Abstract
Tan, et al.,(ROSCO) propose to “transition beyond a subtype classification”, which they ascribe to the National Rosacea Society's Classification of Rosacea (NRSCOR), asserting “Subtype classification may not fully cover the range of clinical presentations and is likely to confound severity assessment, whereas a phenotype-based approach could improve patient outcomes by addressing an individual patient's clinical presentation and concerns”(1). NRSCOR did not invent the phenotypic subtypes, described by expert dermatologists over preceding decades, but sought a common terminology for use in communicating ideas about rosacea (compare use in Fig. 1 by ROSCO). NRSCOR emphasized the potential evolution from one phenotypic subtype to another, and that phenotypic subtypes can occur together. ROSCO's claimed ‘phenotypic approach’ seems to be simply the elimination of these phenotypic subtypes.
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