An Attempt to Establish the Consensus Regarding the Diagnosis, Classification, and Treatment of Rosacea in Japan Using a Modified Delphi Method: The Japan Rosacea Consensus

In Japan, rosacea has attracted increasing interest. However, because rosacea had been thought to be relatively rare in Japan, the perception of this disease varies among dermatologists. To address these challenges, this study developed a consensus regarding the diagnosis, classification, and treatment of rosacea using a modified Delphi method based on the expertise of Japanese specialists in rosacea. Ten Japanese dermatologists were included in the expert panel based on their expertise in rosacea treatment and contributions to the field of rosacea. For each item that mentioned rosacea, the specialists responded with "disagree," "neither agree nor disagree," "agree," or "don't know/can't answer." Consensus was defined as ≥ 80% agreement among panel members. Panel consensus was obtained for all 50 items related to rosacea (e.g., disease types, characteristics, diagnosis, factors for onset and exacerbation, and treatment). An online survey on the consensus statements revealed discrepancies between general dermatologists and panel members. In the postsurvey meeting, the panel members discussed the differentiation between rosacea and similar diseases and proposed an algorithm for differentiating rosacea. The panel members concluded that the goal of rosacea treatment in Japan should be to "maintain a state wherein the patient's daily life is not affected by symptoms over the long term" rather than "complete cure." Thus, this study integrated the findings of the expert panel and proposed a consensus statement on rosacea treatment in Japan. The organization of knowledge and dissemination of information regarding rosacea among general dermatologists will improve the treatment outcomes of patients with rosacea.