Rhinophyma: patient management

Postacne-persistent skin changes that appear as a result of long-term acne, inadequate therapy and manipulations performed in the management of this group of patients. The post-acne symptom complex is stable skin changes that appear as a result of long-term acne inadequate therapy and manipulations performed during the management of this group of patients. The pathogenetic mechanisms underlying the launch of acne currently look as follows: androgens cause hyperseborrhea, sebum lipids activate innate immunity; pathological keratinization due to the production of IL-1 inflammatory mediator and androgen hyperproduction; Cutibacterium acnes activate innate immune responses through toll-like receptors and metalloproteinases, stimulate the production of antimicrobial peptides and sebum production. The subsequent rupture of the follicles activates the wound healing process. Depending on the genetically determined features of the course of the inflammatory process, various individual postacne changes of the skin will prevail in different patients. The article highlights the main factors influencing the formation of post-acne, pathogenetic mechanisms underlying the formation of these changes, systematizes modern data on the classification, morphological and pathohistological characteristics of scars. Quantitative and qualitative scales of assessment of post-acne scars for determining the severity of the pathological process are presented, differentiated approaches to modern methods of therapy are discussed in detail, including the advantages and disadvantages of the most common methods of treating patients based on the principles of evidence-based medicine using a number of personalized methods.

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Mechanisms of rosacea pathogenesis. A phenotypic approach to therapeutic tactics

Drozhdina

Bobro

2022

Vestnik dermatologii i venerologii

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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.

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Rhinophyma: patient management

Cited by 5 publications

References 29 publications

Clinical analysis of patients with acne-like dermatoses

Clinical analysis of patients with acne-like dermatoses

Post-acne symptom complex. Approaches to therapy

Mechanisms of rosacea pathogenesis. A phenotypic approach to therapeutic tactics

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