Pathogenetic therapy of rosacea with systemic tetracyclines

Abstract

The article presents modern data on the pathophysiology of rosacea and diagnostic criteria for dermatosis. The historical aspects of the introduction of systemic tetracyclines into the therapy of rosacea are outlined. The effect of doxycycline and minocycline on the mechanisms of rosacea development is covered in detail, taking into account modern ideas about the pathogenesis of the disease. At the same time, the advantage of minocycline, compared with doxycycline, is noted, which is manifested by a more pronounced anti-inflammatory effect, as well as a higher antibacterial efficacy, which allows the use of low dosages of minocycline and thereby reduces the risk of adverse events, especially from the gastrointestinal tract. The data of various studies are presented, indicating the expediency of prescribing subantimicrobial doses, as well as the results of evaluating the effectiveness and safety of domestic minocycline minoleksin. It has been proven that the effectiveness of tetracyclines is associated with a pathogenetic effect on innate immunity reactions, with a pronounced anti-inflammatory effect, especially minocycline, suppression of a number of microorganisms, which, apparently, are not a key link in the pathogenesis of rosacea, but can be a trigger factor and initiate inflammation. In addition, minocycline most effectively inhibits the activity of metalloproteinases and increases epidermal hydration