[Oral treatment of rosacea with 13-cis-retinoic acid]

Thirteen patients with severe rosacea (rosacea papulopustolosa, rosacea conglobata, and rhinophyma) were treated orally with 0.05, 0.5, or 1.0 mg/kg body weight 13-cis-retinoic acid (isotretinoin, Ro 4-3780) for 12-28 weeks. All patients had been treated previously with high doses of tetracyclines, metronidazole, or dermabrasion, etc., with no or only limited success. The therapeutic effect following 13-cis-retinoic acid was excellent. Inflammatory lesions regressed by 50% within 2 weeks, and by over 95% within 8 weeks. 13-cis-retinoic acid acts as a potent anti-inflammatory and sebum-suppressive agent. Besides papulopustules, nodules, and hemorrhagic abscesses, the inflammatory plaques and facial edema, but to a lesser extent teleangiectasias and the chronic conjunctivitis disappeared. The severe seborrhea disappeared. Long-lasting remission, similar to patients with severe acne being treated with 13-cis-retinoic acid, can be expected, as the first patients are in full remission for over 12 months at the time of writing. Exfoliative cheilitis occurred in every patient. Serum lipids increased only slightly. For female patients a reliable contraception is mandatory as teratogenicity cannot be excluded in this drug (similar to all retinoids).