A clinical case of combined therapy of papulopustular rosacea

A clinical case of 39-year-old patient with papulopustular rosacea is presented. The disease remains insufficiently studied: current studies confirm the involvement of innate and adaptive immunity as well as neurovascular mechanisms determining the spectrum of clinical manifestations. Internal and external triggers can initiate and amplify inflammatory pathways in rosacea. The pathology is manifested by transient and persistent erythema, episodes of hyperemia, papulopustular elements, telangiectasia and phymatous changes. The presence of skin symptoms often leads to psychological distress, low self-esteem, anxiety and depressive disorders. The objective of therapy is achieving long-term remission, but in practice a number of patients don’t achieve complete control of symptoms despite following the prescriptions. The strategy of combined action on key pathogenetic links remains relevant. This report considers the successful experience of combined application of topical metronidazole (1% cream) and systemic doxycycline in patients with papulopustular rosacea. The diagnosis was confirmed based on clinical data, medical history and physical examination. Additionally, a consultation of psychotherapist was also performed, after which therapy was expanded by inclusion of an anxiolytic agent. A significant positive dynamics was noted in presence of the treatment, the patient continues an outpatient follow-up. The presented case is important for practitioners dealing with rosacea and its psychoemotional aspects.