PATHOGENETIC THERAPY OF A PATIENT WITH ERYTHEMATO-TELANGIECTATIC ROSACEA

Background. A female patient M., 31 years old, complained of unbearable itching, pain, redness, facial oedema, crusts on the face, lack of appetite. On examination: diffuse erythema, pronounced pastyness of the soft tissues of the face, multiple excoriations, tense, hot face from pronounced oedema and diffuse inflammatory process, xerosis, hyperkeratosis, a sharply positive leaf symptom, a sharply positive palpation test. The therapy was performed in accordance with the Patent for Invention No. 2811254. 1% hyaluronic acid was injected into the active projections, followed by the application of 15% azelaic acid to the activation zones. No recurrence and progression of skin angioedema was noted during 12 months of patient follow-up. The presented clinical case of erythemato-telangiectatic subtype of rosacea is unique and rare, shows the virtuosity of rosacea, as it can easily disguise itself as immediate and delayed-type hypersensitivity, resulting in erroneous patient management tactics with subsequent complication of the inflammatory process. Purpose. To review a complex clinical case complicated by previous treatment, and to choose an effective alternative therapy for the erythemato- telangiectatic subtype at the pathogenetic level. Materials and methods. For review and analysis, we studied a 31-year-old patient with a long medical history, misdiagnosed initially, complicated by treatment. The patient provided all the data on taking medications and the course of treatment before contacting the clinic. Injection therapy was performed according to the Patent for Invention No. 2811254. Biologically active points were treated with 1% hyaluronic acid, followed by the application of 15% azelaic acid. Results. The clinical result obtained after each procedure, 6, 12 and 48 months, was evaluated. The inflammatory process stagnated after 6 therapy procedures, and after 12 months the patient's skin condition was stable and there was no recurrence. Conclusion. After 6 procedures of injectable therapy with 1% hyaluronic acid and therapy with 15% azelaic acid, the clinical signs of skin inflammation in a patient with angioedema were resolved.