Subject(s)
Ivermectin , Rhinophyma , Ivermectin/administration & dosage , Ivermectin/therapeutic use , Humans , Rhinophyma/drug therapy , Rhinophyma/pathology , Male , Female , Middle Aged , Administration, Topical , Adult , Antiparasitic Agents/administration & dosage , Antiparasitic Agents/therapeutic use , Treatment Outcome , AgedABSTRACT
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.
Subject(s)
Humans , Male , Aged, 80 and over , Rhinophyma/pathology , Sebaceous Glands/pathology , Fibrosis/pathology , Radiofrequency TherapyABSTRACT
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.
Subject(s)
Humans , Male , Middle Aged , Palliative Care , Rhinophyma/etiology , Rhinophyma/history , Rhinophyma/pathology , Rhinophyma/therapy , Rhinophyma/epidemiology , Nose/anatomy & histology , Diagnosis, DifferentialABSTRACT
Rhinophyma affects predominantly the Caucasian population and is rare in those with Fitzpatrick skin type IV-VI. Diagnosis is based on clinical evaluation. Prominent features include abnormal coloration and texture of skin, impaired vascularity, irregular nodular exophytic growth and telangiectasia. Management can be surgical or dermatological. Surgery remains the mainstay of treatment but achieving an acceptable aesthetic result can be challenging, particularly in those with pigmented skin. Postsurgical hyper- and hypopigmentation make for unpredictable outcomes requiring appropriate preoperative counselling. We present a case that exemplifies this issue and discuss our recommended approach to counselling, consenting and managing such dilemmas in these patients, and a proposal for further investigation into the role of autologous melanocyte transplantation in reducing the effect particularly of hypopigmentation on aesthetic outcomes in this group.
Subject(s)
Dermatologic Surgical Procedures/adverse effects , Hyperpigmentation/etiology , Hypopigmentation/etiology , Rhinophyma/surgery , Esthetics , Humans , Male , Melanocytes , Middle Aged , Patient Satisfaction , Rhinophyma/pathology , Skin/pathologySubject(s)
Rhinophyma/pathology , Aged , Humans , India , Male , Plastic Surgery Procedures , Rhinophyma/surgerySubject(s)
Carcinoma, Basal Cell/diagnosis , Hutchinson's Melanotic Freckle/diagnosis , Nose Neoplasms/diagnosis , Rhinophyma/surgery , Skin Neoplasms/diagnosis , Aged , Carcinoma, Basal Cell/complications , Carcinoma, Basal Cell/pathology , Cytoreduction Surgical Procedures , Humans , Hutchinson's Melanotic Freckle/complications , Hutchinson's Melanotic Freckle/pathology , Incidental Findings , Male , Middle Aged , Nose Neoplasms/complications , Nose Neoplasms/pathology , Rhinophyma/complications , Rhinophyma/pathology , Skin/pathology , Skin Neoplasms/complications , Skin Neoplasms/pathologyABSTRACT
A 42-year-old woman presented with a clinically obvious giant rhinophyma. The protocol of the unit handling the case mandated that all lesions amenable to biopsy should have a core biopsy before any definitive surgery, but the unnecessary biopsy was not representative and suggested an incorrect diagnosis of perifollicular fibroma. The lesion was excised. The sections showed dilated hair follicle pores on the skin surface, squamous lined hair follicles plugged with keratin, prominent sebaceous glands, perifollicular inflammation without granulomas, intradermal budding of hair follicle basal cells, and extensive hypocellular, mildly edematous fibrous tissue with slightly dilated, thin-walled vessels and a few chronic inflammatory cells. These fully representative sections confirmed the diagnosis of giant rhinophyma, suggesting that preoperative core biopsies of this condition are unnecessary and may be misleading.
Subject(s)
Nose/pathology , Rhinophyma/pathology , Adult , Female , Humans , Nose/surgery , Rhinophyma/surgeryABSTRACT
Rhinophyma is a skin condition that affects the nose. It is often characterised by a large, red, bulbous nose. It can have a physical, psychological and social impact on the patient. Management options include conservative medical therapy such as retinoids or surgical excision followed by reconstruction as required. The reconstruction options can range from a dermal substitute full-thickness skin graft to local flaps, depending on the wound bed. We present a severe case of rhinophyma that required a complex reconstruction with a three-stage forehead flap because of the mass effect and the wound that resulted from the surgical excision of an extremely large and troublesome rhinophyma.
Subject(s)
Forehead/surgery , Rhinophyma , Skin Transplantation/methods , Surgical Flaps/surgery , Aged , Humans , Male , Rhinophyma/pathology , Rhinophyma/surgerySubject(s)
Carcinoma, Squamous Cell/complications , Lupus Erythematosus, Cutaneous/pathology , Rhinophyma/etiology , Skin Neoplasms/pathology , Aftercare , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy/methods , Drug Therapy , Female , Humans , Hypertrophy , Interleukin-3 Receptor alpha Subunit , Lupus Erythematosus, Cutaneous/diagnosis , Lupus Erythematosus, Discoid/complications , Lupus Erythematosus, Discoid/pathology , Middle Aged , Radiotherapy , Rhinophyma/pathology , Rhinophyma/therapy , Treatment OutcomeSubject(s)
Carbon Dioxide , Lasers, Gas/therapeutic use , Rhinophyma/surgery , Aged , Humans , Male , Rhinophyma/pathology , Treatment OutcomeSubject(s)
Rhinophyma/surgery , Rhinoplasty/methods , Aged , Humans , Male , Rhinophyma/pathology , Surgical Wound , Treatment Outcome , Wound HealingSubject(s)
Cicatrix/surgery , Dermabrasion/instrumentation , Electrocoagulation/instrumentation , Mohs Surgery/adverse effects , Nose , Rhinophyma/surgery , Cicatrix/etiology , Cicatrix/pathology , Female , Humans , Male , Middle Aged , Retrospective Studies , Rhinophyma/pathology , Treatment OutcomeABSTRACT
BACKGROUND: Rhinophyma is the overgrowth of sebaceous glands in nasal tissue and its etiology unclear. Without treatment, rhinophyma can be progressive and cause concern both with respect to function and cosmesis. OBJECTIVE: The objective of this work is to describe treatment options for rhinophyma and their respective risks and benefits. MATERIALS AND METHODS: A PubMed search was performed to include the terms "rhinophyma" and "treatment." RESULTS: Numerous physically destructive modalities exist for treatment of rhinophyma, falling primarily into 3 categories: mechanical destruction, directed electrical energy/radiofrequency, and directed laser energy. CONCLUSION: There are multiple treatment modalities available to dermatologists for the treatment of rhinophyma. To the best of our knowledge, there are no randomized, prospective, control studies for any treatment, which makes it difficult to recommend a single treatment over another. Nonetheless, it is important to recognize that scarring and hypopigmentation most often occur on or near the nasal ala. Moreover, risks may increase if tissue destruction extends to the papillary dermis or pilosebaceous units are ablated.
Subject(s)
Dermatologic Surgical Procedures , Rhinophyma/surgery , Humans , Rhinophyma/pathologySubject(s)
Neurilemmoma/pathology , Nose Neoplasms/pathology , Rhinophyma/pathology , Surgery, Plastic , Female , Humans , Middle Aged , Neurilemmoma/psychology , Neurilemmoma/surgery , Nose Neoplasms/psychology , Nose Neoplasms/surgery , Patient Satisfaction , Quality of Life , Rhinophyma/psychology , Treatment OutcomeABSTRACT
Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment. We present a 63-year-old male with the necessity for tracheostomy at the ICU due to total nasal obstruction and recurrent episodes of pneumonia caused by a huge giant rhinophyma, which had undergone extreme growth in the last five years. The tumor was removed under general anesthesia by decortication with an electrosurgical wire loop to recreate the aesthetic units of the nose preserving the alar cartilage as well as the pilosebaceous appendages. The wounds healed in by secondary intention with a very pleasant cosmetic and improved functional result. The relevant literature is discussed. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Subject(s)
Nasal Obstruction/etiology , Rhinophyma/pathology , Rhinophyma/surgery , Rhinoplasty/methods , Disease Progression , Follow-Up Studies , Humans , Male , Middle Aged , Nasal Obstruction/physiopathology , Nasal Obstruction/surgery , Rare Diseases , Risk Assessment , Rosacea/complications , Rosacea/pathology , Severity of Illness Index , Treatment OutcomeABSTRACT
BACKGROUND: Different methods can be used in the surgical treatment of patients with rhinophyma. There are limited numbers of reports on high-frequency electrosurgery treatment. In addition, an efficient scoring system is required to evaluate severity of the disease in clinical progress and recurrence after treatment. OBJECTIVES: We evaluated patients with rhinophyma who were treated with high-frequency electrosurgery and discussed the methods used to assess severity of the disease. METHODS: Data and photos of 13 patients were retrospectively evaluated and scored via 2 different forms of the rhinophyma severity index. RESULTS: Median rhinophyma severity index scores of patients at first visits were significantly higher than those at second and third visits ( P = .002 and P = .002, respectively). Likewise, median modified rhinophyma severity scores of patients at first visits were significantly higher than those at second and third visits ( P = .001 and P = .001, respectively). Also, there was a strong positive correlation between these 2 assessment methods ( r = 0.838, P < .001). CONCLUSIONS: The rhinophyma severity assessment methods used in this study are positively correlated. High-frequency electrosurgery seems to be a procedure that is safe, effective, and relatively cost-effective in the treatment of rhinophyma lesions.
Subject(s)
Electrosurgery , Rhinophyma , Adolescent , Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Nose/pathology , Nose/surgery , Rhinophyma/diagnosis , Rhinophyma/pathology , Rhinophyma/surgery , Severity of Illness Index , Treatment Outcome , Young AdultABSTRACT
Introdução: Rinofima é uma inflamação crônica dos tecidos do nariz, caracterizada por hipertrofia e hiperplasia progressivas das glândulas sebáceas e do tecido conjuntivo. Determina um aspecto de elefantíase nasal, secundária à congestão dos vasos da derme. Sua etiologia está associada, na maioria dos casos, ao uso abusivo de álcool. É considerada por alguns autores como sendo um estágio avançado de acne rosácea. O artigo tem como objetivo relatar um caso de rinofima, tratado cirurgicamente no Serviço de Cirurgia Plástica do Hospital Universitário da Universidade Federal de Santa Catarina com decorticação e eletrocoagulação. Método: Foi realizado revisão de prontuário e registro fotográfico de um caso de rinofima. Resultados: Paciente foi submetido a tratamento cirúrgico com evolução favorável. Conclusão: Existem diversos tratamentos para rinofima, sendo que a decorticação e a eletrocoagulação constituem uma excelente opção terapêutica.
Introduction: Rhinophyma is a condition involving chronic inflammation of the nose and is characterized by progressive hypertrophy and hyperplasia of sebaceous glands and connective tissue. Rhinophyma leads to an appearance of nasal elephantiasis, which is caused by the congestion of dermis vessels. Its etiology is mostly associated with alcohol abuse. Rhinophyma is considered by some researchers to be an advanced stage of acne rosacea. Here, we report a case of rhinophyma that was surgically treated with decortication and electrocoagulation at the Plastic Surgery Service of the University Hospital of the Federal University of Santa Catarina. Methods: A review of medical and photographic records of a case of rhinophyma was conducted. Results: The patient was underwent surgical treatment with favorable outcomes. Conclusion: There are several treatments for rhinophyma, with decortication and electrocoagulation being an excellent therapeutic option.