{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T10:43:49Z","timestamp":1776077029590,"version":"3.50.1"},"reference-count":35,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81874251"],"award-info":[{"award-number":["81874251"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82003385"],"award-info":[{"award-number":["82003385"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>Reflectance confocal microscopy (RCM), VISIA, and dermoscopy have emerged as promising tools for objective diagnosis and assessment of rosacea. However, little is known about the diagnostic value of these imaging systems for rosacea.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Objectives<\/jats:title>\n               <jats:p>To assess the diagnostic value of RCM, VISIA, and dermoscopy for rosacea by establishing a novel multilayer perceptron (MLP) model.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>A total of 520 patients with rosacea and other facial diseases were included in this study. A total of 474 samples of dermoscopy data, 374 samples of RCM data, 434 samples of VISIA data, and 291 samples containing three data sources were collected. An MLP model was built with the total data to explore the association between the imageological features of each instrument and the probability of rosacea.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>Our MLP model revealed that the area under the receiver operating characteristic curve (AUROC) values of RCM, VISIA and dermoscopy for diagnosing rosacea were 0.5233, 0.5646 and 0.7971, respectively. The integration of these three tools with clinical data could further improve the accuracy of the predictive diagnosis to 0.8385. For the imageological features of each tool, abnormalities (hyperkeratosis or parakeratosis) in the stratum corneum were effective variables for excluding rosacea (odds ratio [OR], 0.4333) under RCM. The indicators of rosacea under VISIA included overall severity of erythema, erythema involving the cheek or superciliary arch, visible red blood vessels, and papules (OR = 2.2745, 3.1592, 1.8365, 2.8647, and 1.4260, respectively). The candidate variables of dermoscopy included yellow background, white background, uniform distribution of vessels, branched vessels, and reticular blood vessels (OR = 0.4259, 0.4949, 2.2858, 3.7444, and 2.4576, respectively).<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusions<\/jats:title>\n               <jats:p>RCM, dermoscopy, and VISIA each can present several imageological features and were of certain value for assisting rosacea diagnosis. The combined analysis of these three tools using our MLP model may be useful for improving the accuracy of diagnosing rosacea.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.13917","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T08:20:43Z","timestamp":1660724443000},"page":"e13917","source":"Crossref","is-referenced-by-count":10,"title":["A novel multi-layer perceptron model for assessing the diagnostic value of non-invasive imaging instruments for rosacea"],"prefix":"10.7717","volume":"10","author":[{"given":"Yingxue","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieyu","family":"He","sequence":"additional","affiliation":[{"name":"School of Public Health, Kunming Medical University, Kuming, Yunnan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Jian","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongfu","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixiang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"Hunan Key Laboratory of Aging Biology, Xiangya Hospital of Central South University, Changsha, Hunan, China"},{"name":"National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University,  Changsha, Hunan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"10.7717\/peerj.13917\/ref-1","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1111\/jocd.12724","article-title":"The new therapeutic choice of tranexamic acid solution in treatment of erythematotelangiectatic rosacea","volume":"18","author":"Bageorgou","year":"2019","journal-title":"Journal of Cosmetic Dermatology"},{"key":"10.7717\/peerj.13917\/ref-2","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1111\/srt.12817","article-title":"Ros-NET: A deep convolutional neural network for automatic identification of rosacea lesions","volume":"26","author":"Binol","year":"2020","journal-title":"Skin Research and Technology: Official Journal of International Society For Bioengineering and the Skin (ISBS) [and] International Society For Digital Imaging of Skin (ISDIS) [and] International Society For Skin Imaging (ISSI)"},{"key":"10.7717\/peerj.13917\/ref-3","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1136\/bmj.310.6973.170","article-title":"Multiple significance tests: the Bonferroni method","volume":"310","author":"Bland","year":"1995","journal-title":"BMJ"},{"key":"10.7717\/peerj.13917\/ref-4","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1111\/exd.12030","article-title":"Quantification of Demodex folliculorum by PCR in rosacea and its relationship to skin innate immune activation","volume":"21","author":"Casas","year":"2012","journal-title":"Experimental Dermatology"},{"key":"10.7717\/peerj.13917\/ref-5","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1111\/bjd.18125","article-title":"Standardization of dermoscopic terminology and basic dermoscopic parameters to evaluate in general dermatology (non-neoplastic dermatoses): an expert consensus on behalf of the International Dermoscopy Society","volume":"182","author":"Errichetti","year":"2020","journal-title":"British Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-6","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1007\/s00403-018-1857-1","article-title":"The investigation of the relationships of demodex density with inflammatory response and oxidative stress in rosacea","volume":"310","author":"Falay Gur","year":"2018","journal-title":"Archives of Dermatological Research"},{"key":"10.7717\/peerj.13917\/ref-7","first-page":"777","article-title":"Comparison of evaluation metrics in classification applications with imbalanced datasets","author":"Fatourechi","year":"2008"},{"key":"10.7717\/peerj.13917\/ref-8","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.jaad.2017.08.037","article-title":"Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee","volume":"78","author":"Gallo","year":"2018","journal-title":"Journal of the American Academy of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-9","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.clindermatol.2003.08.007","article-title":"Changing paradigms in dermatology: confocal microscopy in clinical and surgical dermatology","volume":"21","author":"Gonz\u00e1lez","year":"2003","journal-title":"Clinics in Dermatology"},{"key":"10.7717\/peerj.13917\/ref-10","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1111\/jdv.12178","article-title":"Interest of confocal laser scanning microscopy for the diagnosis and treatment monitoring of demodicosis","volume":"28","author":"Harmelin","year":"2014","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"key":"10.7717\/peerj.13917\/ref-11","doi-asserted-by":"publisher","first-page":"825","DOI":"10.1001\/jamadermatol.2014.4728","article-title":"Clinical, histologic, and molecular analysis of differences between erythematotelangiectatic rosacea and telangiectatic photoaging","volume":"151","author":"Helfrich","year":"2015","journal-title":"JAMA Dermatology"},{"key":"10.7717\/peerj.13917\/ref-12","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.1708.01911","article-title":"Training of deep neural networks based on distance measures using RMSProp","author":"Kurbiel","year":"2017"},{"key":"10.7717\/peerj.13917\/ref-13","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1111\/bjd.16540","article-title":"Demodex mites modulate sebocyte immune reaction: possible role in the pathogenesis of rosacea","volume":"179","author":"Lacey","year":"2018","journal-title":"British Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-14","doi-asserted-by":"publisher","first-page":"265","DOI":"10.4103\/0019-5154.182417","article-title":"Topical steroid damaged\/dependent face (TSDF): an entity of cutaneous pharmacodependence","volume":"61","author":"Lahiri","year":"2016","journal-title":"Indian Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-15","doi-asserted-by":"publisher","first-page":"e325-e327","DOI":"10.1111\/ijd.12270","article-title":"Polygonal vessels of rosacea are highlighted by dermoscopy","volume":"53","author":"Lallas","year":"2014","journal-title":"International Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-16","doi-asserted-by":"publisher","first-page":"1468","DOI":"10.1001\/archdermatol.2011.312","article-title":"Rosettes may be observed in a range of conditions","volume":"147","author":"Liebman","year":"2011","journal-title":"Archives of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-17","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1111\/bjd.18151","article-title":"Noninvasive objective skin measurement methods for rosacea assessment: a systematic review","volume":"182","author":"Logger","year":"2019","journal-title":"British Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-18","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1007\/s10103-017-2318-3","article-title":"Treatment of erythemato-telangiectatic rosacea with brimonidine alone or combined with vascular laser based on preliminary instrumental evaluation of the vascular component","volume":"33","author":"Micali","year":"2018","journal-title":"Lasers in Medical Science"},{"key":"10.7717\/peerj.13917\/ref-19","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.ejps.2005.04.010","article-title":"Optimisation of the predictive ability of artificial neural network (ANN) models: a comparison of three ANN programs and four classes of training algorithm","volume":"25","author":"Plumb","year":"2005","journal-title":"European Journal of Pharmaceutical Sciences"},{"key":"10.7717\/peerj.13917\/ref-20","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1111\/ajd.12024","article-title":"Rosettes: optical effects and not dermoscopic patterns related to skin neoplasms","volume":"54","author":"Rubegni","year":"2013","journal-title":"Australasian Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-21","doi-asserted-by":"publisher","first-page":"e299-e301","DOI":"10.1111\/jdv.14084","article-title":"Monitoring structural changes in Demodex mites under topical Ivermectin in rosacea by means of reflectance confocal microscopy: a case series","volume":"31","author":"Ruini","year":"2017","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"key":"10.7717\/peerj.13917\/ref-22","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1111\/bjd.13783","article-title":"Reflectance confocal microscopy for monitoring the density of Demodex mites in patients with rosacea before and after treatment","volume":"173","author":"Sattler","year":"2015","journal-title":"British Journal of Dermatology"},{"issue":"Suppl 1","key":"10.7717\/peerj.13917\/ref-23","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/jdv.13531","article-title":"Skin compatibility and efficacy of a cosmetic skin care regimen with licochalcone A and 4-t-butylcyclohexanol in patients with rosacea subtype I","volume":"30","author":"Schoelermann","year":"2016","journal-title":"Journal of the European Academy of Dermatology and Venereology"},{"key":"10.7717\/peerj.13917\/ref-24","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.1111\/j.1365-4632.2010.04495.x","article-title":"Dermoscopy as a diagnostic tool in demodicidosis","volume":"49","author":"Segal","year":"2010","journal-title":"International Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-25","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.det.2018.05.003","article-title":"Dermoscopy of common inflammatory disorders","volume":"36","author":"Sgouros","year":"2018","journal-title":"Dermatologic Clinics"},{"key":"10.7717\/peerj.13917\/ref-26","doi-asserted-by":"publisher","first-page":"275","DOI":"10.2147\/ccid.s69410","article-title":"Preliminary open-label clinical evaluation of the soothing and reepithelialization properties of a novel topical formulation for rosacea","volume":"7","author":"Sparavigna","year":"2014","journal-title":"Clinical, Cosmetic and Investigational Dermatology"},{"key":"10.7717\/peerj.13917\/ref-27","doi-asserted-by":"publisher","first-page":"2825","DOI":"10.5555\/1953048.2078195","article-title":"Scikit-learn: machine learning in python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"Journal of Machine Learning Research"},{"key":"10.7717\/peerj.13917\/ref-28","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1111\/bjd.15122","article-title":"Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel","volume":"176","author":"Tan","year":"2017","journal-title":"British Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-29","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1111\/bjd.14819","article-title":"Shortcomings in rosacea diagnosis and classification","volume":"176","author":"Tan","year":"2017","journal-title":"British Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-30","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1016\/j.jaad.2020.01.077","article-title":"Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee","volume":"82","author":"Thiboutot","year":"2020","journal-title":"Journal of the American Academy of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-31","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1111\/srt.12137","article-title":"Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites","volume":"20","author":"Turgut Erdemir","year":"2014","journal-title":"Skin Research and Technology"},{"key":"10.7717\/peerj.13917\/ref-32","doi-asserted-by":"publisher","first-page":"e26-e30","DOI":"10.1111\/ajd.12452","article-title":"Demodex mites in acne rosacea: reflectance confocal microscopic study","volume":"58","author":"Turgut Erdemir","year":"2017","journal-title":"Australasian Journal of Dermatology"},{"key":"10.7717\/peerj.13917\/ref-33","doi-asserted-by":"publisher","first-page":"5703","DOI":"10.1007\/s00216-019-01948-2","article-title":"The application of a lateral flow immunographic assay to rapidly test for dexamethasone in commercial facial masks","volume":"411","author":"Wang","year":"2019","journal-title":"Analytical and Bioanalytical Chemistry"},{"key":"10.7717\/peerj.13917\/ref-34","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1111\/srt.12440","article-title":"Comparison of two kinds of skin imaging analysis software: VISIA(\u00ae) from Canfield and IPP(\u00ae) from Media Cybernetics","volume":"24","author":"Wang","year":"2018","journal-title":"Skin Research and Technology"},{"key":"10.7717\/peerj.13917\/ref-35","doi-asserted-by":"publisher","first-page":"e23415","DOI":"10.2196\/23415","article-title":"A novel convolutional neural network for the diagnosis and classification of rosacea: usability study","volume":"9","author":"Zhao","year":"2021","journal-title":"JMIR Medical Informatics"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/13917.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/13917.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/13917.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/13917.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T08:20:52Z","timestamp":1660724452000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/13917"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,17]]},"references-count":35,"alternative-id":["10.7717\/peerj.13917"],"URL":"https:\/\/doi.org\/10.7717\/peerj.13917","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,17]]},"article-number":"e13917"}}