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).