HOW RHINOPHYMA DEVELOPS: A CASE REPORT

Abstract

Rhinophyma, or bulbous nose as commonly called, is a skin disease that causes a large, bulbous and reddish nose. The exact cause of this condition is unknown, most authors consider it to be a subtype of rosacea. According to the National Rosacea Society, more than 16 million Americans have this disease. Rhinophyma is identified as subtype three of rosacea, and it forms gradually over several years. Rhinophyma is characterized by hypertrophy of nasal skin, with hyperplasia and fibrosis of the sebaceous glands and connective tissue. There is a combination of neurovascular and immune disturbance is thought to be involved, causing inflammation, fibrosis, and neovascularization. A 83-year-old male presented to the surgery clinic with advanced condition of bulbous nose.Fig.2. The patient has a normal life, taking normal food, normal marriage life and normal children, he was working as a military on the Malaysian Navey with No DM or hypertension or hyperlipidemia. No history of other medical diseases. No surgical past history. Observed bad smell from his nose and having very heavy hairs in his nostrils. Complete physical examination was performed. It revealed no abnormality in the function of any system. Local examination showed hypertrphic bulbous nose Grade III Rhinophyma. Nostrils were full of thick hairs, with bad smell coming from the mouth and nose. Investigations included C/S test for discharge and from nostrils. Other general preoperative investigations as patent is considered old, confirmed being free of any medical disorders. Patient was operated under general anesthesia to remove the bulky soft tissue and use local nasolabial flaps to cover the defect (Fig3). After 12 months, revision of the flaps for debulking and refining is performed. Patient was satisfied by the result after debulking of the flap.