Management of rhinophyma with radio frequency: Case series of three patients

Abstract

Rhinophyma is the most common form of phymatous rosacea, typically seen in men. It may appear de novo (without preceding inflammatory changes) or occur in patients with preexisting papulopustular rosacea. It is characterized by slow, bulbous, reddish-purple, painless enlargement of lower two-third of nose with rugose peau d’orange surface resulting from the enlargement of the sebaceous glands and subcutaneous tissue, which does not resolve spontaneously. Though benign, it causes lot of cosmetic and psychological concern. Commonly used treatment modalities include debulking by surgical excision, electrosurgery, carbon dioxide laser ablation, cryosurgery, or dermabrasion. Here we report a case series of three patients with Grade 3 rosacea as per National Rosacea Society grading, treated by radio frequency with good improvement.

Consensus on the therapeutic management of rosacea – Brazilian Society of Dermatology

“…Its effectiveness in the treatment of facial erythema, papulopustular lesions, and rhinophyma is variable. 113 , 115 , 167 , 168 …”

A very severe case of rhinophyma requiring a three-stage reconstruction with a forehead flap

“…1,2 There is currently no gold standard treatment for rhinophyma, although a wide range of non-surgical and surgical options are available. [1][2][3] Medical treatment for this condition includes topical and/or oral antibiotics and retinoids. 1,2 The aim of medical therapy is to slow the progression of the disease and not provide a cure.…”

“…1,2 The aim of medical therapy is to slow the progression of the disease and not provide a cure. 2,3 The surgical options, which tend to aim for complete resolution of the disease, include surgical excision with reconstruction in the form of skin grafts or a flap such as a nasolabial, V-Y advancement and cheek advancement flap if necessary. [1][2][3] Other surgical methods include dermabrasion, electrosurgery, carbon dioxide ablation, radiofrequency and cryosurgery.…”

“…[1][2][3] Other surgical methods include dermabrasion, electrosurgery, carbon dioxide ablation, radiofrequency and cryosurgery. 2,3 Forehead flap: the three stages…”

“…The forehead flap has long been used to reconstruct nasal defects commonly resulting from excisions of skin cancer. 1,3 The colour and texture of the forehead flap make it an ideal choice to resurface the nose, often resulting in superior aesthetic results to other treatment modalities such as skin grafts. 1,3,4 Initially the forehead flap reconstruction is carried out in two stages: 1) the flap is harvested from its forehead donor site and inset into the recipient site; 2) the pedicle supplying the flap is divided, usually three to six weeks after the initial procedure, once it has healed.…”