Rosacea Treatment with Intermediate-dose Isotretinoin: Follow-up with Erythema and Sebum Measurements

Abstract

Isotretinoin is one of the therapeutic options for rosacea. However, the response of erythema to treatment with isotretinoin is usually slow and incomplete with common (0.5-1 mg/kg/day) or low (10 mg/day) doses. This study investigated the efficacy of, and relapse on, 20 mg/day isotretinoin treatment in rosacea, with the aid of instrumental measurement of facial erythema and sebum levels. A 20 mg/day dose of isotretinoin was given for 4 months, and then the dose was tapered off within the following 6 months. A total of 25 patients were included in the study. Papule and pustule counts, erythema index, sebum level, dermatologist's and patient's erythema scores, and dermatologist's sebum scores were significantly lower in the first month of therapy compared with pre-treatment values (p < 0.05). Within a median follow-up of 11 months (95% confidence interval: 8.4-13.5 months) 45% of patients had a relapse. In conclusion, 20 mg/day isotretinoin was rapidly efficient for reducing both inflammatory lesions and erythema in rosacea.

Noninvasive objective skin measurement methods for rosacea assessment: a systematic review

“…73,74,76,77 Sebum Eleven studies were interested in quantifying sebum in rosacea. 38,68,82,84,85,[92][93][94][95][96][97] Seven studies used a Sebumeter â (Courage + Khazaka electronic GmbH, K€ oln, Germany), 38,68,82,84,85,96,97 five studies used other methods (photometric quantification of cigarette paper, 95 gravimetric absorption 92,93 and chromatography 92,94 ). It is important to note that a 1 : 1 correlation between Sebumeter score and amount of skin oily material is not present.…”

“…[99][100][101][102] Erythema Twenty-two studies assessed monitoring of facial skin erythema by spectrometry. 48,64,68,[78][79][80]82,83,90,96,[103][104][105][106][107][108][109][110][111][112][113][114] Three spectrometric methods were applied; 28 reflectance spectrophotometry, 3,64,68,[78][79][80]82,96,104,[106][107][108]110,111,113 tristimulus colorimetry 83,90,103,109,112 and diffuse reflectance spectroscopy. 105,114 One study used an optical densitometer.…”

“…92 Two studies noticed no change in sebum levels after treatment (topical photodynamic therapy, oral tetracyclines); 68,82 two did (other sebum composition, decrease of sebum levels). 92,96 pH Skin pH was measured with pH-meters in three studies. 82,83,85 Results were inconclusive: one case-control study found significantly higher centrofacial pH values in patients with PPR vs. controls, 82 while the other did not.…”

Modern possibilities of using systemic retinoids in dermatological practice (review of international literature)

“…Для получения длительной ремиссии при лечении розацеа, в отличие от акне, требуется постоянное применение СИ. В нескольких исследованиях предлагают непрерывное применение СИ в минимальной дозе [42]. Опубликованы результаты нескольких исследований, в которых показана высокая эффективность СИ при лечении фиматоидной формы розацеа [43].…”

Improving adherence to treatment in patients with rosacea

“…M. Uslu и соавт. [26] применяли среднюю дозу 20 мг/сут в течение 10 мес исследования. Первоначальная доза 20 мг/сут назначалась в течение 4 мес, а затем медленно снижалась до дозы 20 мг в неделю.…”