Changes in PACAP, CGRP, and VIP Levels in Rosacea Patients on Systemic Isotretinoin and Their Association with Erythema

Inclusion Criteria: * Patients aged 18 to 75 years with a diagnosis of papulopustular rosacea (PPR) * No history of systemic or topical medication use for rosacea or other dermatological conditions in the past four weeks * No known autoimmune or dysregulated systemic disease * No history of migraine, inflammatory bowel disease or malignancy * No daily sun exposure exceeding three hours * No excessive spice consumption (more than three times per week) * Non-smokers * No excessive tea or coffee consumption (more than three times per week) * Non-alcohol consumers * No contraindications for systemic isotretinoin treatment Exclusion Criteria: * Patients younger than 18 or older than 75 years or without a diagnosis of papulopustular rosacea (PPR) * History of systemic or topical medication use for rosacea or other dermatological conditions in the past four weeks * Presence of a known autoimmune or dysregulated systemic disease * History of migraine, inflammatory bowel disease, or malignancy * Daily sun exposure exceeding three hours * Frequent spice consumption (more than three times per week) * Smokers * Excessive tea or coffee consumption (more than three times per week) * Alcohol consumers * Presence of contraindications for systemic isotretinoin treatment