Rosacea is a common, chronic condition seen most frequently in lightly pigmented skin presenting with centrofacial redness, papules, pustules, flushing, telangiectasia, and phymatous skin changes. Phymatous rosacea on the nose is called rhinophyma. This condition predominantly affects males in their 5th-7th decade of life. Rosacea has a complex pathophysiology involving the innate and adaptive immune system and its interaction with environmental stimuli. Correlation of non-melanoma skin cancer and rosacea is documented albeit uncommon, and none published from the Philippines.

This is a case of a 76-Year Old British male who presents with a 3 year history of skin colored mass on the nose, which was excised with paramedian forehead flap and was diagnosed with squamous cell carcinoma. In the interim, the patient noted the appearance of rubbery erythematous plaque on the nose with progressively increasing size and erythema and ulceration. Skin punch biopsies were done revealing both infiltrative basal cell carcinoma and rhinophyma. Patient was eventually seen by general surgery and underwent a wide excision.

This case highlights the importance of having a high index of suspicion for malignancies in the appropriate population. The different findings of biopsy sites also reminds us of choosing the appropriate biopsy sites for accurate and timely diagnosis. Lastly, a multidisciplinary approach for successful and comprehensive treatment is of paramount importance.

INTRODUCTION: Rhinophyma, aside from persistent centrofacial redness is a major diagnostic criteria for rosacea. Phyma may be mistaken for hypertrophy of tissue due to an underlying hemangioma. CASE REPORT: A 35-year-old female presented with few erythematous papules on the face and nose 19 years prior to consult. Lesions evolved into multiple erythematous nodules on nose and was mistaken for tissue hypertrophy due to an adjacent congenital hemangioma. Her hemangioma was treated with pulsed dye laser 16 years prior with noted decrease in size and erythema. Recently she noticed enlargement of her nose with persistent redness. She presented with multiple firm, thick irregularly shaped erythematous nodules with prominent pilosebaceous pores and telangiectasia on the nose. Skin punch biopsy was done which revealed hypertrophy and lysis of sebaceous lobules with a moderately dense inflammatory infiltrate of lymphocytes. Histopathological diagnosis was rhinophyma. Patient was treated with low dose isotretinoin (0.20 mkd) with marked flattening of lesions in just one month. CONCLUSION: Distinguishing phyma from tissue hypertrophy caused by hemangioma poses as a diagnostic challenge. Careful dermatological examination and histopathological findings will aid in correct diagnosis. Low dose oral isotretinoin is an effective treatment for rhinophyma.
Rhinophyma ; Isotretinoin ; Rosacea ; Hemangioma ; Hydrozoa

No abstract available.
Rhinophyma*

No abstract available.
Light ; Rhinophyma

A rhinophyma lesion can mask the existence of coexisting occult skin cancers, and many types of tumors can mimic a rhinophyma. Although several coexistent malignant tumors have been reported in patients with rhinophyma, few reports have described the coexistence of rhinophyma and cutaneous squamous cell carcinoma (SCC). Herein, we report on a case of SCC in a 45-year-old man who presented with 2-month-history of a painful, erythematous, globular plaque on the tip of his nose and this lesion mimicked a rhinophyma lesion. The histopathologic examination showed a proliferation of atypical squamous cells that extended into the dermis, which was consistent with SCC. He was treated with surgical excision, and there has been no evidence of recurrence during the follow-up period of 1 year.
Carcinoma, Squamous Cell ; Dermis ; Follow-Up Studies ; Humans ; Hydrazines ; Masks ; Middle Aged ; Nose ; Recurrence ; Rhinophyma ; Skin Neoplasms

Rhinophyma is characterized by a disfiguring soft tissue hypertrophy of the nose. Severe cosmetic deformity and impairment of breathing may coexist, making the surgical treatment necessary. We present a case of giant rhinophyma, who had difficulty in nasal breathing and took preventive aspirin for CVA. We treated this patient with scalpel tangential excision and skin graft. A giant rhinophyma involved two thirds of nasal dorsum, nasal tip, and both alae. The patient withdrew aspirin 7 days prior to surgery, and rhinophyma was excised with scalpel. The defect was covered with full-thickness skin graft from right supraclavicular area. Five days after surgery, the patient resumed to take aspirin. A skin graft was taken completely and a pathologist confirmed an excised specimen to be a rhinophyma. Within 1 month postoperatively, the patient showed more natural nasal contour and improvement of nasal respiration. Six months after the operation, the nose represented a good appearance without recurrence of rhinophyma. We present a case of giant rhinophyma which had bleeding tendency because of preventive aspirin. We treated this case with scalpel excision and full-thickness skin graft, instead of secondary intention wound healing.
Aspirin ; Congenital Abnormalities ; Cosmetics ; Hemorrhage ; Humans ; Hypertrophy ; Intention ; Nose ; Recurrence ; Respiration ; Respiration Disorders ; Rhinophyma ; Skin ; Transplants ; Wound Healing

RHINOPHYMA NOSE SKIN DISEASES

Rhinophyma is a disfiguring soft tissue hypertrophy of the nose. It is an uncommon disease that primarily affects Caucasian men in the fifth to seventh decades of life. Many treatment methods have been advocated, often with acceptable success, but there appears to be no one modality that is universally endorsed. We present a case of a 70 year old male who was treated with dermabrasion for rhinophyma in the nose.
Aged ; Dermabrasion ; Humans ; Hypertrophy ; Male ; Nose ; Rhinophyma*

Kimura's disease is a benign, uncommon, chronic inflammatory condition that usually presents with painless subcutaneous nodules or plaques. Head and neck are the most frequently involved sites in Kimura's disease. Mandible is the most commonly involved, followed by neck, cheek, scalp and forehead. Other possible sites are oral cavity, inguinal area and extremities, but there have been no reports involving the nose, especially the one that looks like a rhinophyma. We describe a case of Kimura's disease presenting like a rhinophyma.
Cheek ; Extremities ; Forehead ; Head ; Mandible ; Mouth ; Neck ; Nose ; Rhinophyma ; Scalp

BACKGROUND: Rosacea is a chronic skin disease which primarily affects the face. There have been many basic and clinical studies on rosacea in the West, but little in Korea. OBJECTIVE: This study was to investigate clinical features of rosacea in Korea and to compare them with those in the West. METHODS: During a 20-month period, 67 patients diagnosed as having rosacea were examined for their clinical presentations by means of personal interview. RESULTS: Erythema and telangiectasia were found in almost all of the 67 patients. Comparing with the results in the West, flushing and telangiectasia were more common whereas papules, pustules, and rhinophyma were less common with no case of ocular complaints or migraine. CONCLUSION: Because early detection and treatment is necessary to prevent the progression of rosacea, it is important to realize that rosacea is not uncommon in Korea and to recognize its somewhat different clinical manifestations from those in the West.
Erythema ; Flushing ; Humans ; Korea ; Migraine Disorders ; Rhinophyma ; Rosacea* ; Skin Diseases ; Telangiectasis