Broadband pulsed light and systemic isotretinoin in the treatment of erythematotelangiectatic rosacea in patients with metabolic disorders – results of an open, prospective, randomized study

Rosacea is a chronic, genetically determined skin disease predominantly affecting the facial skin. It is characterized by vascular (erythema, telangiectasias) and inflammatory (papules, pustules) changes. Less commonly, the sebaceous glands are involved, leading to the formation of phyma. The development of effective and safe treatments for rosacea in patients with comorbid somatic pathologies, including metabolic syndrome, remains a pressing interdisciplinary challenge. Study objective. To evaluate the efficacy of combined use of systemic isotretinoin at a dose of 10 mg/day and BBL light technology (420–1400 nm) in patients with the erythematotelangiectatic subtype of rosacea associated with metabolic disorders, taking into account clinical symptoms and quality of life indicators based on immediate and long-term follow-up.

Methods. A single-center, open-label, prospective, randomized, comparative study included 39 patients with erythematotelangiectatic rosacea (ETR) with one or more metabolic syndrome components. Patients were divided into two groups. Group 1A (n=19) received broadband pulsed light (BBL) therapy, while Group 1B received combination therapy with isotretinoin (10 mg/day for 4 months) and BBL light technology. Skin lesion activity was assessed using the modified Dermatology Index of the Rosacea Symptom Scale (DIRSS). The impact of dermatosis on patients’ quality of life was assessed using the Dermatology Index of Quality of Life (DIQOL). Follow-up examinations were conducted before treatment, after completion of therapy, and at 6 and 12 months after completion of treatment.

Results. According to the DISHSR and DIQI indices, both broadband light monotherapy and the combination regimen containing isotretinoin demonstrated high efficacy in the short-term follow-up period. However, in the long-term follow-up period (6 and 12 months), a significant advantage of Group 1B was established for the studied indices.

Conclusion. The results of this study confirm the high efficacy of BBL phototherapy and the combination regimen containing systemic isotretinoin and BBL phototherapy in the treatment of erythematotelangiectatic rosacea in patients with metabolic disorders. However, the developed combination treatment regimen has a more pronounced preventive potential.

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