Related Experiment Video
Updated: Aug 21, 2026

Measuring Psoriasis Severity at Home
Published on: March 1, 2024
Measurement of the severity of rosacea
Joel T M Bamford1, Charles E Gessert, Colleen M Renier
1Department of Dermatology, St. Mary's/Duluth Clinic Health System, Duluth, MN 55805-1983, USA. jbamford@smdc.org
Background:
There are no standardized measures for the severity of rosacea.
Objectives:
To determine what clinical signs correlate best with global severity of rosacea, and to examine inter-rater reliability. Methods Four clinicians each made 82 assessments of rosacea patients. Each assessment used 60 0-to-10 Likert-like scales for the signs of rosacea. Subjects also assessed the severity of their rosacea.
Results:
The clinicians' assessment of global severity correlated strongly with erythema, especially on the cheeks. Subjects' assessment of global severity correlated more strongly with papules/pustules. Different methods of assessing severity--estimation of area involved, intensity, or lesion counts--did not produce significantly different results. Inter-rater reliability was low on 11-point (0-10) scales, but improved when scales were collapsed to 5 or 4 points.
Conclusions:
Clinicians and patients assess severity of rosacea differently, with clinicians focusing on erythema and patients focusing on papules/pustules. New instruments for assessing severity must address inter-rater reliability.
