Systemic therapy in patients with severe rosacea

Abstract

Rosacea is a polietiologic disease with a complex pathogenesis, resulting in the problem is the selection of therapeutic tactics, especially in severe disease. The result of the study revealed that the isotretinoin treatment for rosacea had a positive result, even in the absence of the effect of previous systemic antibiotic therapy. Aim of the study. To study the effect and tolerability of systemic isotretinoin treatment for severe rosacea that is resistant to antibiotic therapy. Materials and methods. Under the supervision and treatment were 16 patients with severe course of rosacea, 14 of them had pustules and papules and 2 - fimatodes subtype. The severity was estimated by the method a 4-point scale proposed by V.P. Adaskevich, and was in average 18.6 points. All patients had a duration of 3 ± 1.2 years for systemic antibacterial therapy (clarithromycin, Ornidazole) with insufficient effect in the past. All patients (n = 16) was conducted therapy with isotretinoin (using Aknekutan). Daily dose was calculated on body weight, the initial dose was 0.2-0.3 mg/ kg, with subsequent dose reduction. Topically patients received clindamycin phosphate gel 1% treatment (5-7 days), then metronidazole 1% cream (Rosamet) 1-2 times a day. The duration of therapy ranged from 3 to 5 months. Results. After the course of therapy using Aknekutan remission or significant improvement was achieved in 87.5% of cases. The severity of the disease fell to 6.5 points, i.e. 2.8 times. Conclusion. Aknekutan showed a high therapeutic effect in severe rosacea, so it can be recommended to patients with resistance to conventional therapy. As external therapy, and supportive treatment patients are recommended - cream metronidazole 1% (Rosamet) and adequate skin care, photoprotective creams.