Unilateral rhinophyma: report of a case and review

Rhinophyma is the most prevalent presentation of the phymatous subtype of rosacea. Rosacea subtypes include erythematotelangiectatic type (type 1), papulopustular rosacea (type 2), phymatous rosacea (type 3) and ocular rosacea (type 4).[1] Phymatous rosacea is characterized early by prominent follicular pores or patulous follicles with mild swelling while advanced disease reveals pronounced hyperemic skin thickening, irregular surface nodularities representing sebaceous gland hypertrophy and eventual distortion of the nasal surface architecture.[2] It typically occurs on the nose as a bulbous irregular growth with dilated pores and background telangiectasia. Occasionally very advanced disease may lead to nasal obstruction and sleep apnea.[3] While rhinophyma refers to when this subtype occurs on the nose, phymatous rosacea can also occur more rarely on the chin (gnathophyma), ears (otophyma), forehead (mentophyma), or eyelids (blepharophyma). Rhinophyma can occur in isolation and its severity does not always correlate with duration of disease.[4] It is no longer thought to be an end stage of rosacea.[2]