, periorbital edema
• Blepharitis, conjunctivitis, irregular eyelid margins, meibomian gland dysfunction may also occur w/ keratitis as serious complications

Variant

Granulomatous

• Noninflammatory
• Hard, brown, yellow or red cutaneous papules or nodules of similar size
• May be severe & eventually lead to scarring