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1.
J Craniofac Surg ; 32(8): 2821-2822, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727484

RESUMO

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.


Assuntos
Rinofima , Rosácea , Cicatriz , Humanos , Masculino , Nariz/cirurgia , Rinofima/cirurgia , Instrumentos Cirúrgicos
2.
Vestn Otorinolaringol ; 86(4): 95-98, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34499455

RESUMO

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.


Assuntos
Rinofima , Humanos , Nariz , Rinofima/diagnóstico , Rinofima/epidemiologia , Rinofima/cirurgia
3.
J Drugs Dermatol ; 20(7): 772-775, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34231998

RESUMO

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.


Assuntos
Lasers de Gás , Rinofima , Estética , Feminino , Humanos , Lasers de Gás/uso terapêutico , Pessoa de Meia-Idade , Nariz/cirurgia , Rinofima/diagnóstico , Rinofima/cirurgia , Rosácea/diagnóstico
5.
Ann Dermatol Venereol ; 148(3): 172-176, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34176641

RESUMO

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.


Assuntos
Eletrocoagulação/métodos , Lasers de Gás/uso terapêutico , Rinofima/cirurgia , Humanos , Terapia a Laser , Estudos Retrospectivos , Resultado do Tratamento
7.
Ann R Coll Surg Engl ; 103(5): e165-e168, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33930281

RESUMO

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.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Hiperpigmentação/etiologia , Hipopigmentação/etiologia , Rinofima/cirurgia , Estética , Humanos , Masculino , Melanócitos , Pessoa de Meia-Idade , Satisfação do Paciente , Rinofima/patologia , Pele/patologia
9.
Lasers Med Sci ; 36(6): 1283-1287, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33411129

RESUMO

Rosacea has an overall female predominance; however, rhinophyma, a feature attributed to advanced rosacea, is exceedingly rare in females. The impact of this condition on quality of life can be profound. Multiple treatment modalities have been described. However fully ablative carbon dioxide (CO2) laser for moderate-severe rhinophyma has been shown to be most effective with good cosmetic outcome and high patient satisfaction. We describe a series of 7 female patients presenting with rhinophyma to a tertiary NHS laser centre and a private dermatology clinic. A retrospective case review of rhinophyma management was performed, assessing presentation, treatments and outcomes. The mean age at presentation was 47 years (27-62 years). Three patients developed rhinophyma before the age of 30 years. One patient had severe, 2 patients had moderate and 4 patients had minor rhinophyma. Four patients underwent fractional CO2 laser treatment with a good cosmetic outcome. Two further patients developed scarring following fully ablative CO2 laser. Long-term low-dose oral isotretinoin was used in 3 patients following laser treatment, to prevent relapse. One patient solely received isotretinoin with a good outcome. In our experience, females suffering with rhinophyma presented for treatment at an early age and stage of severity. Fractional or fully ablative CO2 laser alone or in combination with oral isotretinoin is a very effective treatment modality.


Assuntos
Rinofima , Adulto , Dióxido de Carbono , Cicatriz , Feminino , Humanos , Terapia a Laser , Lasers de Gás/uso terapêutico , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Qualidade de Vida , Estudos Retrospectivos , Rinofima/cirurgia , Rosácea , Resultado do Tratamento
12.
Br J Oral Maxillofac Surg ; 59(2): 222-227, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32951923

RESUMO

Rhinophyma is a progressive disease of the nose, which is characterised by skin thickening and sebaceous hyperplasia. Patients with rhinophyma are often stigmatised due to worsening disfigurement of their nose. This can also result in functional impairment such as reduced nasal patency. Severe cases of rhinophyma are best managed with varied surgical interventions, as there is no clear 'gold standard' treatment that has been described. We present our experiences in the management of rhinophyma and the evolution of treatment modalities that have been employed over a nine-year period.


Assuntos
Rinofima , Humanos , Hiperplasia , Nariz , Rinofima/cirurgia
14.
Facial Plast Surg ; 37(1): 122-131, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32886947

RESUMO

Rhinophyma is a progressive and disfiguring thickening of the nasal skin. It is typically found in middle-aged or elderly Caucasian males. The exact cause of the disease is unknown. There is excessive formation of scar-like tissue and hyperplasia of the sebaceous glands. This article will demonstrate our experience of treating rhinophyma using a combined surgical approach and propose a novel classification system. This is a retrospective analysis of cases operated by a single surgeon over 9 years using the Glasgow Benefit Inventory (GBI) tool. Thirty-three patients were identified. Twenty-nine patients had three techniques used in one sitting, two patients had two techniques used, and two further patients had one technique used. Total GBI showed a +50.99 result following surgery. Rhinophyma treatments can benefit patients as demonstrated by the GBI outcome. This can improve the patients' quality of life. The use of more than one technique in the same sitting potentially improves the outcome. Our classification system helps categorize the disease better as well as choosing the treatment and comparing disease and treatment. The Level of Evidence for the study is 4.


Assuntos
Qualidade de Vida , Rinofima , Idoso , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade , Nariz , Estudos Retrospectivos , Rinofima/cirurgia , Resultado do Tratamento
16.
Laryngorhinootologie ; 99(11): 772-778, 2020 11.
Artigo em Alemão | MEDLINE | ID: mdl-33111293

RESUMO

Rhinophyma is a benign disease involving the skin of the nose, which is characterized by skin thickening and hypertrophy of the sebaceous glands and connective tissue. It occurs predominantly by Caucasians in their fifth to seventh life decades and is 12-30 times more likely to affect males. The etiology and pathogenesis of Rhinophyma remains unclear, however it is generally stated to be the final stage of rosacea. A causative relationship between rhinophyma and alcohol consumption has not yet been proven. This review highlights the treatment options of rhinophyma. Surgery is gold standard for management of advanced rhinophyma. Each technique has pros and cons, but using surgical instruments with monopolar energy as loop and ball electrode seem to combine several goals best - first of all simultaneous removal and hemostasis followed by nasal contour refinement. Due to possible coincidence of skin cancer such as a basal- or squamous cell carcinoma, histopathological examination of all removed tissue is recommended.


Assuntos
Rinofima , Rosácea , Neoplasias Cutâneas , Humanos , Hipertrofia , Masculino , Nariz , Rinofima/cirurgia
17.
Adv Anat Pathol ; 27(6): 422-424, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33027095

RESUMO

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.


Assuntos
Nariz/patologia , Rinofima/patologia , Adulto , Feminino , Humanos , Nariz/cirurgia , Rinofima/cirurgia
18.
Ann R Coll Surg Engl ; 102(8): e219-e222, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32808811

RESUMO

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.


Assuntos
Testa/cirurgia , Rinofima , Transplante de Pele/métodos , Retalhos Cirúrgicos/cirurgia , Idoso , Humanos , Masculino , Rinofima/patologia , Rinofima/cirurgia
19.
J Oral Maxillofac Surg ; 78(12): 2296.e1-2296.e7, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32640206

RESUMO

Rhinophyma, an unsightly and obstructive skin lesion of the nasal area, can be difficult to treat. Numerous modalities have been tried, including medical, excision, and ablation, with various tools and results. In the present report, we have demonstrated the use of the carbon dioxide (CO2) laser on the nose of a 56-year-old man, with excellent cosmetic results even at 59 months after treatment. Discussion of the disease entity and the advantages and disadvantages of the different treatment options are presented. Given the results shown in our patient, we believe that CO2 laser ablation should be a standard treatment of rhinophyma, given its practicality, predictability, and excellent outcomes.


Assuntos
Terapia a Laser , Lasers de Gás , Rinofima , Dióxido de Carbono , Humanos , Lasers de Gás/uso terapêutico , Masculino , Pessoa de Meia-Idade , Nariz , Rinofima/cirurgia
20.
Med Hypotheses ; 143: 110097, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32721796

RESUMO

BACKGROUND: Rhinophyma is a skin disorder which causes nose enlargement and deformation due to proliferation of sebaceous glands and connective tissue. It is not only an aesthetic problem but may also lead to impaired nasal breathing and problems with liquids intake. HYPOTHESIS: Although rhinophyma is considered to be a subtype of rosacea, here we hypothesise whether it is a separate disease with mechanical trauma as a main reason of the disease progress. METHODS: 22 patients with diagnosed rhinophyma were qualified for the study. All patients were physically examined and detailed patients' medical history was obtained. Patients were asked to answer a number of questions regarding their usual skin care, purification procedure as well as handling of the nose and nasal cavity. Results were subjected to statistical analysis. RESULTS: Due to our observations there is a group of patients who have never presented any typical symptoms of rosacea while they are now suffering from rhinophymatous changes. Most of those patients confirmed longlasting mechanical nose cleaning which included any skin lesions removal by squeezing and nose picking which resulted in local skin inflammation, swelling, pain or itching. CONCLUSION: It is suspected that many different factors may induce rhinophyma development. In our opinion, mechanical repetitive trauma is one of the most important. Therefore we encourage physicians to include adequate questions while taking medical history from the patient and implement proper recommendations for nasal care as soon as possible.


Assuntos
Rinofima , Humanos , Nariz , Glândulas Sebáceas
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