Systemic therapy in patients with severe rosacea

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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.

About the authors

E. A. Bakhlykova

ФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава России

Author for correspondence.
Russian Federation

N. N. Filimonkova

ГБУЗ СО «Уральский научно-исследовательский институт дерматовенерологии и иммунопатологии»

Russian Federation

S. L. Matusevich

ФГБОУ ВО «Тюменский государственный медицинский университет» Минздрава России

Russian Federation


  1. Steinhoff M., Buddenkotte J., Aubert J. et al. Clinical, cellular, and molecular aspects in the pathophysilogy of rosacea. J Investig Dermol Symp Proc 2011; 15 (1): 2-11.
  2. Tan J., Schöfer H., Araviiskaia E. et al. Prevalence of rosacea in the general population of Germany and Russia - The RISE study. J Eur Acad Dermatol Venereol. 2016 Mar; 30 (3): 428-34.
  3. Lacey N., Delaney S., Kavanagh K. et al. Mite related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol 2007; 157: 474-481.
  4. Yamasaki K., Schauber J., Coda A. et al. Kallikrein-mediated proteolysis regulates the antimicrobial effects of cathelicidins in skin. FASEB J 2006; 20: 2068-2080.
  5. Steinhoff M., Schauber J., Leyden J. J. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol Elsevier 2013; 69: 15-26.
  6. Yamasaki K., Gallo R. L. Rosacea as a disease of cathelicidins and skin innate immunity. J Investig Dermatol Symp Proc 2011; 15 (1): 12-15.
  7. Khayrutdinov V.R. Rozatsea: sovremennye predstavleniya o patogeneze, klinicheskoy kartine i lechenii. Effektivnaya farmakoterapiyH 2014; (3): 32-37. [Хайрутдинов В.Р. Розацеа: современные представления о патогенезе, кли нической картине и лечении. Эффективная фармакотерапия. 2014; 3: 32-37.]
  8. Kubanova A.A., Machackova Y.B. Rosacea: diagnosis, treatment. Vestn dermatol venereol 2015; (4): 27-35. [Кубанова А.А., Махакова Ю.Б. Розацеа: диагностика, лечение. Вестн дерматол венерол 2015; (4): 27-35.]
  9. Samtsov A.V. Acne i acneformnye dermatosy. M: 2014. [Самцов А.В. Акне и акнеформные дерматозы. М; 2014.]
  10. Boixeda de Miquel D., Vаzquez Romero M., Vаzquez Sequeiros E. et al. Effect of Helicobacter pylori eradication therapy in rosacea patients. Rev Esp Enferm Dig 2006; 98: 501-509.
  11. Rusak J.E., Chernyak A.Y., Solonytsia L.P. et al. Helicobacter pylori in patients with rosacea. Vestn dermatol venereol 2002; (1): 34-35. [Русак Ю.Э., Черняк А.Я., Солоница Л.П. и др. Helicobacter pylori у больных розацеа. Вестн дерматол венерол 2002; (1): 34-35.]
  12. Wilkin J., Dahl M., Detmar M. et al. Standardized classification system of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2002; 46: 584-587.
  13. Araviiskaya E.R., Samtzov A.V. Federal clinical practice guidelines for the management of patients with rosacea. RODVK, M; 2015. [Аравийская Е.Р., Самцов А.В. Федеральные клинические рекомендации по ведению больных розацеа. РОДВК, М; 2015.]
  14. Thielitz A., Gollnick H. Rosasea. Systemic therapy with retinoids. Hautarzt 2011; 62: 820-7.
  15. Park H., James Q. Del Rosso. Use of Oral Isotretinoin in the Management of Rosasea. J Clin Aestethic Derm 2011; 9: 54-61.
  16. Dispenza M., Wolpert E., Gilliland L. et al. Systemic Isotretinoin Therapy Normalizes Exaggerated TLR-2-Mediated Innate Immune Responses in Acne Patients. J Invest Dermatol 2012 Apr 19.
  17. Adaskevich V.P. Diagnosticheskie indeksy v dermatologii. M: Isdatel'stvo Panfilova 2014. [Адаскевич В.П. Диагностические индексы в дерматологии. М: Изд-во Панфилова 2014.]
  18. Kondratieva Y. S., Kokina O. A., Eroshenko N.V. Titkova K. V. Experience of application isotretinoin with rosasea fulminans (a clinical case). Clinical dermatology 2015; (5): 91-96. [Кондратьева Ю.С., Кокина О.А., Ерошенко Н.В., Титкова К.В. Опыт применения изтретиноина при rosasea fulminans (клинический случай). Клин дерматол венерол 2015; (5): 91-96.]
  19. Yamasaki K., Kanada K., Macleod D. T. et al. TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes. J Invest Dermatol. The Society for Investigative Dermatology Inc 2011; 131 (3): 688-697.

Copyright (c) 2016 Bakhlykova E.A., Filimonkova N.N., Matusevich S.L.

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