ArticleClinical, cosmetic and investigational dermatology2026
Evaluation of VISIA-Derived Erythema Metrics Against Blinded Clinician Assessment After Intense Pulsed Light Therapy in Erythematotelangiectatic Rosacea: A Real-World Cohort Study.
Article in Clinical, cosmetic and investigational dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Erythematotelangiectatic rosacea (ETR) is characterized by persistent facial erythema, but objective evaluation of treatment response remains challenging. This study aimed to evaluate VISIA-derived erythema metrics against blinded clinician assessment and identify imaging-based thresholds associated with clinical improvement after intense pulsed light (IPL) therapy. Methods: This retrospective single-center real-world cohort study included 227 patients with ETR who completed three regular IPL sessions with paired baseline and post-treatment VISIA images. Three dermatologists independently performed blinded Clinician Erythema Assessment (CEA), and consensus scores were used as the clinical reference. Inter-rater reliability was assessed using quadratic weighted κ, and receiver operating characteristic (ROC) analysis with bootstrap resampling was performed to identify candidate VISIA thresholds corresponding to a ≥2-grade CEA reduction. Results: Blinded CEA demonstrated good-to-excellent reliability, with mean pairwise quadratic weighted κ values of 0.795 at baseline and 0.863 after treatment. VISIA erythema area, erythema concentration, and consensus CEA scores significantly improved after IPL therapy (all p<0.001). Changes in erythema area correlated more strongly with ΔCEA than erythema concentration ( Conclusion: VISIA-derived erythema area reduction correlated with blinded clinician-assessed improvement and may serve as an objective adjunct for monitoring IPL response in ETR. The 18.76% threshold is exploratory and requires external validation. Patient-reported outcomes were unavailable and should be incorporated in future prospective studies.
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