A Case of Rhinophyma in a 57-year old Male

Authors: Maria Criselda C. Valerio, MD, Patricia Anne Nicole Ramirez-Ecarma, MD, Vilma O. Pelino, MD, FPDS, Milali T. Torres, MD, FPDS, Dee Jay B. Arcega, MD, FPDS

Abstract

Introduction: Rhinophyma is a slowly progressive enlargement of the nose with irregular thickening of the skin and nodular deformation. This reflects the hypertrophy of the sebaceous glands in nasal skin. It occurs almost exclusively in middle-aged to elderly Caucasian men with a male predominance of 5:1. Exact pathogenesis remains unknown.

Case Summary: This is a rare case of a 57-year-old Filipino male who presents with a 1-year history of gradually enlarging mound of papules and nodule on the lower 2/3 of the nose associated with erythema, aggravated by exposure to heat or after intake of spicy food and drink. Skin punch biopsy revealed histopathologic findings consistent with Rhinophyma. Patient underwent Ablative and Fractional CO2 laser, a recommended treatment for moderate to severe rhinophyma. The patient underwent 2 sessions of Ablative CO2 laser for debulking and 2 sessions of Fractional CO2 laser for resurfacing resulting into a reported 85% improvement of lesions.

Conclusion: Rhinophyma is a chronic condition with no spontaneous resolution. Variety of external factors can aggravate the manifestation of the disease. Treatment of choice includes oral isotretinoin for mild rhinophyma and combination of oral isotretinoin and surgery for moderate to severe rhinophyma. Variety of surgical procedures are available with CO2 laser having the advantage of excellent hemostatic effect, better intraoperative visualization, minimal complications and satisfactory cosmetic results.

 

Citation

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Keywords

rhinophyma, phymatous rosacea, rosacea, fractional CO2 laser

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