Papulopustular Rosacea Persisting After Low-Dose Oral Isotretinoin
This protocol is for patients with inflammatory papules and pustules in the central region of the face and facial erythema whose prior treatment has not achieved the expected level of improvement and remission.
Clinical Presentation
Inflammatory papules and pustules concentrated in the central facial region, accompanied by erythema — the hallmarks of papulopustular (subtype II) rosacea.
Prior Treatment — Insufficient Response
When low-dose oral isotretinoin has not achieved improvement and remission of papulopustular lesions, this next-line protocol provides the structured approach for what to do next.
Next-Line Approach (Overview — Partial)
For therapy-resistant papulopustular lesions, a laser-based intervention is recommended. The complete eligibility criteria, clinical algorithm, and sequencing are available in the full protocol.
Treatment Goal
Reduction of papulopustular lesions.
References
DOI: 10.1111/jdv.14349
In subtype II, inflammatory papules and pustules are seen in the central region of the face.
Inflammatory lesions such as papules and pustules as well as erythema occur in subtype II.
Conclusion: In therapy-resistant cases, we recommend (B) the treatment with Nd:YAG lasers.
In an open clinical trial (n = 66), the Nd:YAG laser was shown to be safe and effective against papulopustular lesions.
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