APPLICATION OF INTENSIVE LIGHT RADIATION IN THE PATIENT WITH ERYTHEMATOTELANGIECTATIC ROSACEA
https://doi.org/10.20514/2226-6704-2018-8-1-71-76
Abstract
We present a description of the clinical case of a patient with an erythematotelangiectatic type of rosacea. Rosacea is a chronic recurrent dermatosis, characterized by skin lesions of the face in the form of erythema and papulopustular elements, which has polyethological origin. The disease occurs more frequently in women aged 30-50 years who have a certain genetic predisposition to transient reddening of the skin of the face or less often of the neck and the decollete zone. It is believed that the dermatosis is more likely to affect the I and II phototypes, but the disease can occur in any skin phototype. The patient came to the clinic with complaints about rashes in the chin and nasolabial triangle, flushing of the face, accompanied by tingling and burning. The patient turned to the clinic with complaints about rashes in the chin and nasolabial triangle, flushing of the face, accompanied by tingling and burning. She never consulted a dermatologist before. A diagnosis was made: “erythematotelangiectatic type of rosacea” (according to the classification proposed by the USA National Rosacea Society, stage I — persistent erythema and telangiectasia). Using the scale of diagnostic evaluation of rosacea, it was evaluated at 12 points. There are many approaches to the treatment of rosacea. Drug therapy is divided into systemic, external and complex. Systemic therapy has a number of side effects, so for light and medium-to- severe rosacea, only external therapy is more often prescribed. Because of the presence of pathologically altered vessels, the low efficacy of metronidazole, the patient was assigned a course of phototherapy with intense incoherent pulsating light at standard parameters. There was a significant improvement after two procedures, but vessels smaller than 0.4 mm remained intact, so the duration of the first pulse was increased in order to influence small- caliber vessels. Individual selection of parameters (duration of the first impulse and fluence) was made based on the dermatoscopic picture and patient’s phototype, which resulted in a significant clinical effect and persistent remission. Using the scale of diagnostic evaluation of rosacea it was evaluated at 1 point after treatment. This clinical case demonstrates the effectiveness of phototherapy with intense incoherent pulsating light with individual selection of the duration of the first pulse and energy density in patients with erythematotelangiectatic rosacea. In IPL-treatment schemes, it is desirable to select individual parameters for the duration of the first pulse and the energy density, based on the features of the dermatoscopic picture and skin phototype of each individual patient.
About the Authors
T. A. GaydinaRussian Federation
Department of dermatology, Medical faculty
Moscow
P. A. Skripkina
Russian Federation
Department of dermatology, Medical faculty
Moscow
A. O. Galayda
Russian Federation
E. G. Dvornikova
Russian Federation
E. I. Kaletnik
Russian Federation
E. V. Dontsova
Russian Federation
Department of dermatovenerology
Voronezh
References
1. Самцов А.В., Аравийская Е.Р. Федеральные клинические рекомендации по ведению больных акне. Российское общество дерматовенерологов и косметологов. Москва, 2015; 23 Samtsov A.V., Araviyskaya E.R. Federal clinical guidelines for managing acne patients. Russian Society of Dermatovenereology and Cosmetology, 2015; 23 [in Russian].
2. Коган Б.Г., Головченко Д.Я. Современные подходы в комплексном лечении пациентов с демодекозом и розовыми угрями. Клиническая иммунология. Аллергология. Инфектология. 2011; (1): 38—43 Kogan B.G., Golovchenko D.Ya. Modern approaches in complex treatment of patients with demodicosis and rosacea. Klinicheskaja immunologija. Allergologija. Infektologija. 2011; (1): 38—43 [in Russian].
3. Сай далиева В.Ш. Эффективность низких доз изотретиноина при лечении больных папуло-пустулезным подтипом розацеа. Лечебное дело. 2012; (2): 88—92 Saydalieva V.Sh. The effectiveness of low doses of isotretinoin in the treatment of patients with papulo-pustular subtype rosacea. Lechebnoe delo. 2012; (2): 88—92. [in Russian].
4. Давыдова А.В., Бакулев А.Л. Исследование личностных особенностей пациентов с розацеа. Саратовский научно-медицинский журнал. 2014; (3): 560-564 Davydova A.V., Bakulev A.L. Issledovanie lichnostnyh osobennostej pacientov s rozacea. Saratovskij nauchno-medicinskij zhurnal. 2014; (3): 560-564 [in Russian].
5. Кубанова А.А., Махакова Ю.Б. Розацеа: диагностика и лечение. Вестник дерматологии и венерологии. 2015; (4): 27-35. Kubanova A.A., Mahakova Ju.B. Rosacea: diagnosis and treatment. Vestnik dermatologii i venerologii. 2015; (4): 27-35 [in Russian].
6. Гайдина Т.А., Корчажкина Н.Б., Навасардян М.Г., Круглова Л.С. Сравнительная эффективность различных методик лазеротерапии хронических дерматозов. Физиотерапия. Бальнеология и реабилитация. 2011; (2): 37-40. Gaidina T.A., Korchazhkina N.B., Navasardyan M.G., Kruglova L.S. Comparative effectiveness of different methods of laser therapy for chronic dermatoses. Fizioterapiya. Balneologiya i reabilitatsya. 2011; (2): 37-40 [in Russian]
7. Schroeter C.A., Haaf-von Below S., Neumann H.A. Effective treatment of rosacea using intense pulsed light systems. Dermatol Surg. 2005; 31(10): 1285–1289.
8. Адаскевич В.П., Михалева Е.А. Диагностические показатели дерматологии: гид. Москва. Медицинская книга. 2004; 165 с. Adaskevich, V.P., Mihaleva E. Diagnosticheskie indeksy v dermatologii [Diagnostic indices in dermatology: a guide]. Moscow, Medical book. 2004; 165 р. [in Russian].
9. Goldman M.P. Treatment of benign vascular lesions with the Photoderm VL high-intensity pulsed light source. Adv. Dermatol. 1997; 13: 503—21.
10. Papageorgiou P., Clayton W., Norwood S. et al. Treatment of rosacea with intense pulsed light: significant improvement and long-lasting results. Br. J. Dermatol. 2008; 159 (3): 628—32.
11. Кубанова А.А., Махакова Ю.Б. Лечение больных розацеа широкополосным импульсным световым излучением с технологиями гладкий импульс и рециркуляция фотонов. Вестник дерматологии и венерологии. 2015; (4): 51-59. Kubanova A.A., Mahakova Ju.B. Treatment of patients with rosacea with broadband pulsed light radiation with smooth pulse and photon recirculation technologies. Vestnik dermatologii i venerologii. 2015; (4): 51-59 [in Russian].
12. Goldberg D.J. Current Trends in Intense Pulsed Light. The Journal of Clinical and Aesthetic Dermatology. 2012; 5(6): 45-53.
Review
For citations:
Gaydina T.A., Skripkina P.A., Galayda A.O., Dvornikova E.G., Kaletnik E.I., Dontsova E.V. APPLICATION OF INTENSIVE LIGHT RADIATION IN THE PATIENT WITH ERYTHEMATOTELANGIECTATIC ROSACEA. The Russian Archives of Internal Medicine. 2018;8(1):71-76. https://doi.org/10.20514/2226-6704-2018-8-1-71-76