Rhinoplyma is a massive lobular swelling of the nose. Originally, it was thought to be related to excessive drinking, i.e. W.C. Field’s nose, but later on it was found to be caused by distinct processes. It can be caused by a form of acne, called acne rosacea, which in term traps bacteria (dermodex follicularium) in the sebaceous glands. Eventually, the sebaceous glands grow in size and create a large nose.Suprisingly, this condition responds quite well to treatment.
Histologic features of rhinophyma (increase connective tissue and sebaceous glands).
Pathophysciology: Massive hypertrophy of sebaceous glands (form of acne rosacea), associated with Demodex folliculorum.
SSx: begins with coarsening of nasal skin over cartilaginous portion of the nose, develops into a large protuberant lobular swelling of the nasal tip, nasal obstruction
Dx: clinical exam
Rx: surgical full thickness excision (laser, cold scalpel, or dermabrasion) until normal nasal contour, may require STSG