COMPARISON OF LOW-DOSE AND MEDIUM-DOSE ORAL ISOTRETINOIN FOR TREATMENT OF ROSACEA

Abstract

Objectives: To compare the results of treatment of papulopustular rosacea by low-dose oral isotretinoin (0.15-0.25 mg/kg/day) and medium-dose (0.4-0.5 mg/kg/day).

Subjects and methods: Randomized controlled clinical trial: 54 patients with papulopustular  rosacea were randomly assigned to 2 groups: group 1 treated by low-dose oral isotretinoin  and group 2 treated by medium-dose for 8 weeks.

Results: After 8 weeks of treatment, the number of papules and pustules and erythema decreased clearly in both groups. The improvement of erythema by CEA score  was similar  in all patients treated by medium and low doses of isotretinoin (52.7% vs 45.4, p>0.05). The reduction of number of papules and pustules in patients with mild and moderate IGA score was not diferent between two groups treated by medium  and low-dose oral isotretinoin. However, the reduction of number of papules and pustules in group with severe IGA score was significantly more rapidly when treated by medium-dose than low-dose oral isotretinoin (76.8 % vs 84.7%; p<0.05). Adverse events were observed only on the skin including dryness and irritation which were more frequent and severe in group treated by medium-doses compared to group treated by lose-dose oral isotretinoin.

Conclusion: Isotretinoin is safe and effective in the treatment of papulopustular  rosacea. The improvement of erythema, papules and pustules was similar in all patients treated by medium and low-dose of oral isotretinoin. However, the reduction of number of papules and pustules in severe IGA group was significantly more rapidly when treated by medium-dose than low-dose of oral isotretinoin at week 8^th.