- Definition: A skin condition characterized by thickened skin and enlarged sebaceous glands on the nose.
- Appearance:
- Skin color: Red or skin-colored.
- Blood vessels: Prominent, with possible telangiectasia (thin, red) or venulectasia (larger, purplish).
- Texture: Bulbous, pitted with prominent pores, potentially oozing sebum or containing scaly plugs.
- Scarring may be present.
- Affected Areas: Mainly the tip of the nose, but can also involve sides and top.
- Cosmetic Impact: Can cause irregular nodular growth and nasal deformity.
- Relation to Rosacea: A type of rosacea, which may or may not coexist with other rosacea forms. Sometimes preceded by acne.
Cause of Rhinophyma:
- Not Fully Understood
- Theories:
- Enlarged blood vessels leading to skin thickening.
- Vascular instability causing tissue fluid leakage, inflammation, and scarring.
Other Forms of Phymatous Rosacea:
- Can affect the chin (gnathophyma), ears (otophyma), eyelids (blepharophyma), and forehead (metophyma).
Severity Classification:
- Grade 1: Prominent follicular openings without skin thickening.
- Grade 2: Prominent follicular openings with mild skin thickening.
- Grade 3: Prominent follicular openings, significant skin thickening, overactive sebaceous glands, nodular nasal contour.
Demographics:
- Predominantly Affects Males: Male-to-female ratio ranges from 5:1 to 30:1, possibly influenced by androgens.
Treatment Options:
- Non-Surgical:
- May include topical metronidazole, azelaic acid, retinoids, oral tetracycline antibiotics.
- Systemic isotretinoin can be effective in reducing bulk.
- Surgical:
- Techniques include dermaplaning, dermabrasion, cryotherapy, laser resurfacing (CO2, Argon, Nd:YAG, Er:YAG), electrosurgery.
Complications:
- Basal Cell Carcinoma: Can arise in rhinophyma but it’s not considered a precursor for malignancy.
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