{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:56:46Z","timestamp":1791284206439,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T00:00:00Z","timestamp":1725580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rosacea is a chronic, relapsing inflammatory dermatosis predominantly affecting the central face and can result in significant psychosocial impacts. Isotretinoin has been studied for rosacea due to its anti\u2010inflammatory and sebum reduction properties, but its use remains limited likely due to its off\u2010label use and potential adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This systematic review and meta\u2010analysis investigated the efficacy and safety of low\u2010dose isotretinoin (LDI; \u22640.5\u2009mg\/kg\/day) for the four main types of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular rosacea.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomized and non\u2010randomized studies evaluating LDI for rosacea were included. Incomplete studies, non\u2010English studies and case reports were excluded. Study quality was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 435 studies, and 16 studies involving 1445 patients were included. LDI decreased lesion count (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) and erythema (<jats:italic>p<\/jats:italic>\u2009=\u20090.01) with large effect [standardized mean difference (SMD)\u2009&gt;\u20090.8]. Compared to topical retinoids and topical antimicrobials, isotretinoin had larger reductions in lesion count (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) with moderate effect (SMD\u2009&gt;\u20090.5). Mean lesion count and erythema remained reduced by 70% and 47%, respectively, at 16\u2009weeks after LDI cessation. Relapse rate was 35% at 5.5\u2009months post\u2010isotretinoin, and three patients (0.4%) experienced worsening of rosacea. Three patients (0.4%) experienced serious adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Study design heterogeneity limited more comprehensive comparisons. Overall, low\u2010dose isotretinoin may serve as an effective treatment for rosacea with good tolerability and safety.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdv.20315","type":"journal-article","created":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T13:05:55Z","timestamp":1725627955000},"page":"785-792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Low\u2010dose isotretinoin for the management of rosacea: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3342-265X","authenticated-orcid":false,"given":"Aliyah","family":"King","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5718-7783","authenticated-orcid":false,"given":"Marcus G.","family":"Tan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Division of Dermatology University of Ottawa  Ottawa Ontario Canada"},{"name":"Department of Dermatology The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Kirshen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Division of Dermatology University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0725-1649","authenticated-orcid":false,"given":"Stanislav N.","family":"Tolkachjov","sequence":"additional","affiliation":[{"name":"Epiphany Dermatology  Dallas Texas USA"},{"name":"Baylor University Medical Center  Dallas Texas USA"},{"name":"Department of Dermatology University of Texas at Southwestern  Dallas Texas USA"},{"name":"Texas A&amp;M College of Medicine  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,6]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.5935\/0004\u20102749.20200016"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0888"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.12522"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14986"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2016.01.025"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1994.01690030051008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555641521"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","unstructured":"HigginsJP GreenS.Cochrane handbook for systematic reviews of interventions.2008.","DOI":"10.1002\/9780470712184"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8721.ep10768783"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-6-52"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18721"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.01.048"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12365600"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1994.tb01167.x"},{"issue":"7","key":"e_1_2_13_17_1","first-page":"505","article-title":"Systemic isotretinoin in the treatment of rosacea \u2010 doxycycline\u2010 and placebo\u2010controlled, randomized clinical study","volume":"8","author":"Gollnick H","year":"2010","journal-title":"JDDG\u2014J Ger Soc Dermatol"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(82)70067-2"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1986.tb04533.x"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2004.01472.x"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12982"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1984.tb00842.x"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.09894.x"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1204"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555678991"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/ceo.13900"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18468"},{"key":"e_1_2_13_28_1","unstructured":"iPLEDGE program.US Food and Drug Administration [Internet]. 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