“…On the contrary, combination therapy with minocycline and tranilast given in a patient with no presence of mast cell infiltrates in histology remained ineffective (Nagasaka et al, ). Promising results have been demonstrated after long‐term isotretinoin monotherapy or systemic combination of isotretinoin with ketotifen (Smith & Cohen, ; Kabuto, Fujimoto, Honda, & Tanaka, ; Mazzatenta, Giorgino, Rubegni, Aloe, & Fimiani, ; Rebellato, Rezende, Battaglin, Lima, & Fillus Neto, ). Isotretinoin's mechanism of action in MD is postulated to be correlated with its anti‐inflammatory and immunomodulatory properties that make it also useful in treatment of rosacea (Smith & Cohen, ).…”