{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T23:52:47Z","timestamp":1790553167947,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,8,29]],"date-time":"2017-08-29T00:00:00Z","timestamp":1503964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Galderma international, France"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Recently, therapy of rosacea with inflammatory lesions (papulopustular) has improved substantially with the approval of topical ivermectin 1% cream. It is assumed to have a dual mode of action with anti\u2010inflammatory capacities and anti\u2010parasitic effects against\n                      <jats:italic>Demodex<\/jats:italic>\n                      , which however has not yet been demonstrated\n                      <jats:italic>in vivo<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To find scientific rationale for the dual anti\u2010inflammatory and anti\u2010parasitic mode of action of topical ivermectin 1% cream in patients with rosacea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A monocentric pilot study was performed including 20 caucasion patients with moderate to severe rosacea, as assessed by investigator global assessment (\n                      <jats:styled-content style=\"fixed-case\">IGA<\/jats:styled-content>\n                      score \u22653) and a Demodex density \u226515\/cm\n                      <jats:sup>2<\/jats:sup>\n                      . Patients were treated with topical ivermectin 1% cream once daily (Soolantra\n                      <jats:sup>\u00ae<\/jats:sup>\n                      ) for \u226512 weeks. The density of Demodex mites was assessed with skin surface biopsies. Expression of inflammatory and immune markers was evaluated with\n                      <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\n                      \u2010\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      and by immunofluorescence staining.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean density of mites was significantly decreased at week 6 and week 12 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). The gene expression levels of\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\n                        \u20108,\n                        <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content>\n                        \u201037,\n                        <jats:styled-content style=\"fixed-case\">HBD<\/jats:styled-content>\n                        3,\n                        <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n                        4 and\n                        <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\n                        \u2010\n                      <\/jats:italic>\n                      \u03b1 were downregulated at both time points. Reductions in gene expression were significant for\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content>\n                        \u201037,\n                        <jats:styled-content style=\"fixed-case\">HBD<\/jats:styled-content>\n                        3 and\n                        <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\n                        \u2010\n                      <\/jats:italic>\n                      \u03b1 at both follow\u2010up time points and at week 12 for\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">TLR<\/jats:styled-content>\n                        4\n                      <\/jats:italic>\n                      (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). Reduced\n                      <jats:styled-content style=\"fixed-case\">LL<\/jats:styled-content>\n                      \u201037 expression (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) and\n                      <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\n                      \u20108 expression were confirmed on the protein level by immunofluorescence staining. All patients improved clinically, and 16 of 20 patients reached therapeutic success defined as\n                      <jats:styled-content style=\"fixed-case\">IGA<\/jats:styled-content>\n                      score \u22641.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Topical ivermectin 1% cream acts by a dual, anti\u2010inflammatory and anti\u2010parasitic mode of action against rosacea by killing\n                      <jats:italic>Demodex spp. in vivo,<\/jats:italic>\n                      in addition to significantly improving clinical signs and symptoms in the skin.\n                    <\/jats:p>\n                  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