Successful treatment of rosacea by trephination combined with photodynamic therapy: A case report

• Patients often suffer from multiple subtypes of rosacea, requiring more precise assessments and individualized therapies. • The early treatment of rosacea can help prevent the progression to rhinophyma (phymatous type with hypertrophied). • Photodynamic therapy showed potential to treat rosacea with efficacy and safety. • Trepanation helps destroy blood vessels in erythemato-telangiectatic rosacea, preproccessing for Photodynamic therapy. • We present a successful case of erythemato-telangiectatic rosacea and rhinophyma treated with trepanation combined with photodynamic therapy. Rosacea is a chronic, inflammatory dermatological condition primarily affecting the central face, including the cheeks, nose, chin, and forehead[1]. It presents with erythema, phymatous changes, papules, pustules, and telangiectasia. The pathogenesis of rosacea is still unknown. Patients often suffer from multiple symptoms of rosacea, requiring more precise assessments and individualized therapies[2]. 5-Aminolevulinic acid photodynamic therapy (ALA-PDT) has shown promise as a safe and effective treatment for rosacea[3], especially in patients with multiple subtypes. To our knowledge, this is the first case of successful treatment involving a 46-year-old male patient with erythematotelangiectatic rosacea and phymatous changes using trephination combined with photodynamic therapy (PDT), improving quality of life without recurrence during the 9-month follow-up period.