A retrospective review of a cohort of patients with periorificial dermatitis treated with sarecycline
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Abstract
INTRODUCTION: Periorificial dermatitis (POD) is a common, chronic, inflammatory facial skin rash that presents as non-pruritic, tiny papules and papulopustules with underlying eczematous-like patches, typically confined to the perioral, perinasal and periorbital areas. The exact cause of POD is not well understood, however environmental exposures are linked to the manifestation. There is currently no FDA indicated treatment for POD, however broad-spectrum antibiotics are efficacious as a treatment option. However, broad-spectrum antibiotics negatively impact gut negatively impact gut flora, and lead to antibiotic resistance. Narrow-spectrum tetracyclines, such as sarecycline, have a low potential for promoting bacterial resistance and gastrointestinal issues.
OBJECTIVE: This study’s intended purpose is to evaluate the efficacy of sarecycline in a cohort of patients diagnosed with periorificial dermatitis that were treated with sarecycline. Sarecycline, a third-generation tetracycline, is currently only FDA- indicated to treat acne vulgaris. We hypothesized that not only the subjects responded well to sarecycline treatment, but that it was well-tolerated.
METHODS: A review of medical records from February 1, 2018- February 15, 2022, was completed using an electronic medical record. The patients were identified by ICD code “L71.0” (POD) and “Seysara®” (sarecycline). Inclusion criteria included males and females, ages 18-95 with a diagnosis of POD, treated with sarecycline that had a documented follow up. Patients who were lost to follow up or had a diagnosis that was changed from POD at a subsequent visit were excluded.
RESULTS: Out of the 17 patients that were prescribed sarecycline for periorificial dermatitis, 6 patients met inclusion criteria. All 6 patients had shown improvement of POD with the use of sarecycline, and none reported side effects. Of the 6 patients, 4 were female and 2 were male and the patient ages ranged from 26-58 years old (m=41 years old). The course of therapy ranged from 30 days-180 days (med=90 days).
CONCLUSION: Based on the outcome of this retrospective study, there are many potential benefits to treatment with sarecycline over the alternative tetracycline-class antibiotics. There is a need for more large-scale clinical studies evaluating treatment options for POD, with special attention to the impact on antibiotic resistance and its implications on public health. Based on the efficacy and tolerability of sarecycline in large- scale acne studies, sarecycline may be an appropriate novel treatment option for POD and should be explored further with studies capturing this data.