MECHANISMS OF ROSACEA PATHOGENESIS. A PHENOTYPIC APPROACH TO THERAPEUTIC TACTICS. DEMONSTRATION OF A CLINICAL CASE

Abstract

Rosacea is a widespread disease among the population, infected 5.5%. It is known that the activation of the innate and susceptible immune system, as well as neurovascular dysregulation underlying the manifestation of rosacea signs, do not fully explain all the clinical peculiarities of this disease. This dictates the prospect of continuing the diagnostic search and the therapeutic approach with the personalization of management tactics individually for the patient, depending on the prevalence of the manifestation of the characteristics of the course of the disease. A genetic predisposition to modified immune reactivity suggests an association of rosacea with single nucleotide polymorphisms in genes associated with the major histocompatibility complex. Currently, rosacea is considered as a single disease with several main phenotypes: facial erythema, telangiectasias, papulo-pustular manifestations, phimosis and ophthalmic rosacea. Most experts tend to think about the phenotypic approach in modern rosacea therapy, which should be aimed at achieving an improvement in the patient's overall well-being, focusing on those aspects that are most disturbing to the patient, based on the principles of evidence-based medicine. A clinical case of a patient with a papulo-pustular rosacea phenotype is presented. The high effectiveness of the therapy with systemic isotretinoin and topical support in the form of metronidazole and tacrolimus was demonstrated.