Schaller Martin, Gonser Lena
Department of Dermatology, Eberhard Karls University Tübingen, Liebermeisterstrasse 25, 72076, Tübingen, Germany.
Drugs R D. 2016 Sep;16(3):279-283. doi: 10.1007/s40268-016-0141-0.
Rosacea is a chronic inflammatory disease that can manifest as a spectrum of symptoms including erythema, inflammatory lesions, edema, and telangiectasia. Treatment decisions need to be adapted to reflect the nature and severity of the different symptoms present. In this report, we discuss the case of a female patient diagnosed with severe, inflamed papulopustular rosacea (PPR) presenting with a large number of inflammatory lesions and severe background erythema. This patient responded well to a treatment regimen consisting of a short course of antibiotics in combination with a corticosteroid, followed by monotherapy with isotretinoin to reduce the inflammation. Brimonidine gel, used as needed, was then added to isotretinoin to target the remaining background erythema. This case of severe PPR required a combinatorial treatment regimen to effectively target all symptoms present. The patient continued to apply topical metronidazole throughout the different treatment regimens prescribed over the course of almost 1 year. Use of topical metronidazole helped to repair and protect the skin barrier, which minimized the occurrence of dermatological adverse events when topical treatments were used. We conclude that in patients with severe disease and an important inflammatory component, a rapid response can be obtained with a multimodal, tailored approach that also includes treatment to repair and protect the skin barrier.
酒渣鼻是一种慢性炎症性疾病，可表现为一系列症状，包括红斑、炎性损害、水肿和毛细血管扩张。治疗决策需要根据所出现的不同症状的性质和严重程度进行调整。在本报告中，我们讨论了一例被诊断为重度炎性丘疹脓疱型酒渣鼻（PPR）的女性患者，该患者出现大量炎性损害和严重的背景红斑。该患者对由短期抗生素联合皮质类固醇组成的治疗方案反应良好，随后用异维A酸单药治疗以减轻炎症。然后根据需要将溴莫尼定凝胶添加到异维A酸中，以针对剩余的背景红斑。这例重度PPR病例需要联合治疗方案来有效针对所有出现的症状。在近1年的不同规定治疗方案过程中，患者持续外用甲硝唑。外用甲硝唑有助于修复和保护皮肤屏障，从而在使用外用治疗时将皮肤不良事件的发生降至最低。我们得出结论，对于患有严重疾病且有重要炎症成分的患者，采用多模式、量身定制的方法（包括修复和保护皮肤屏障的治疗）可以获得快速反应。
