Granulomatous variant rosacea. Patients treatment experience

Granulomatous variant rosacea is a rare form of rosacea, which is characterized by a special clinical picture and approaches to patient management that differ from traditional rosacea. The clinical picture of granulomatous rosacea is represented by the monomorphic papules, which tends to be yellow on dermotoscopy. Treatment of this variant of rosacea is difficult, the first-line therapy of rosacea is ineffective. The article presents two cases of granulomatous rosacea similar in clinical picture, gender and age of patients, but with different approaches of treatment. Both patients were prescribed therapy with 0.1% tacrolimus ointment 2 times a day for a month,10 procedures of photodynamic therapy. One of the patients was planning a pregnancy, in which case treatment with isotretinoin was excluded, and the other patient agreed to systemic therapy with isotretinoin. Systemic isotretinoin has been shown to be effective in a patient with granulomatous rosacea and it has been achieved long-term remission at a dose of less than 0.2 mg/kg body weight for 6 months.