Topical calcineurin inhibitors as a double‐edged sword in rosacea: A systematic review

Zhang, Hanlin; Yang, Liu; Wang, Yuchen; Zhang, Dingyue; Tang, Keyun; Fang, Rouyu; Sun, Qiuning

doi:10.1111/jocd.14315

Cited by 6 publications

(4 citation statements)

References 51 publications

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“…Also, Zhang et al conducted a systematic review to study the effects of topical calcineurin inhibitors on rosacea. They studied 28 articles (published from 2001 to 2016) and reported the noticeable efficacy of both pimecrolimus and tacrolimus on treating rosacea patients 17 . Their results were concordant with our study, in terms of the efficacy of topical tacrolimus as a treatment for an immune‐mediated skin disease.…”

Section: Discussionsupporting

confidence: 89%

“…They found that finasteride was more effective than systemic steroids for treating FFA patients (p-value <0.05). 15 The results were concordant with our study, in terms of the efficacy of finasteride for 17 Their results were concordant with our study, in terms of the efficacy of topical tacrolimus as a treatment for an immunemediated skin disease.…”

Section: Ta B L Esupporting

confidence: 87%

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Evaluating the combined efficacy of oral isotretinoin and topical tacrolimus versus oral finasteride and topical tacrolimus in frontal fibrosing alopecia—A randomized controlled trial

Rokni

Emadi

Dabbaghzade

et al. 2022

J of Cosmetic Dermatology

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Objective: Treatment of frontal fibrosing alopecia (FFA) is complicated and challenging. In this study, we evaluated the efficacy of combining topical tacrolimus with isotretinoin versus finasteride in patients with FFA.Methodology: Thirty-one patients with FFA were divided randomly into two groups.Therapeutic regimen of the first group (group A, n = 16) was isotretinoin and tacrolimus (Capsule isotretinoin 20 mg daily and topical tacrolimus 0.1% BD). The second group (group B, n = 15) was given finasteride and tacrolimus (Tablet finasteride 2.5 mg daily and topical tacrolimus 0.1% BD). Patients were treated and followed up periodically for 12 weeks. Evaluation of the treatment efficacy was based on Patient Global Assessment and Physician Global Assessment scales. Objective evaluation was based on improving the severity of skin lesions by viewing serial images taken from the affected areas.Results: Physician Global Assessment (PGA) was significantly better in the group A as compared with the group B at 4 weeks (p = 0.038). Physician satisfaction in the group A was better than the group B at 12 weeks, but this was not statistically significant (p > 0.05). Patient Global Assessment and patient satisfaction in the group A was better than the group B at 8 and 12 weeks, but it was not statistically significant (p > 0.05). Conclusion:Although both therapeutic regimens were effective in the treatment of FFA, treatment with tacrolimus and isotretinoin is significantly more effective than tacrolimus and finasteride.

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Section: Discussionsupporting

confidence: 89%

Section: Ta B L Esupporting

confidence: 87%

Evaluating the combined efficacy of oral isotretinoin and topical tacrolimus versus oral finasteride and topical tacrolimus in frontal fibrosing alopecia—A randomized controlled trial

Rokni

Emadi

Dabbaghzade

et al. 2022

J of Cosmetic Dermatology

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“…Several clinical trials on topical calcineurin inhibitors in papulopustular rosacea, such as pimecrolimus and tacrolimus, have shown excellent results in reducing the erythematous inflammatory component [83,84], even in the steroid-induced form of rosacea [85,86]. Conversely, Zhang et al [87] underline a possible negative effect of pimecrolimus and tacrolimus since these drugs can even induce paradoxical rosacea-like eruptions.…”

Section: Transient/persistent Centrofacial Erythema and Telangiectasiamentioning

confidence: 99%

Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

Galluccio,

D’Onghia,

Malvaso

et al. 2024

Cosmetics

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Rosacea is a common chronic inflammatory skin disorder that mainly affects the central face. It is primarily characterized by recurrent episodes of flushing, persistent erythema, inflammatory papules, telangiectasias, phymatous changes, and ocular symptoms. Its pathogenesis is complex and still not completely understood. It encompasses innate and adaptive immune system dysregulation, neurovascular dysfunction, and genetic and environmental factors. To date, four subtypes of rosacea have been identified, based on the predominant clinical features: erythemato-teleangiectatic, papulopustular, pyhomatous, and ocular rosacea. New insights into this condition have led to several pharmacological treatments, including topical medications, spanning from the conventional azelaic acid, metronidazole, benzoyl peroxide, clindamycin, and erythromycin to new ones including not only brimonidine, oxymetazoline, ivermectine, and minocycline but also systemic drugs such as oral antibiotics, isotretinoin, non-selective β-blockers or α2-adrenergic agonists, and laser- or light-based therapies, together with new therapeutic approaches. The aim of this study was to review the current literature on the pathophysiology of rosacea and to provide an overview of therapeutic approaches that specifically address each clinical subtype.

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“…In accordance with Swiss guidelines, pimecrolimus 1%, a calcineurin inhibitor, is a recommended treatment for erythema and papulopustular lesions [ 2 ]. Pimecrolimus 1% inhibits T cell and mast cell activation [ 200 ], but caution is needed due to potential rosacea-like eruptions, which may be due to its immunosuppressive effect resulting in the overgrowth of microorganisms such as Demodex folliculorum [ 2 , 201 ]. Similarly, tacrolimus also exhibits this double-edged sword effect [ 201 ].…”

Section: Treatmentsmentioning

confidence: 99%

Exploring the Pathogenesis and Mechanism-Targeted Treatments of Rosacea: Previous Understanding and Updates

Chen,

Wang,

Zhang

et al. 2023

Biomedicines

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Rosacea is a chronic inflammatory skin disease characterized by recurrent erythema, flushing, telangiectasia, papules, pustules, and phymatous changes in the central area of the face. Patients with this condition often experience a significant negative impact on their quality of life, self-esteem, and overall well-being. Despite its prevalence, the pathogenesis of rosacea is not yet fully understood. Recent research advances are reshaping our understanding of the underlying mechanisms of rosacea, and treatment options based on the pathophysiological perspective hold promise to improve patient outcomes and reduce incidence. In this comprehensive review, we investigate the pathogenesis of rosacea in depth, with a focus on emerging and novel mechanisms, and provide an up-to-date overview of therapeutic strategies that target the diverse pathogenic mechanisms of rosacea. Lastly, we discuss potential future research directions aimed at enhancing our understanding of the condition and developing effective treatments.

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Topical calcineurin inhibitors as a double‐edged sword in rosacea: A systematic review

Cited by 6 publications

References 51 publications

Evaluating the combined efficacy of oral isotretinoin and topical tacrolimus versus oral finasteride and topical tacrolimus in frontal fibrosing alopecia—A randomized controlled trial

Evaluating the combined efficacy of oral isotretinoin and topical tacrolimus versus oral finasteride and topical tacrolimus in frontal fibrosing alopecia—A randomized controlled trial

Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

Exploring the Pathogenesis and Mechanism-Targeted Treatments of Rosacea: Previous Understanding and Updates

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