Rhinophyma Research Articles

Basal Cell Carcinoma Camouflaged by Rhinophyma.

Basal Cell Carcinoma Camouflaged by Rhinophyma.

Effects of artesunate on rosacea-like inflammation in mouse models

Objective To evaluate effects of artesunate on rosacea-like inflammation in mouse models. Methods Twenty-five male BALB/c mice aged 7 weeks were injected subcutaneously with 40 μl antibacterial peptide LL-37 into the back once every 12 hours for 4 sessions to establish mouse models with rosacea-like inflammation. These 25 mice were randomly and equally divided into 5 groups: after each injection of LL-37, model group were gavaged with sodium chloride physiological solution, treatment groups gavaged with 25, 50 and 100 mg/kg artesunate solution separately, and positive control group gavaged with 30 mg/kg doxycycline hydrochloride solution. Another 5 healthy mice injected subcutaneously with pure water into the back for 4 sessions served as blank control group. Forty-eight hours after the initial injection of LL-37, changes in skin lesions and the intensity of erythema were assessed. Skin tissues at the dorsal injection site were resected and subjected to HE staining, the tissue structure was observed and the number of inflammatory cells was counted. Enzyme-linked immunosorbent assay (ELISA) was performed to estimate the activity of myeloperoxidase (MPO) in skin lesions. Results The model group showed obvious inflammatory reactions, and significantly increased erythema score (3.20 ± 0.84) , inflammatory cell count (517.27 ± 99.43) and MPO activity (0.57 ± 0.08) compared with the blank control group (all P 0.05) . Conclusion Artesunate can inhibit rosacea-like inflammatory reactions in mouse models, especially the middle-and high-dose artesunate. Key words: Rhinophyma; Artemisinins; Doxycycline; Cathelicidins; Disease models, animal; Artesunate; LL-37

Lasers and intense pulsed light for the treatment of rosacea

Rosacea is a common skin disease clinically characterized by skin flushing, persistent erythema, papules/pustules and telangiectasia. Laser therapy is an ideal option for the treatment of rosacea-associated telangiectasia and rhinophyma. The most commonly used lasers include 585-/595-nm pulsed dye lasers, long-pulsed 1 064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser, carbon dioxide (CO2) laser, erbium:yttrium-aluminum-garnet (Er:YAG) laser, fractional laser, and so on. Intense pulsed light and pulsed dye laser have shown favorable therapeutic effects on rosacea-associated erythema and telangiectasia with high safety and short downtime. Long-pulsed Nd:YAG laser can only be used to target wide blood vessels and to treat resistant telangiectasia. CO2 laser, Er:YAG laser and fractional laser can be used to improve rhinophyma. In clinic, combined treatment using multiple lasers may result in better therapeutic outcomes. Key words: Rhinophyma; Lasers; Lasers, dye; Therapeutic uses; Intense pulsed light

Drug therapies for rosacea

Rosacea is a kind of common chronic inflammatory skin disease. According to clinical manifestations, rosacea can be divided into erythematous telangiectatic type, papulopustular type, hypertrophic type and ocular type. As the guideline of the American National Rosacea Society mentions, rosacea should be treated according to its subtypes. The treatment of rosacea mainly includes skin care, drugs, lasers, surgery, and so on. The development of new drugs, such as α-adrenergic receptor agonists, β-blockers and botulinum toxin-A targeting erythematous telangiectatic rosacea, and subantimicrobial-dose doxycycline and ivermectin targeting papulopustular rosacea, has brought possibilities to treat rosacea effectively. Owing to lack of experience in application of brimonidine tartrate, subantimicrobial-dose doxycycline and ivermectin, more evidence from clinical research is needed to evaluate their safety and efficacy. Key words: Rosacea; Rhinophyma; Chemistry, pharmaceutical; Therapeutic uses; Telangiectasis

Clinical analysis of 421 cases of rosacea

Objective To analyze clinical manifestations of patients with rosacea so as to improve the understanding of clinical characteristics of rosacea. Methods Clinical data on patients' gender, age, lesion location and type, and subjective symptoms were collected from 421 patients with rosacea, and retrospectively analyzed. Results Of the 421 patients, 58 were male and 363 were female with a male/female ratio of 1 ∶ 6.25. The patients aged 33.81 ± 11.32 years, and rosacea could occur at all ages in both genders. The most common skin lesions were intermittent flushing (93.8%, 395/421) , persistent erythema (84.3%, 355/421) and inflammatory papules (68.9%, 290/421) . Two or more types of skin lesions were usually concurrent, and 83.1% of these patients had concurrent skin lesions. Intermittent flushing and persistent erythema were the most common concurrent lesions. Moreover, the most frequently involved regions were the cheek (87.2%, 367/421) , nose (76.5%, 322/421) , and perioral areas (63.7%, 268/421) . Three or more areas were involved concurrently in 67.2% of these patients, and the cheek, nose and perioral areas appeared to be the most frequently concurrently affected regions. The three most common subjective symptoms were burning sensation (73.6% , 310/421) , dryness sensation (69.6% , 293/421) and itching (66.0% , 278/421) . Conclusion Intermittent flushing and persistent erythema in the cheek, nose, or perioral regions are the main clinical symptoms of rosacea, and papules/pustules, rhinophyma, telangiectasia, burning sensation, dryness sensation and itching are important clinical manifestations of rosacea. Key words: Rosacea; Disease attributes; Signs and symptoms; Retrospective studies

Vestibulophyma and Giant Rhinophyma Associated With Variant Rosacea

In July 2013, a 44-year-old Taiwanese man was admitted to Kaohsiung Chung-Ho Memorial Hospital, presenting with a 3-year history of progressively growing nasal mass with pustules and foul smelling discharge. He is a victim of cerebrovascular accident 4 years ago, hypertension for 12 years, and left hemiplegia. He has no personal history of smoking or alcoholism. Facial disfigurement led to psychological distress, and he sought out residence at a nursing home as a social recluse. Examination revealed a giant pedunculated bulbar mass measuring 23 × 13 × 8 cm and extending from the forehead to over the tip of the nose, with complete obliteration of the normal nasal contour. MRI scan revealed extensive nasal cutaneous lobulated tumors with complete obstruction of his left nostril due to vestibular phymatous lesions. Following biopsy results, we diagnosed the patient with “vestibulophyma”, giant rhinophyma with extensive external phymatous lesions, and concomitant presentation of all four rosacea subtypes. After undergoing application of topical metranidazole jelly and low oral dose of doxycycline (40 mg/day) for 2 weeks, we proceeded with surgical intervention of giant rhinophyma de-bulking, vestibulophyma resection, inferior turbinectomy, and middle turbinectomy with microdebrider. Full thickness skin graft played an important role as an ideal and effective biological dressing during the healing process. The patient is currently well and satisfied with the results. J Med Cases. 2015;6(5):216-218 doi: http://dx.doi.org/10.14740/jmc2121w

Clinical observation on radiofrequency scalpel in the treatment of rhinophyma

Objective To assess the efficacy of radiofrequency scalpel in the treatment of rhinophyma.Methods Twenty-three patients diagnosed with rhinophyma were randomly divided into radiofrequency group (13 patients) and routine surgery group (10 patients).Hypertrophic nasal tissue was removed by a radiofrequency scalpel in the radiofrequency group,and by a scalpel followed by dermabrasion in the routine surgery group.Several parameters,including operation time,intraoperative blood loss,surgical wound healing time,postoperative erythema duration,scarring incidence rate and appearance improvement value,were compared by t test or chi-square test between the two groups.Results All the patients completed the treatment.Compared with the routine surgery group,the radiofrequency group showed shorter operation time ((24.4 ± 2.8) vs.(44.0 ± 4.7) minutes,P ＜ 0.01)and less blood loss ((10.4 ± 1.4) vs.(39.0 ± 5.7) ml,P ＜ 0.01).No significant difference was observed in the surgical wound healing time,erythema duration,postoperative appearance improvement value and scarring incidence between the two groups.Conclusion Radiofrequency scalpel is effective and safe in the treatment of rhinophyma with shorter operation time and less intraoperative blood loss.

Advances in the etiology and pathogenesis of rosecea

Rosacea is a chronic inflammatory skin disease occurring in the central region of the face with a predilection for middle-aged people.It is usually characterized by flushing,permanent erythema,telangiectasia,papules,rhinophyma,sometimes with the involvement of eyes.Its etiology and pathogenesis have not been completely understood.Past hypotheses on its pathogenesis were mainly focused on ultraviolet radiation,vascular abnormalities and infection by microorganisms such as Demodex folliculorum,and it was believed that chronic ultraviolet radiation could destroy epidermal barrier and perivascular connective tissue,resulting in vascular abnormalities.More evidences are needed to support the role of microbes in the development of rosacea.Recent molecular studies have suggested that innate immune system,increased serine protease activity and abnormal expression of antimicrobial peptides are all involved in the pathogenesis of rosacea. Key words: Rosacea; Ultraviolet rays; Blood vessels; Microbiology; Immunity

Lasers and photochemotherapy for rosacea

Rosacea is a common chronic inflammatory disease of the skin.It is characterized by erythematous changes of the facial skin accompanied by papules,pustules or telangiectasias,and eventually,it may progress into rhinophyma.Rosacea can be categorized into four subtypes.To get a satisfactory outcome,appropriate lasers and photochemotherapies should be selected from pulsed dye laser,intense pulsed laser,photodynamic therapy and carbon dioxide laser according to the subtype of rosacea.This review states the mechanisms,efficacy,side effects as well as targeting subtypes of these phototherapies for rosacea. Key words: Rhinophyma; Lasers; Photochemotherapy

Treatment of massive rhinophyma by decortication

Treatment of massive rhinophyma by decortication

Technical Notes and Tips: ‘A Close Shave’ – Use of a Disposable Razor Blade in the Management of Rhinophyma

Technical Notes and Tips: ‘A Close Shave’ – Use of a Disposable Razor Blade in the Management of Rhinophyma

Rhinophyma-A Case Report

Rhinophyma is a rare disease that primary affects Caucasian men. It is thought to represent the most severe expression of acne rosacea with a proliferation of sebaceous glands and fibrous tissue. It adversely impacts both the appearance and the function of the nose. Many cases of rhinophyma have been reported in the western world; however, there has none been reported from Taiwan. We reported one case of a 74-year-old man who sustained a growing rhinophyma with nasal deformity for 2 years. He received total excision of tumor mass, and the nasal defect was restored with a full-thickness skin graft from the left supra-clavicle region. Thirteen months follow-up, the patient was satisfied with the surgical result.

Rhinophyma: Review and Update

Rhinophyma: Review and Update

Rhinophyma degeneration. (French)

Rhinophyma degeneration. (French)

A modification of the rhinophyma operation

A modification of the rhinophyma operation

Rhinophyma with carcinoma

Rhinophyma with carcinoma

Rhinophyma and Its Treatment

Rhinophyma and Its Treatment

Case of Rhinophyma Treated Operatively

Case of Rhinophyma Treated Operatively