Systemic isotretinoin in the treatment of rosacea – doxycycline‐ and placebo‐controlled, randomized clinical study

Gollnick, Harald; Blume-Peytavi, Ulrike; Szabó, Eörs Lāszlō; Meyer, Karl‐Gustav; Hauptmann, Petra; Popp, Georg; Sebastian, Michael; Zwingers, Thomas; Willers, Christoph; Weth, Renate von der

doi:10.1111/j.1610-0387.2010.07345.x

Cited by 69 publications

(100 citation statements)

References 9 publications

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“…Conceivably, MD may respond to the same immunomodulatory and anti-inflammatory properties that make oral isotretinoin useful for the management of rosacea. 23,[25][26][27][28] There is also evidence to support isotretinoin's role in the repair of structural tissue damage via alterations in cellular metabolism and its ability to inhibit fibroblast proliferation as well as the migration and proliferation of connective tissue constituents. 29 As a result, isotretinoin therapy may alter the downstream effects of chronic inflammation that would otherwise result in damage to the dermal matrix.…”

Section: Report Of Casesmentioning

confidence: 99%

Successful Long-term Use of Oral Isotretinoin for the Management of Morbihan Disease

Smith¹,

Cohen²

2012

Arch Dermatol

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Background: Morbihan disease (MD) is characterized by persistent erythema and solid edema of the upper twothirds of the face. It is generally regarded as a late-stage complication of rosacea, although its etiology is poorly understood. The standard therapeutic management includes systemic anti-inflammatory medications; however, the clinical response, if any, is often unsatisfactory. We review the current challenges and a promising new option for the treatment of MD.Observations: Five cases of MD were treated with longterm (Ͼ6 months; mean, 16 months) oral isotretinoin, with documented nonrecurrence. The mean sustained daily dose was 60 mg/d (range, 40-80 mg/d), and the mean cumulative dose was approximately 285 mg/kg (range, 170-491 mg/kg). The total treatment period ranged from 10 to 24 months, with a mean disease-free follow-up period of 9 months (range, 1-24 months). A substantial clinical improvement was not noted until 6 months of treatment in all 5 cases. Conclusions:We report 5 cases of MD that were successfully treated with long-term oral isotretinoin, with lasting results. Further research is required to better understand the pathogenesis of MD and isotretinoin's mechanism of action in this condition.

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Section: Report Of Casesmentioning

confidence: 99%

Successful Long-term Use of Oral Isotretinoin for the Management of Morbihan Disease

Smith¹,

Cohen²

2012

Arch Dermatol

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“…67 Patients with subtypes II (papulopustular) and/or III (phymatous) rosacea were randomly assigned into one of five treatment groups: doxycycline 100 mg daily for 14 days then 50 mg daily (n=143), isotretinoin 0.1 mg/kg (n=109), 0.3 mg/kg (n=142), or 0.5 mg/kg (n=109), or placebo (n=46). These groups were followed until the interim analysis, at which point isotretinoin 0.3 mg/kg stood out as the most efficacious and tolerable dosage.…”

Section: Systemic Therapiesmentioning

confidence: 99%

“…Patients treated with isotretinoin rated treatment results at the end of the study as "excellent improvement" more frequently, at 32.6% in comparison with 24.2% for patients treated with doxycycline. 67 …”

Section: Management Of Rosaceamentioning

confidence: 99%

Update on the Management of Rosacea

Weinkle

Doktor

Emer

2015

Plastic Surgical Nursing

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Abstract:Refining diagnostic criteria has identified key characteristics differentiating rosacea, a chronic skin disorder, from other common cutaneous inflammatory conditions. The current classification system developed by the National Rosacea Society Expert Committee consists of erythematotelangiectatic, papulopustular, phymatous, and ocular subtypes. Each subtype stands as a unique entity among a spectrum, with characteristic symptoms and physical findings, along with an intricate pathophysiology. The main treatment modalities for rosacea include topical, systemic, laser, and light therapies. Topical brimonidine tartrate gel and calcineurin inhibitors are at the forefront of topical therapies, alone or in combination with traditional therapies such as topical metronidazole or azelaic acid and oral tetracyclines or isotretinoin. Vascular laser and intense pulsed light therapies are beneficial for the erythema and telangiectasia, as well as the symptoms (itching, burning, pain, stinging, swelling) of rosacea. Injectable botulinum toxin, topical ivermectin, and microsecond long-pulsed neodymium-yttrium aluminum garnet laser are emerging therapies that may prove to be extremely beneficial in the future. Once a debilitating disorder, rosacea has become a well known and manageable entity in the setting of numerous emerging therapeutic options. Herein, we describe the treatments currently available and give our opinions regarding emerging and combination therapies.

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“…Histopathologically, isotretinoin has been shown to reduce lymphohistiocytic perivascular infiltration, edema, and the number of ectatic vessels in patients with rosacea. Isotretinoin 0.3 mg/kg is an effective and well-tolerated therapy option for the treatment of rosacea subtype II and III and can therefore be used successfully as an alternative to therapy with oral antibiotics [90].…”

Section: Rosaceamentioning

confidence: 99%

Off-label uses of retinoids in dermatology

Li¹,

Liu²,

Luo³

et al. 2012

Our Dermatol Online

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Systemic isotretinoin in the treatment of rosacea – doxycycline‐ and placebo‐controlled, randomized clinical study

Abstract: Isotretinoin 0.3 mg/kg is an effective and well-tolerated therapy option for the treatment of rosacea subtype II and III and can therefore be used successfully as an alternative to therapy with oral antibiotics.

Cited by 69 publications

References 9 publications

Successful Long-term Use of Oral Isotretinoin for the Management of Morbihan Disease

Successful Long-term Use of Oral Isotretinoin for the Management of Morbihan Disease

Update on the Management of Rosacea

Off-label uses of retinoids in dermatology

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