European Journal of Molecular & Clinical Medicine

Background: The excessive, regular use of topical fluorinated steroids on the face often produces an array of skin complications, including an eruption clinically indistinguishable from rosacea-‘steroid-induced rosacea like eruption ’  or iatrosacea . Although it was believed that only high potency topical steroids could produce SIRD, it is important to note that topical hydrocortisone 1% can also cause such an eruption after prolonged use. Objective: To assess the efficacy and tolerability  of low dose oral Isotretinoin for  steroid induced  rosacea- like eruption. Methodology: A retrospective registry/ photographic analysis  of 30 patients enrolled between Jan 2013 to Jan 2014 was done at  Cutis academy. Case records and photographs  of 30 patients between the age group of 15- 45 years   clinically diagnosed with steroid induced rosacea  on  low dose oral isotretinoin 20mg alternate days for 3 months were analysed. Patients were evaluated by a rosacea clinical score at weeks 0, 6,  and 12 weeks. Results: A total of  30 patients (23females and 7 males) were enrolled in this study.  The mean age of the study population was 30.1+/- 14.8 (14 to 45) years. Among the 30 patients, 2  dropped out due to side effects of  treatment such as dryness and itching. According to seven point static score, Investigator global assessment of steroid induced rosacea eruption at baseline was 5.36+/- 1.1. This score decreased to 3.2 +/-0.8 at week 6, then 0.73 +/-0.6 at week 12.The difference of IGA between week 0, week 2, and week 6 was statistically significant.(p<0-0001) . At baseline the 16 patients had ratings of ‘severe’ , 7 patients had ratings of  ‘moderate to severe’, 2 patients had rating of ‘moderate’, 3 patients had rating of ‘mild to moderate’ .Conclusion : Low dose oral isotretinoin with cessation /avoidance of topical steroid use as well as the avoidance of other agents known to aggravate rosacea is proved to be an   effective alternative mode of treatment of steroid rosacea like eruption.

Background:Dermatophytosis is a common skin diseasein Egypt. It iscaused by
keratinophilic fungi. Tinea become chronic, recurrent and resistant to traditional
therapies. Isotretinoin is a good adjuvant to systemic antifungal in chronic
dermatophytosis due to its keratolytic effect.
Aim: This is a prospective study to assess the effectiveness of combined oral
itraconazole/isotretinoin therapyin the treatment of chronic and recalcitrant
dermatophytosis.
Patients and Methods:A total of 30 patients with chronic and/or recalcitrant
dermatophytosis were included. Potassium hydroxide microscopy was performed.All
the patients received combined oral itraconazole/isotretinoin therapy;Itraconazole
200 mg twice daily with adjuvant isotretinoin20 mg dailyfor 6 weeks. The patients
were followed up to 6 monthsfor signs of recurrence.
Results:Mycological cure was observed in83.3% andcomplete cureoccurred in 70%
of the patients.
Conclusions: Combined oral itraconazole/isotretinoin therapycould be an effective
treatment in recalcitrant dermatophytosis.