Rhinophyma Rhis (Greek for nose) and phyyma (Greek for growth)

Untreated rosacea may develop into rhinophyma, which the nose has hypertrophy of the sebaceous tissue resulting in some serious disfigurement. (See photo) W.C. Fields had rhinophyma and has become the rosacea poster boy. However, it has been around a long time as noted by this painting by Ghirlandiao referred to in this article. There are a number of different treatments for rhinophyma, including surgery, but it is better to treat the rosacea before it reaches the advance stage of rhinophyma. However, once rhinophyma has developed it can usually be corrected by surgery using either laser, scapel, or dermabrasion. The good thing about rhinophyma is that though this condition is generally regarded as a severe form of rosacea it is a relatively rare disorder involving thickening of the skin on the nose and the presence of many oil glands and this condition can usually can be corrected. Accutane is usually the drug of choice, but your physician may use other prescription drugs such as antibiotics if you have this skin disorder. Other treatment may involve cryosurgery, dermashaving and electrosurgery. If you have waited to go to a physician until you have rhinophyma you obviously have a problem that could have been prevented by earlier rosacea treatment. Rhinophyma is a common form of phymatous rosacea which is Subtype 3 in the new rosacea classification system standardized by the NRS. One case of rhinophyma was treated successfully with kilovoltage photons.

There are four variants of rhinoplyma: Glandular Fibrous Fibroangiomatous Actinic

There are also other phymas such as gnatophyma (chin), metophyma (forehead), otophyma (one or both ears), and blepharophyma (eyelids).

What causes rhinophyma?

"The most widely accepted theory is that rhinophyma is the end stage result of chronic acne rosacea." source

One case that initially was thought to be rhinophyma was actually granulomata consistent with sarcoidosis (see below):

"...Initially, the mass was thought to be rhinophyma, but biopsy of the mass revealed noncaseating granulomata consistent with sarcoidosis. The mass resolved following several steroid injections..." source

You might also want to read more on the use of steroids for rosacea.

Sources

Rosacea 101, Appendix O Rhinophyma

NRS Rhinophyma Article

Dr. Michael Bermant

Skinsite.com

MedlinePlus

DermisNet

DermIS

R-S Thread

Excision of rhinophyma with a laser scanner handpiece--a modified technique.
Skoulakis CE, Papadakis CE, Papadakis DG, Bizakis JG, Kyrmizakis DE, Helidonis ES.
Department of Otolaryngology, University of Thessaly School of Medicine, Larissa, Greece. - 2002

Sarcoidosis of the external nose mimicking rhinophyma. Case report and review of the literature.
Goldenberg JD, Kotler HS, Shamsai R, Gruber B.
Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, USA. - 1998

Rhinophyma treated with kilovoltage photons
Skala M, Delaney G, Towell V, Vladica N.
Department of Radiation Oncology, Cancer Therapy Centre, Liverpool, New South Wales, Australia.

Clinical and histological variants of rhinophyma, including nonsurgical treatment modalities.
Jansen T, Plewig G.
Department of Dermatology, Ludwig-Maximillian University, Frauenlobstrasse 9-11, D-80337 Munich, Germany.