THE ROLE OF LYMPHATIC DRAINAGE THERAPY AT HOME IN A PATIENT WITH ERYTHEMATO-TELANGIECTATIC SUBTYPE OF ROSACEA

Background. Patient S., 28 years old, complained of redness of the face, swelling, burn of the skin to stress, sun, wind and temperature changes. The redness was permanent, which caused anxiety in the patient and contributed to increased hot flashes and fever in the face. The patient's skin condition worsened over the past 2 years, the swelling began to increase, became permanent, the dryness of the face increased (the patient could not remove it herself with home remedies), a dry crust appeared on the face, the face "stopped breathing", "as in a shell", there were restrictions in facial activity. On examination: erythema of the cheeks, forehead, temporal region, chin, pronounced skin sensitization in the décolleté area, pronounced pastyness of the soft tissues of the face with emphasis in the middle third of the face, xerosis, pronounced hyperkeratosis, crusts in the forehead, cheeks, nose, traces of excoriation, a positive symptom of white glasses (characterized by white skin color around the eyes with a clear demarcation zone), a sharply positive “leaf ” symptom (a characteristic feature for patients with rosacea, manifested by the appearance of a characteristic rustling sound (rustle of dry foliage) when running a hand in a medical glove over the surface of the patient's skin, especially with severe xerosis. The more pronounced the dryness of the skin was, the more pronounced this test became. А positive palpation test (significant increase of erythema to the focus of mechanical irritation of the skin during palpation, friction for more than 3 minutes).Examination of the body revealed pronounced fibrosis of the subcutaneous fatty tissue of the outer surface of the legs, abdomen, which indicated persistent lymphostasis of the lower extremities, pelvic organs, and face, contributing to a large area of skin damage in patients with rosacea (often involving the décolleté area, which we observe in a specific clinical case). Pathogenetic home therapy was prescribed in accordance with the clinical picture of rosacea and the concomitant condition of the patient. The presented clinical case of a patient with erythemato-telangiectatic subtype of rosacea clearly demonstrated the complexity of the pathology, the variability of the prevalence of different pathogenesis links in pathology, and the importance of personalized home care appointment and management (correction of home care every 2 months based on the patient's clinical condition at the time of examination). Purpose. To analyze the presented clinical case, to develop effective pathogenetic home care in a patient with erythemato-telangiectatic subtype, to carry out a competent correction of the appointment of cosmeceuticals based on the dynamics of the process. Materials and methods. To understand the dominant links of pathogenesis, the medical history of Patient S. 28 was analyzed. The patient provided all the data on the intake and use of drugs and cosmetics before contacting the Clinic of Dermatology and Cosmetology "MDElena". Home care products were prescribed based on the links in the pathogenesis of the erythemato-telangiectatic subtype of rosacea, and the patient was monitored during home therapy. Results. The patient was observed later 14, 28, 60, 90, 120 and 180 days after the appointment of pathogenetically based home care. Clinical manifestations of rosacea decreased by 40% after 14 days of prescribing cosmeceuticals, the inflammatory process was stopped after 28 days, and stagnation of the aseptic inflammatory process was achieved after 60 days. Conclusions. After the home care appointments, the signs of inflammation of the facial skin were completely eliminated and sensitization of the skin of the décolleté was stopped.