INTRODUCTION
Rosacea has variable clinical presentation consisting of four overlapping phenotypes: erythematotelangiectatic, papulopustular, phymatous, and ocular.1 Rosacea's pathogenesis involves increased cutaneous density of Demodex folliculorum mites, which drive inflammation through activation of Toll-like receptor-2.1,2 Thus, topical ivermectin (IVM) 1.0% cream's anti-inflammatory and acaricidal activity provides an effective and targeted treatment for moderate-to-severe rosacea. However, literature assessing IVM is limited to efficacy in treating the papulopustular presentation, limiting generalizability.1,3,4 Although our primary endpoint was to assess patient adherence, the objective of this secondary analysis was to assess IVM efficacy in rosacea, regardless of clinical presentation.
METHODS
Thirty (30) adult subjects at Atrium Health Wake Forest Baptist Dermatology clinics were recruited after IRB approval. Inclusion criteria were age greater than or equal to 18 years, working knowledge of English, and clinical rosacea diagnosis (ICD-10: L71.9). Exclusion criteria were diagnosis of skin condition other than rosacea and known IVM allergy. All used IVM cream 1% once daily for three months. Subjects were followed at two visits: baseline and three-month follow-up to approximate real-world use. Adherence was assessed using the Medication Events Monitoring System cap. Disease severity was assessed using the Investigators Global Assessment (IGA) and Rosacea Severity Indices Global Assessment of Subtypes. One team member assessed the severity at each visit. Subjects also self-reported severity using a patient self-assessment tool (PSA), based on IGA. Three subjects
