Treatment Of Rhinophyma Research Articles

Surgical Management of Moderate Rhinophyma with Nasal Nodules: An Electrosurgery Approach

Introduction: Rhinophyma, a severe manifestation of rosacea, is characterized by hypertrophy of sebaceous glands and fibrosis of the nose, often leading to significant aesthetic and functional impairments. Surgical treatment is the preferred approach for advanced cases to restore nasal appearance and function. Case Report: We present the case of a 60-year-old man with moderate rhinophyma and nodules on the nostrils. Surgical management under local anesthesia involved the use of thermal loops for excision of the lesions and bipolar electrosurgery for hemostasis. The patient was also treated for rosacea with topical agents, including metronidazole and azelaic acid, and oral doxycycline for inflammatory lesions. Directed healing followed the surgery, along with LED phototherapy and ablative erbium laser sessions to optimize results. Discussion: The use of thermal loops and electrosurgery allowed for precise excision and control of bleeding. Postoperative care, including daily greasy vaseline dressings, facilitated rapid healing. Mild infection at the excision sites was treated with topical and prophylactic antibiotics. Six sessions of LED therapy combining four types of light (infrared, red, yellow, and blue) improved healing and reduced inflammation. Ablative erbium laser was proposed to further enhance the aesthetic outcome. Conclusion: A combined surgical approach and careful postoperative management yielded satisfactory results in the treatment of rhinophyma.

Rhinophyma – Case Report of a 67-Year-Old Male with Extensive Nodular Changes of the External Nose in the Course of Rosacea

<b>Introduction:</b> Rhinophyma is a particularly advanced form of rosacea. It typically affects middle-aged and elderly men. It develops due to significant hypertrophy of the sebaceous glands, blood vessels, and connective tissue of the nasal skin. The external nose becomes enlarged, with the skin becoming thickened, fibrous, and oily. When pressure is applied, a mixture of sebum and blood may be expelled. Facial deformity often leads to social withdrawal in affected individuals. In extreme cases, it can lead to nasal passage obstruction.<b>Case report:</b> This paper discusses the case of a 67-year-old male patient with a long history of rosacea. A diagnosis of rhinophyma was established, and surgical treatment was employed, yielding satisfactory results. Various methods of treating rhinophyma are described.<b>Discussion:</b> The diagnosis of rosacea is based on medical history and characteristic skin changes on the face, with histopathological examination being decisive in doubtful cases. The etiopathogenesis of the condition is not well understood. Risk factors may include a positive family history of rosacea, improper treatment of rosacea, smoking, and excessive alcohol consumption.<b>Conclusions:</b> The treatment of choice for rhinophyma is surgical intervention. Patients should be informed about the possibilities that modern medicine offers in the treatment of rhinophyma. This can improve both nasal patency and external appearance, significantly enhancing the patient’s psychological comfort.

A systematic review and current recommendation for treatment ofrhinophyma

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.

Treatment of Rhinophyma by Surgical Excision and Electrocautery: A Case Report and Review of Literature

Treatment of Rhinophyma by Surgical Excision and Electrocautery: A Case Report and Review of Literature

Treatment of rhinophyma using a copper vapor laser

Background. Rhinophyma is considered to be the most severe stage of rosacea, associated with the proliferation of the nose skin epithelium, hyperproduction of the sebaceous glands and telangiectasia.The treatment of rhinophyma remains a difficult task. One of the problems associated with rhinophyma is thickened and lumpy skin, penetrated with telangiectasias. The use of laser radiation in the treatment of rhinophyma seems to be promising, since this method allows blood vessels to be selectively heated.For the first time, we describe the treatment of rhinophyma using a copper vapour laser (CVL) equipped with a computerized scanner.Patient description. A 63-year-old male with Fitzpatrick skin type II was treated using an CVL (‘Yakhroma-med' model, RaS P. N. Lebedev Physical Institute). The clinical manifestations of the disease were typical of the phymatous or hypertrophic rhinophyma type, including significant thickening of the tissues and an uneven roughness of the skin surface. The treatment was carried out using a radiation wavelength of 578 nm, exposure duration of 0.2 s and energy exposure (fluence) of 15-30 J/cm2. Operational parameters used for the CVL in the scanner mode were the average power of 0.6-1.2 W and the focusing size of the light spot on the skin of 0.6 mm. The hexagonal mode of the scanning head was used with a maximum size of 12 mm and 1 mm distance between the centres of the laser spots. The treatment resulted in the restoration of the natural nose shape without redness. No side effects were noted.Conclusion: CVL radiation provided a selective photodisruption of the vessels with increased diameter.Due to the remodelling of the vasculature, the described method showed excellent results in the treatment of rhinophyma without side effects.

Rhinophyma and Gnathophyma Concomitantly in a 54-Year-Old Female a Clinical-Histopathology Correlation and Review of the Literature

Rhinophyma (Greek “nose growth”) is a benign dermatologic disease of the nose [1]. It is characterized by a slowly progressive enlargement of the nasal skin, with irregular thickening and nodular deformation leading to an erythematous appearing nose. Phyma is the last stage of rosacea and is due to chronic inflammation and edema. Although the great majority of phymatous lesions occur on the nose (rhinophyma), they may also occur at other sites. It affects mostly men. Even though the exact cause of rhinophyma is unknown, it is believed to be multifactorial in origin with a principal etiology of unregulated superficial vasodilation. The main reasons that urge the patients to seek help are functional and cosmetic impairments, such as nasal obstruction or disfigurement. Surgical removal of the hyperplastic tumor mass is the treatment of choice for rhinophyma. The aim of the article is to present an update on the pathophysiology, clinical features and treatment of rhinophyma and gnathophyma in a 54-year-old female patient.

Surgical treatment of rynophyma – own observation

Rhinophyma is the end-stage of rosacea. Nodular hypertrophy of the external nose is a chronic disease lasting for many years. The main problem in patients with rhinophyma apart from functional disorders are deformities of the nose regarding aesthetics. Therefore patients often isolate themselves and avoid interpersonal and social contacts. Majority of patients with symptoms of nodular hypertrophy are not aware of possibility of treatment which impoves functional disorders and aesthetic of the face. Surgical treatment still remains the basic method of treatment of rhinophyma. The long –term observations have proved satisfactory cosmetics and functional results.

Flexible blade decortication and pulsed dye laser for the treatment of rhinophyma: A case series

Flexible blade decortication and pulsed dye laser for the treatment of rhinophyma: A case series

Dermachemabrasion: a safe and effective treatment for rhinophyma

Dermachemabrasion: a safe and effective treatment for rhinophyma

Combined treatment for rhinophyma

Combined treatment for rhinophyma

A New Surgical Technique of Rhinophyma (Gull-Wing Technique)

A variety of surgical techniques have been described for the treatment of rhinophyma. A case of severe rhinophyma was operated with a new surgical technique. The full-thickness excision was combined with the gull-wing incision in this technique. The patient was very satisfied with the result.

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.

Optimizing Cosmesis with Conservative Surgical Excision in a Giant Rhinophyma

Rhinophyma is considered the end stage in the development of rosacea, with a clinical aspect characterized by sebaceous hyperplasia, fibrosis, follicular plugging, and telangiectasia. Although the treatment of rhinophyma typically has an aesthetic purpose, in some cases it also can help with nasal obstruction and eating difficulties caused by rhinophyma beyond the abnormal physical appearance that can cause social seclusion. Very few giant rhinophymas have been reported in the literature. In most cases full-thickness excision of the rhinophymatous tissue down to perichondrium and periosteum of the nasal osteocartilaginous framework followed by coverage of the residual defect with a full-thickness skin graft or local flap has been described in patients affected by giant rhinophyma. The poor results of this approach encouraged us to manage conservatively a very severe form of rhinophyma. We describe the case of a 62-year-old man who presented with a 12-year history of a progressively growing mass on the nose and with a history of nasal obstruction and eating difficulties. We advocate a careful tangential excision of the rhinophymatous tissue which allows the residual deep pilosebaceous appendages to reepithelialize as a safe method and provides a good cosmetic result with minimal scarring. To our knowledge this is the first case of a giant rhinophyma treated with conservative excision followed by secondary healing. 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 .

Rapid Treatment of Rhinophyma with Powered Microdebrider

We describe here our experience in using sinus microdebrider to rapidly debulk and sculpt the tissues in cases of rhinophyma correction. We utilized the use of the 4 mm M4 Rotatable Cutting Straight Sinus Blade on a straight Straightshot M4 Microdebrider by Medtronic at 800 rpm oscillation which is normally utilised in our sinus surgery practice. The microdebrider is straightforward to use and is already stocked in most ENT departments. It requires no additional training or cost outlay for departments that perform endoscopic sinus surgery with microdebrider. In our experience it affords the surgeon the ability to rapidly and accurately sculpt the nose to an excellent aesthetic result. We feel it is a more precise tool than cold steel or Bovie cautery, quicker than CO2 laser techniques, and avoids the aerosol of dermabrasion. No complications occurred in our series, and all patients rated their cosmetic outcome as good to excellent.

The treatment of rhinophyma with excision and full-thickness skin graft

The treatment of rhinophyma with excision and full-thickness skin graft

Rinofima: opções cirúrgicas utilizadas no serviço de cirurgia Plástica do hospital Agamenon Magalhães - PE

INTRODUCTION: Rhinophyma is a chronic inflammation of the nose with involvement of color, texture and vascularization, with irregular exophytic growth and telangiectasia. OBJECTIVE: To analyze epidemiological data of patients with rhinophyma and evaluate the results of various treatments for this disease at the Service of Plastic Surgery of Hospital Agamenon Magalhaes, Recife, PE, Brasil, comparing them with the treatments described in the literature. METHODS: A retrospective study using analysis of medical records of 28 patients undergoing treatment of rhinophyma, between March 2002 and March 2010. RESULTS: The average patient age was 50.1 years, with 72.72% male and 17.28% female. The most common treatment was an association of decortication/ dermabrasion and electrocoagulation, in 96% of cases. Complications observed: one case of hypopigmentation, two cases of hyperpigmentation and one case of unsightly scar. In three cases, there was need for more surgery to completion of treatment. No cancer was found on surgical specimens. The degree of patient satisfaction was 100%. CONCLUSION: Rhinophyma is a disease that has simple and effective treatment with excellent cosmetic results.

Coblation‐assisted decortication for the treatment of rhinophyma

Coblation‐assisted decortication for the treatment of rhinophyma

'A close shave' -- use of a disposable razor blade in the management of rhinophyma.

Rhinophyma is a common clinical problem, generally affecting older males. The treatment for rhinophyma is predominantly surgical. Conventional surgical methods utilise a scalpel, skin graft knife, carbon dioxide laser vaporisation,1,2 electrocautery, cryotherapy, or a combination of the above. We present a simple technique for the surgical management of rhinophyma …

Treatment of Rhinophyma with a Radiofrequency Device

Background: Rhinophyma is an uncommon complication of long-standing rosacea that is caused by sebaceous gland hypertrophy. There is no consensus regarding the treatment of rosacea. Retinoids, steroids, antibiotics, electrocautery, ablative laser therapy, dermabrasion, and excisional modalities have been used, but no single treatment method has proved effective for all patients. Objective: Radiofrequency has been shown to decrease sebaceous gland activity in acne vulgaris. Thus, the authors postulated that it could also improve the clinical course and severity of rhinophyma by acting on the hypertrophied sebaceous apparatus. Methods: A 77-year-old man presenting with long-standing rhinophyma received 2 monopolar radiofrequency treatment spaced 3 months apart. Results: Two months after treatment, the patient reported significant improvement in symptoms. Specifically, the frequency of pustular flares decreased notably from once weekly before treatment to once every 3 weeks after the second treatment. The intensity of flares also decreased significantly, from 7–8 on a 10-point scale before treatment to 3–4 after the second treatment. The patient has continued to do well 5 months after his initial treatment, using only topical maintenance therapy. Conclusions: Monopolar radiofrequency can effectively improve the clinical course and severity of rhinophyma. This noninvasive, nonablative modality may be a valuable adjunct in managing this often refractory and therapeutically challenging condition.

Rhinophyma treated with kilovoltage photons

A 72-year-old retired truck driver presented with a 10-year history of rhinophyma and was successfully treated with 90-kV photons to a total dose of 40 Gy in 20 daily fractions. A brief discussion of radiotherapy in the treatment of rhinophyma follows.