关键词: 红斑痤疮, 皮肤表现, 延迟诊断, 药物疗法, 流行病学, 地域性, 真实世界

Abstract: 【Abstract】 Objective To analyze the current status of diagnosis and treatment of rosacea in China, and to strengthen the understanding and management of this disease. Methods A retrospective cross-sectional study was conducted, and patients with rosacea were enrolled from 23 tertiary hospitals in 6 provinces or municipalities in northern and southern China. Clinical characteristics, previous diagnosis and treatment status of these patients were collected through questionnaires. Non-normally distributed continuous data were described by M （Q1 , Q3）, and compared using Mann-Whitney U test, while categorical data were compared using chi-square test. Results Among the 593 patients with rosacea, 164 were males and 429 were females, with a male-to-female ratio of 1∶2.6; 205 patients were from southern China, and 388 from northern China; most patients （349 cases, 58.8%） were aged 20 to 40 years, and the patients from northern China were significantly older than those from southern China （median age: 37 years vs. 30 years, P < 0.001）. Multiple-site involvement （371 cases, 62.6%） and coexistence of multiple phenotypes （391 cases, 65.9%） were common, the cheeks （429 cases, 72.3%） and nose （393 cases, 66.3%） were mostly affected, and skin lesions mainly manifested as persistent erythema （354 cases, 59.7%）, papulopustules （344 cases, 58.0%）, and telangiectasia （282 cases, 47.6%）. Involvement of the cheeks was more common in the patients from southern China （160 cases, 78.0%） than in those from northern China （269 cases, 69.3%）, but the nose and eyes were less involved in the patients from southern China than in those from northern China （nose: 125 cases ［61.0%］ vs. 268 cases ［69.1%］; eyes: 3 cases ［1.5%］ vs. 23 cases ［5.9%］; both P < 0.05）. The prevalence of transient erythema and papulopustules was significantly higher in the patients from southern China （38.0% and 65.4%, respectively） than in those from northern China （20.9% and 54.1% respectively, both P < 0.05）, while the patients from northern China more frequently presented with persistent erythema compared with those from southern China （64.9% vs. 49.8%, P < 0.05）. The disease duration （M ［Q1 , Q3］） was 12 （4, 30） months among the patients with rosacea, and the time from the onset to diagnosis was 10 （3, 24） months. The disease duration was significantly longer （12 ［4, 36］ months）, and the proportion of patients with disease duration > 5 years was significantly higher （16.4% ［63 cases］） in the patients from northern China than in those from southern China （12 ［3, 24］ months, 9.4% ［19 cases］, respectively; both P < 0.05）. The patients with varied subtypes and severity of rosacea were previously mainly treated with topical antimicrobial agents （71.9%）; 72.7% of the patients with mild rosacea were treated with systemic drugs; poor patient compliance was observed, and only 40.6% of the patients completed more than 4 consecutive weeks of treatment at a time. Conclusions Rosacea usually occurred in young and middle-aged people in China, mostly involved the cheeks and nose, and mainly manifested as erythema or papulopustules. Delayed diagnosis, non-standard treatment and poor patient compliance existed in clinical practice.

Key words: Rosacea, Skin manifestations, Delayed diagnosis, Drug therapy, Epidemiology, Regionality, Real world