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. 2025 Jan;24(1):e16593.
doi: 10.1111/jocd.16593. Epub 2024 Oct 27.

Validation of a Photonumeric Scale for Evaluation of Telangiectasia in Rosacea

Lynhda Nguyen  1 , Nikolaus Seeber  2 , Jens M Baron  3 , Stefan Hammes  4 , Syrus Karsai  5 , Tanja C Fischer  6 , Laurence Imhof  7 , Gerd Kautz  8 , Sonja Sattler  9 , Maximilian Deussing  10 , Cathy Dierckxsens  11 , Alexander Thiem  12 , Zacharias Drosos  5 , Stephan Grosse-Buening  13 , Nomun Ganjuur  14 , Anna-Sophie Kampmann  1 , Johanna K May  15 , Stefan W Schneider  15 , Martina Kerscher  16 , Katharina Herberger  1
Affiliations

Validation of a Photonumeric Scale for Evaluation of Telangiectasia in Rosacea

Lynhda Nguyen et al. J Cosmet Dermatol. 2025 Jan.

Abstract

Background: Telangiectasia is a prominent feature of rosacea leading to a high demand for effective treatment. To ensure consistent clinical and scientific evaluations and assess treatment response accurately, standardized assessment tools are necessary for grading the severity of telangiectasia. However, no validated grading scales for this condition are currently available.

Aim: To develop and validate a photonumeric scale for assessing the severity of telangiectasia in rosacea patients.

Methods: The five-point photonumeric Telangiectasia in Rosacea Severity Assessment (TRoSA) scale was developed for the severity of telangiectasia in rosacea. Sixteen experts participated in the validation process, evaluating 50 images of rosacea patients in two rounds. Interrater and intrarater reliability were analyzed using the intraclass correlation coefficient (ICC) and weighted kappa, respectively.

Results: Interrater reliability was found to be "almost perfect" in both validation rounds (Round 1: ICC 0.847; Round 2: ICC 0.828). The mean weighted kappa indicated "substantial" intrarater reliability between the two rounds with a weighted kappa of 0.719. A bubble plot of the two rounds illustrated a diagonal order, confirming the consistency of the intrarater agreement.

Conclusions: The TRoSA scale demonstrated high interrater and intrarater reliability indicating that it is a consistent and reproducible tool for grading the severity of telangiectasia in rosacea. This scale can standardize clinical assessments, assisting in diagnosis, treatment planning, and evaluation of therapeutic efficacy.

Keywords: photonumeric scale; rosacea; telangiectasia.

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Conflict of interest statement

L.N., C.D., S.G.‐B., and K.H. have received lecture fees and travel support for meetings from Lutronic Medical Systems. L.I. has received lecture fees from Galderma. M.D. has received meeting support from La Roche‐Posay. The other authors have none to be declared.

Figures

FIGURE 1
FIGURE 1
Telangiectasia in Rosacea Severity Assessment (TRoSA) scale, a five‐point photonumeric grading scale ranging from 0 to 4.
FIGURE 2
FIGURE 2
Bubble plot of all experts between the first and second validation round indicates high intrarater reliability.
See this image and copyright information in PMC

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