Rhinophyma managed via partial-thickness surgical excision with a good cosmetic outcome: a case report

Once popularly known as whiskey nose or rum blossom, rhinophyma is a permanent thickening of the nasal skin composed of confluent erythematous papules and prominent follicles. The etiology is not fully known, but many authors describe rhinophyma as the fourth stage of acne rosacea, a chronic inflammatory cutaneous disease characterized by erythema, telangiectasia, papules, pustules, and edema. It is benign yet disfiguring and can be stigmatizing. Here, we report the case of a 54-year-old man who presented with a mass on the nose that had slowly grown over the prior two years. He had a history of acne, treated with isotretinoin 10 mg daily by a dermatologist, one year before the onset of this mass. Examination from the frontal view revealed asymmetric, diffuse, multilobulated skin hypertrophy over the middle and lower nasal vault. On the basal view, there was a 10 x 7 mm epithelizing ulceration over the right alar rim. He underwent a partial-thickness resection of the hypertrophied nasal skin, and the resulting wound was left to heal via secondary intention, with a good cosmetic outcome.