Giant rhinophyma treated by excision and full thickness skin grafting

Abstract

Rhinophyma is a slowly progressive, disfiguring disorder of the nose seen almost exclusively in men  over the age of forty. It consists of large nodular masses of hypertrophic and hyperemic connective tissue and sebaceous glands. The supposed association with increased alcohol abuse often leads to psychological problems for the person concerned. Rhinophyma is the final stage in poorly controlled acne rosacea. Its etiology remains uncertain. Surgery is the most common treatment of choice. Different surgical procedures have been described, such as excision with primary suture or extirpation with plastic covering of the defect by free transplants, subcutaneous rhinophyma resection, as well as decortication with peeling off the proliferations, dermal abrasion, or dermal shaving.
We report on a  72-year-old man presented with an unusually severe case of rhinophyma. The patient presented with a seven-year history of a progressively growing mass on the nose with a history of nasal obstruction and history of alchocol abuse. On examination, there was a large pedunculated mass measuring 7,5x7x5,5cm arising from the tip to the dorsum of the nose.The pedunculated mass was widely excised and a skin graft from the medial upper leg was applied. A very satisfactory cosmetic result was obtained.