The Role of IL-17 in Papulopustular Rosacea and Future Directions. Issue 6 (November 2019)

• Record Type: Journal Article
• Authors: Amir Ali, Asma; Vender, Reid; Vender, Ronald
• Is Part Of: Journal of cutaneous medicine and surgery. Volume 23:Issue 6(2019)
• Page Start: 635
• Page End: 641
• Publication Date: 2019-11
• Subjects: rosacea -- IL-17 inhibitor -- metronidazole -- ivermectin -- azelaic acid -- Demodex folliculorum -- isotretinoin -- secukinumab -- ixekizumab -- brodalumab; Dermatology -- Periodicals; Skin -- Diseases -- Treatment -- Periodicals; Skin -- Surgery -- Periodicals; Dermatology -- Canada -- Periodicals; Skin -- Diseases -- Treatment -- Canada -- Periodicals; Skin -- Surgery -- Canada -- Periodicals; 616.5005
• DOI: 10.1177/1203475419867611
• Languages: English
• ISSNs: 1203-4754

Abstract

Rosacea is a chronic, progressive, inflammatory condition phenotypically subtyped into diagnostic features, major features, and minor/secondary features. There is currently no cure for rosacea, and it carries a significant negative psychosocial burden for afflicted patients. While there are a number of treatment modalities at the disposal of the clinician, clinical experience has suggested a need for updated treatments. The pathogenesis of rosacea is multifactorial; however, this paper will focus on the pivotal role of interleukin 17 (IL-17) in the development and progression of the disease. Furthermore, this paper will explore the mechanism of action of standard rosacea treatments and their effect on different stages of the IL-17 pathway. The standard treatments for rosacea are usually effective in controlling the symptoms of the disease in its mild-to-moderate form; however, their efficacy is diminished in the setting of severe and treatment-resistant rosacea. We hypothesize that IL-17 inhibitors, currently used successfully in psoriasis and psoriatic arthritis, could perhaps be used to treat severe and treatment-resistant papulopustular rosacea in the future; however, clinical trials and case reports will be needed to dictate expanded indications of IL-17 inhibitors. Furthermore, the high cost of IL-17 inhibitors presently prevents their use in disease states other than psoriasis or psoriatic arthritis.