TREATMENT OF ROSATEA FULMINANS WITH ISOTRETINOIN AND TOPICAL ALCLOMETASONE DIPROPIONATE

Five adult Caucasian women with rosacea fulminans (RF) were treated wi th isotretinoin and a low-potency topical corticosteroid alclometasone dipropionate. All patients had been previously treated at other centr es with contraceptives, and systemic and topical antibiotics: these dr ugs produced only partial remissions df short duration. Isotretinoin w as used at the dosage of 0.5 mg/kg/day for 1 month and 0.7 mg/kg/day f or the next 3 months. Contraception was effected using the cyproterone acetate - ethinyloestradiol association. Alclometasone dipropionate w as employed as a cream (2 applications/day for 10 days and 1 systemic drugs were used. In particular, systemic corticosteroids were not used because of patients' refusal (2 cases) or the presence of concomitant diseases (3 cases) which could be worsened by corticosteroids. In all patients a marked improvement was observed after about 1 month and th e complete disappearance of the lesions after 4 months. No side effect s were either reported or observed. No laboratory abnormalities were r ecorded. No recurrences were seen (follow up duration: 14-19 months; m edian: 17.6 months). RF is slightly or not at all sensitive to contrac eptives, and systemic and topical antibiotics, while it is markedly se nsitive to isotretinoin. The use of systemic corticosteroids may be av oided: these may be substituted by low-potency topical corticosteroids .