A Case of Complex Giant Rhinophyma Treated With Cosmetic Surgery.

ABSTRACT: Rhinophyma leads to severe facial deformities and significant social pressure for patients. Patients often seek medical intervention due to cosmetic defects and functional impairments, such as nasal congestion and airway collapse. Currently, there are numerous treatment modalities for rhinophyma, each with distinct advantages and disadvantages, leading to a lack of consensus in nasal vegetation management. Severe thickening in the nasal area can obstruct breathing through external nasal valve blockage, necessitating appropriate management for relief. This article presents a case study involving severe rhinophyma with respiratory obstruction that was successfully treated using incomplete resection followed by reconstruction to restore normal nasal contour. This not only achieved an upright position for nasal columella but also improved nasal contour to achieve normal appearance levels while completely relieving respiratory tract obstruction and enhancing patients' ventilation function. This method is easily performed without requiring additional expensive equipment, making it economically feasible even in ordinary medical centers while enabling patients to achieve a high quality of life.

Wound excision and closure by secondary intention and growth factor application in the management of rosacea complicated by giant rhinophyma.

BACKGROUND: Rosacea is a significant problem, affecting 5.5% of the world population. Currently used treatment techniques such as transfer flaps and implants are insufficient to meet the needs of many patients, which suggests that alternative approaches are needed. CASE REPORT: This report describes a case of rosacea complicated by giant rhinophyma treated with excision and closure by secondary intention and growth factor application. The patient was admitted to the Department of Dermatology at The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, in July 2021, and underwent excision of the external nasal redundancy under general anesthesia. The postoperative wound was left open. The patient's wounds healed completely 2 months after surgery, and there was no recurrence at 6-month follow-up. The wounds recovered well, with only slight scarring. CONCLUSION: The positive outcomes for this patient suggest that wound excision and closure by secondary intention and growth factor application may be beneficial for patients with rosacea complicated by giant rhinophyma.

A retrospective 10 years- experience overview of dye laser treatments for vascular pathologies.

INTRODUCTION: The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we gathered data from 10 years of experience regarding dye laser treatment of patients presenting vascular malformations such as telangiectasia, rhinophyma, port-wine stain, cherry and spider angioma and vascular tumours. METHODS: Subjects were enrolled from 2013 to 2023 based on the vascular anomalies they presented. They underwent different treatment sessions with the FPDL device. RESULTS: The age-range distribution by vascular anomaly confirmed that haemangiomas are typical in children while rhinophyma is a condition very common in older adults. A difference in sex distribution showed that pathologies such as telangiectasias typically affect women whereas rhinophyma is more frequent in men. Most of the treatments interested the face area but no permanent side effects were registered. CONCLUSIONS: Our 10 years of experience with FPDL demonstrated good results in a wide range of applications for the treatment of different vascular anomalies. The absence of long-term side effects and bearable pain during the treatment makes it a valuable solution for the resolution of benign tumours also in very young patients.

[Rosacea-the updated S2k guideline]. / Rosazea ­ die neue S2k-Leitlinie.

Rosacea is a common chronic inflammatory dermatosis of the face, clinically characterized by erythema, telangiectasia, papules, pustules, and rhinophyma. In January 2022, the updated guideline on rosacea was published. Groundbreaking innovations include the new clinical classification according to phenotypes, extended diagnostic and therapeutic recommendations for ocular rosacea and implications of the gut microbiome on rosacea. Furthermore, the guideline encompasses a new chapter on the psychosocial aspects of rosacea and detailed recommendations for approved and off-label therapies.

Rinofima: reporte de un caso de Clínica Estrella / Rhinophyma: a case report of Clínica Estrella

La rinofima es una patología que se caracteriza por presentar hipertrofia de las glándulas sebáceas con proliferación de tejido fibroso, donde la nariz toma un aspecto lobulado dando como resultado la deformidad de la punta nasal; es una forma de rosácea. La prevalencia de esta variedad de rosácea es de aproximadamente un 5-7% en la población y con predominio en el sexo masculino de la quinta a séptima década de vida. Su etiología no se conoce con exactitud. Se presenta el caso de un paciente masculino de 84 años, con antecedentes patológicos de hipertensión arterial e hipotiroidismo; su lesión inició hace 10 años, como una lesión eritematosa con presencia de telangiectasia a nivel de alas y punta nasal, no dolorosa. Se realizó tratamiento con bisturí frío y radiofrecuencia, se realizaron cortes transversales hasta dejar el lecho desprovisto del tumor y finalmente se usó radiofrecuencia en toda la superficie de la lesión restante. Se realizó el procedimiento ambulatorio sin complicaciones inmediatas o tardías

Rhinophyma is a pathology characterized by hypertrophy of the sebaceous glands with proliferation of fibrous tissue, the nose has a lobed appearance, as a result there is a deformity of the nasal tip; rhinophyma is a form of rosacea. The prevalence of this variety of rosacea is approximately 5-7% in the population and predominantly in males from the fifth to seventh decade of life, the etiology is not well known, however there are several predisposing genetic and environmental factors. We present the case of an 84-year-old male patient with a pathological history of arterial hypertension and hypothyroidism; his lesion began 10 years ago, as an erythematous lesion with presence of telangiectasia in the wings and nasal tip, not painful. Treatment was performed with a cold scalpel and radiofrequency, transverse cuts were made until the tumor was gone, and finally radiofrequency was used on the entire surface of the remaining lesion. The outpatient procedure was performed without immediate or late complications.

Angiosarcoma Mimicking Rhinophyma.

This case report describes a man in his 60s who was referred to the department of dermatology for further evaluation of a lesion on the nose.

Rinofima. Desfiguración estética de la anatomía nasal / RHINOPHYMA. AESTHETIC DISFIGURATION OF THE NASAL ANATOMY

Se describen distintos aspectos del rinofima: historia, etiopatogenia, histopatología, epidemiologia, clínica, diagnósticos diferenciales, tratamientos y pronóstico. Se hace hincapié en que es una enfermedad localizada en la nariz asociada a desórdenes generales, y que repercute en las áreas psicológica y social. Se presenta un caso clínico operado con cirugía plástica. Los autores plantean una hipótesis sobre la etiopatogenia y la fisiopatología de la enfermedad; y consideran a los tratamientos de rinofima como paliativos y no curativos

Different aspects of rhinophyma were described: history, etiopathogeny, histopathology, epidemiology, clinical, differential diagnoses, treatments and prognosis. It is emphasized that it is a localized disease in the nose associated to general disorders, and that it brings psychological and social problems. We present a case operated with plastic surgery. The authors present a hypothesis about the etiopathogeny and pathophysiology of the disease and consider rhinophyma treatments as palliative and non-curative.

A Novel Surgical Approach for Rhinophyma: Experience From a Cohort of Thirty Patients.

BACKGROUND: Rhinophyma is the severe rosacea whit hypertrophy of sebaceous glands in nasal tissue, which severely influences the patient's appearance. Surgical therapy is the best method for treating moderate-to-severe rhinophyma. In this study, we used a new ameliorated scarification for 30 patients with moderate-to-severe rhinophyma. OBJECTIVE: To observe the effect of five-blades scratcher surgery on moderate-to severe rhinophyma between 2016 and 2019 in our center. MATERIALS AND METHODS: A total of 30 patients were treated with five-blades scratcher under tumescent anesthesia. Outcomes were determined by a patient questionnaire. RESULTS: Of 30 patients, all of them answered the questionnaire and were included in this study with a follow-up time of 12 months. Cosmetic results were evaluated as very good or good in 90% of patients. The majority of patients (87%) were very satisfied or satisfied with the postoperative result. Surgical treatment of rhinophyma improved patients' quality of life in 67% of patients. Recurrence of rhinophyma was detected in 7% of patients. In all, 100% of the patients stated that they would recommend this treatment to others. CONCLUSIONS: Five-blades scratcher is an effective therapy for rhinophyma with excellent outcome.

A Surgical Management for Severe Rhinophyma With Five-Blade Scratcher.

ABSTRACT: Rhinophyma, the final stage of acne rosacea, severely influences the patient's appearance and can only be treated by surgical methods. This case reports a simple, safe, effective, and economical surgical method-five-blade scratcher. After the surgical treatment, the overall nasal contour of the patient, a male with severe rosacea, was restored without scar formation. Thus, this surgical method reported in this case is feasible and easy to operate, and worthy of clinical promotion.

[The rhinophyma through the prism of time]. / Rinofima cherez prizmu vremeni.

One of the frequent causes of a significant increase in the external nose, forming a persistent deformity of the face, as well as leading to a non-standard clinical picture is rhinophyma disease. The article considers some historical data, epidemiology, peculiarities of pathogenesis, as well as the basics of surgical treatment tactics along with possible preventive measures against rhinophyma. At present, the treatment of this pathology presents great difficulties. Despite the many surgical methods, rhinophyma is poorly treatable, often relapses and leaves no less noticeable disfigurement of the face in the postoperative period. In this regard, there is a constant search for new surgical methods, which has not only medical but also important social significance.

Treatment of Rhinophyma With Fractional CO2 Laser Resurfacing in a Woman of Color: Case Report and Review of the Literature.

Rhinophyma is a disfiguring disorder that is characterized by an erythematous, hypertrophied, and inflamed lower two-thirds of the nose. Widely accepted as the severe form of acne rosacea, rhinophyma can result in functional, aesthetic, and psychosocial concerns that require treatment in a cosmetic fashion. Rosacea should be treated in its earliest manifestations to mitigate the progression towards rhinophyma; therefore, early detection and intervention is a crucial part of treatment. Little has been written on this subject in people of color. We present the first reported case of rhinophyma in a 62-year-old Fitzpatrick V female patient who was successfully treated with one session of fractional CO2 laser resurfacing. This case highlights the successful use of the fractional CO2 laser to treat rhinophyma in darker skin types (Fitzpatrick IV–VI) and underscores the potential for future use among patients of color. J Drugs Dermatol. 2021;20(7):772-775. doi:10.36849/JDD.C702.

Surgical treatment of rhinophyma: Retrospective monocentric study and literature review.

BACKGROUND: Treatment of rhinophyma consists primarily of destructive procedures. There is currently no consensus regarding treatment. In this study, we propose an algorithm based on a cohort of 25 patients and a literature review. PATIENTS AND METHODS: This was a retrospective study conducted between January 2016 and December 2018. The cosmetic outcome was evaluated by 2 independent assessors based on pre- and postoperative photographs. Patients were ranked according to the severity (mild, moderate, severe) of their rhinophyma. The different surgical methods used were cold blade excision or rhinoshave, electrosurgery or monopolar diathermy knife (MDK), and carbon dioxide laser (CO2 laser), either alone or in combination with another technique. All patients were contacted after the procedure to evaluate their satisfaction and to investigate for adverse effects. RESULTS: Twenty-five patients were included retrospectively: 7 with mild rhinophyma (5 were treated by MDK, 1 by fractional CO2 laser, and 1 by cold-blade excision and TCA solution), 11 with moderate rhinophyma (2 were treated by MDK, 9 by continuous CO2 laser), and 7 with severe rhinophyma (2 were treated by MDK, 5 by MDK plus CO2 laser). Cosmetic outcomes were deemed good or excellent in 80% of cases, and 84% of patients were fully satisfied with the result. We observed 5 cases of hypertrophic scarring, 2 cases of hypopigmentation, 3 cases of notching of the nasal ala, and 7 cases of prolonged erythema, most of which were caused by the MDK technique. CONCLUSION: A wide range of treatment options are available for rhinophyma. We suggest the use of cold-blade excision and trichloroacetic acid or fractional carbon dioxide laser for mild rhinophyma, continuous and pulsed CO2 laser for moderate rhinophyma, and MDK for severe rhinophyma.