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.

государственный медицинский университет» министерства здравоохранения российской Федерации 2 КогБуЗ "Кировский областной клинический кожно-венерологический диспансер" Clinic, diagnostics and treatment of bullous epidermolysis

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Rhinophyma is a rare subtype of rosacea, which is a thickening of the skin in the nasal area due to an overgrowth of the sebaceous glands and the underlying connective tissue. The exact pathogenesis of rhinophyma is unknown, but potential factors include a combination of neurovascular disorders, innate immune responses, and the presence of microorganisms. The article presents current data on the treatment of rosacea, in particular, rhinophyma. A clinical case of a 67-year-old patient with a combination of papulo-pustular subtype of rosacea and rhinophyma is presented. The high effectiveness of the therapy with systemic isotretinoin was demonstrated.

The paper reviews current data on lichen ruber planus, a disease characterized by multifactorial pathogenesis, polymorphic clinical symptoms, severe long recurrent course, and a significant resistance to treatment. In the last decades, a substantial growth in the prevalence of this dermatosis is observed. Moreover, the rate of atypical cases also increases. The most common symptoms at disease onset are a generalized rash, severe itching, and malaise. Many patients present with acute clinical signs. Patients with the different forms of the disease (in particular, those with oral lichen planus) report on the significant reduction in the quality of life. The authors describe the specificity of clinical polymorphism, the variability of clinical manifestations and HLA system in annular lichen planus. The aim of this paper is to summarize currently available data considering the diversity of clinical variants which are required for the understanding of the pathogenesis to improve the diagnosis in difficult cases and to control its course. The authors also address a case study of annular lichen planus in a 63-year-old woman. KEYWORDS: lichen ruber planus, dermatosis, histopathology, HLA system. FOR CITATION: Zakhur I.I., Koshkin S.V., Bobro V.A. Annular lichen planus, a rare variant of lichen planus. Russian Medical Inquiry. 2020;4(10):642–646. DOI: 10.32364/2587-6821-2020-4-10-642-646.