Rosacea drugs

Taub AF (2003) Treatment of rosacea with intense pulsed light. J Drugs Dermatol 2 254-259... 

Topical metronidazole is effective in the treatment of rosacea. The mechanism of action is unknown, but it may relate to the inhibitory effects of metronidazole on Demodex brevis alternately, the drug may act as an anti-inflammatory agent by direct effect on neutrophil cellular function. Oral metronidazole has been shown to be a carcinogen in susceptible rodent species, and topical use during pregnancy and by nursing mothers and children is therefore not recommended. 

A 48-year-old man with urethritis took doxycycline 100 mg bd and developed a fixed drug eruption on the glans penis. Doxycycline was withdrawn and the eruption healed with symptomatic treatment. Eight months later he took minocycline 100 mg/day for rosacea. A few hours after having taken the first tablet he became aware of oval erythematous patches on the glans, prepuce, and scrotum. The patches rapidly became violaceous and developed into superficial erosions. He stopped taking minocycline and the lesions faded. 

TORMENTIL, Tormentillae rhizoma is the rhizome of Potentilla erecta (L), Rausch, family Rosaceae, a plant belonging to the European flora. It is used in the same way as Rhattany root and it has also been used internally as an antidiarrheal drug. 

KAMALA which consists of the trichomes and glands separated from the fruits of Mallotus philippinensis (Lam) Miill. Arg., family Euphorbiaceae, a tree in India, Pakistan and the East Indies. Similar phlorogucine-type substances occur in Koso flos., which are the flowers of the Ethiopian tree Hapienia abyssinica, J.F.Gmelin, family Rosaceae. These two drugs have local use as anthelmintics against tapeworm. 

QUILLAIA BARK Quillajae cortex is the bark of Quillaja saponaria, Molina, family Rosaceae, from which the cork is removed. This species is an evergreen tree in Chile (in the valleys of the Cordilleras), Peru and Bolivia. The drug consists of the inner bark which is generally cut before marketing. It has an acrid taste and causes sneezing. The bark contains about 10% of a saponin mixture (Quillaia saponin), which besides its use as an expectorant also has a technical use and as an adjuvant in some vaccines as the saponin potentiates the immunising power of the vaccine. 

A hydroxycinnamic acid-spermidine amide has been isolated from the drug Crataegi flos, which is raw material prepared from the flowers of a Crataegus subspecies and is reported to have cardiotoxic properties. Chemical and spectroscopic methods have indicated that this amide is iV, A, A -tri-4-( )-coumaroylspermidine (87). Also, the occurrence of this amide in flowers of various members of the Rosaceae has been investigated... 

Campbell, T.M., R. Neems, and J. Moore. 2008. Severe exacerbation of rosacea induced by cinnamon supplements. /. Drugs Dermatol. 7(6) 586-587. 

The etiopathogenetic role of corticosteroids, both topical and systemic [5, 6], is well known from the 1970s, when Leyden et al. [6] described ten patients who developed a rosaceiform dermatitis on the face following a prolonged application of fluorinated corticosteroids. These authors [6] named this clinical entity steroid rosacea. Other drugs that can uncommonly cause rosacea or rosaceiform eruptions are peripheral vasodilators, vitamins B6 and B12, amiodarone [7] and pimecrolimus [8]. 

Topical antibiotics (erythromycin [42] and clindamycin [43]) are not commonly used in rosacea. They reduce neutrophil chemotaxis and oxygen-free radical synthesis [44]. These drugs are usually well tolerated uncommon and mild side effects are erythema, dryness, and burning [45]. 

It may be used at different concentrations (from 0.01% to 0.05%, although 0.025% is the concentration most frequently used in rosacea). Its efficacy is comparable with oral isotretinoin at a daily dosage of 10 mg [56]. Side effects are much more frequent and severe than all the other topical drugs used in rosacea (burning, xerosis, redness, scaling). Because of these side effects, tretinoin is a second choice in rosacea. 

Literature data about these drugs in the treatment of rosacea are so far limited [57-59]. Some cases of rosacea induced by pimeCToIimus were also reported [8]. Local side effects (burning and redness) are rather conunon and sometimes severe. 

Nally JB, Berson DS (2006) Topical therapies for rosacea. J Drugs Dermatol 5 23-26... 

Depending on the type of product and exposition, several occupation-induced dermatoses may occur among workers in the pharmaceutical industry. They include irritation, contact allergy, photosensitivity, urticaria, acne venenata and, less frequently, fixed drug eruption and steroid rosacea (H. Degreef, personal communication), and even toxic epidermal necrolysis (as was the case with the transcutaneous absorption of an intermediary product in the synthesis of tetramisole, an anthelminthic drug Valsecchi et al. 1987). 

Other common techniques and devices include the use of intense pulsed light for resurfacing (to treat vascular lesions and acne) and light-activated drugs in photodynamic therapy (for precancerous and cancerous cells, acne, rosacea, or skin enhancement). 

Amygdalin occurs in the seeds of Rosaceae -bitter almonds, peach, and apricot seeds. It has been suggested as an anti-cancer drug, and has been used in some countries to treat cancers. There, however, is no hard data to substantiate its effectiveness in such treatments. 

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