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The following is a summary of “A comparative exploration of immunohistochemical markers in patients with papulopustular rosacea undergoing treatment with oral isotretinoin versus doxycycline,” published in the August 2024 issue of Dermatology by Picosse et al.

Rosacea, a chronic inflammatory condition, is commonly treated with doxycycline (DOXY) for anti-inflammatory properties, while oral isotretinoin (ISO) decreases sebaceous gland activity and modulates toll-like receptors to alleviate inflammation.

Researchers conducted a retrospective study evaluating the effect of DOXY and ISO on the expression of cutaneous immunohistochemical biomarkers linked to rosacea’s etiopathogenesis.

They included 40 participants suffering from moderate to severe papulopustular and ocular rosacea. Participants received either DOXY 100 mg daily or ISO 0.3 mg/kg daily. Immunohistochemical analysis was performed on affected skin samples taken at baseline and after 4 months to assess biomarker expression.

The result showed several changes including a reduction in vessel count after VEGF (Vascular Endothelial Growth Factor) application with DOXY (P=0.010), a decrease in VEGF intensity with both ISO (P<0.001) and DOXY (P=0.020), a reduction in nitric oxide synthase enzyme in the inflammatory infiltrate with both drugs (ISO P<0.001; DOXY P=0.003), though a significant decrease in nitric oxide synthesis at the sebaceous glands was noted only with ISO (P=0.030); a reduction in TRPV-1 expression at the sebaceous glands observed only with DOXY (P=0.041), and a decrease in cathelicidin LL37 expression, a key antimicrobial peptide in rosacea etiopathogenesis, with both drugs, although at the sebaceous glands, this was significant only with DOXY (P=0.007).

Investigators concluded that oral ISO and DOXY alter the expression of cutaneous biomarkers related to rosacea etiopathogenesis, highlighting their role in regulating inflammatory and vascular processes.

Source: onlinelibrary.wiley.com/doi/abs/10.1111/ijd.17420