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<p>Dermoscopy plays a fundamental role in diagnosing skin tumors, but can also be helpful in inflammatory conditions, like rosacea. Its usefulness in rosacea has been studied not only for diagnostic purposes, but also for monitoring treatment response. We conducted a nested cross-sectional study within a rosacea patient cohort to assess the prevalence of common dermatoscopic findings and the dermatoscopic evidence of Demodex. Dermoscopic findings were analysed by two experienced dermatologists, considering nine criteria: polygonal vessels, linear vessels with branches, dotted vessels, scales, red structureless areas, follicular pustules, follicular plugs, <i>Demodex</i> tails, and <i>Demodex</i> follicular openings. Results were analysed according to age, gender, skin phototype, body composition (eutrophic, overweight or obese), rosacea subtypes and rosacea severity. The most common finding was linear vessels with branches, observed in 62 (89.9%) of the patients. Polygonal vessels, red structureless areas and dotted vessels were seen in 52 (75.4%), 51 (73.9%), and 46 (66.7%) of patients, respectively. <i>Demodex</i> tails and <i>Demodex</i> follicular openings were observed in 32 (46.4%) and 36 (52.2%), respectively. A significant association was found between male gender and polygonal vessels (<i>p</i> = 0.024) as well as follicular plugs (<i>p</i> = 0.011). Patients with papulopustular rosacea (PPR) exhibited more frequently red structureless areas (<i>p</i> = 0.004), and follicular pustules (<i>p</i> = 0.024), while follicular plugs were more common in patients with phymatous changes (<i>p</i> = 0.005). Polygonal vessels were more frequently observed in patients with moderate to severe erythematotelangiectatic rosacea compared to mild cases (<i>p</i> = 0.013), and scales, and follicular pustules were more common in patients with moderate to severe PPR than in mild cases (<i>p</i> = 0.043). This study provides additional evidence on the dermoscopic findings in rosacea and demonstrates the high prevalence of dermoscopic features associated with the presence of <i>Demodex folliculorum</i> in these patients. Associations with subtype and severity should be interpreted with caution given the exploratory nature of the analyses and the frequent overlap among rosacea phenotypes.</p>

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Dermoscopy of rosacea: correlations with subtype and severity

  • 期刊论文

  • 发表日期：

    2026年7月20日

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  • Juliano Peruzzo,
  • Paula Barea,
  • Miriãn Ferrão Maciel-Fiuza,
  • Fernanda Sales Luiz Vianna,
  • Renan Rangel Bonamigo

摘要

Dermoscopy plays a fundamental role in diagnosing skin tumors, but can also be helpful in inflammatory conditions, like rosacea. Its usefulness in rosacea has been studied not only for diagnostic purposes, but also for monitoring treatment response. We conducted a nested cross-sectional study within a rosacea patient cohort to assess the prevalence of common dermatoscopic findings and the dermatoscopic evidence of Demodex. Dermoscopic findings were analysed by two experienced dermatologists, considering nine criteria: polygonal vessels, linear vessels with branches, dotted vessels, scales, red structureless areas, follicular pustules, follicular plugs, Demodex tails, and Demodex follicular openings. Results were analysed according to age, gender, skin phototype, body composition (eutrophic, overweight or obese), rosacea subtypes and rosacea severity. The most common finding was linear vessels with branches, observed in 62 (89.9%) of the patients. Polygonal vessels, red structureless areas and dotted vessels were seen in 52 (75.4%), 51 (73.9%), and 46 (66.7%) of patients, respectively. Demodex tails and Demodex follicular openings were observed in 32 (46.4%) and 36 (52.2%), respectively. A significant association was found between male gender and polygonal vessels (p = 0.024) as well as follicular plugs (p = 0.011). Patients with papulopustular rosacea (PPR) exhibited more frequently red structureless areas (p = 0.004), and follicular pustules (p = 0.024), while follicular plugs were more common in patients with phymatous changes (p = 0.005). Polygonal vessels were more frequently observed in patients with moderate to severe erythematotelangiectatic rosacea compared to mild cases (p = 0.013), and scales, and follicular pustules were more common in patients with moderate to severe PPR than in mild cases (p = 0.043). This study provides additional evidence on the dermoscopic findings in rosacea and demonstrates the high prevalence of dermoscopic features associated with the presence of Demodex folliculorum in these patients. Associations with subtype and severity should be interpreted with caution given the exploratory nature of the analyses and the frequent overlap among rosacea phenotypes.