Rhinophyma, Associated with Carcinoma, Treated Successfully with Radiation

Malignancies Within Rhinophyma: Report of Three New Cases and Review of the Literature

“…Regardless of the extent of the malignancy at diagnosis and the type of treatment, resolution was obtained in 17 patients, including those in our series, with a mean followup of 34.8 months (SD ± 29.4; ranging from 6 months [16,26,32] to 108 months [27]) [15, 16, 19, 21, 26-28, 30, 32]. In one case [18], although multiple consecutive surgical tangential excisions followed by skin graft and submandibular lymph node removal was performed, bilateral conjunctival irritation due to the growth of the tumor in the medial canthus and infraorbital regions persisted after 2 years.…”

“…In four patients an association with malignant basal and squamous type cells was observed within the tumor [8,17,22,29], and in one case no histological data were reported [10]. All patients [15-19, 21-24, 26-33] but one [27] were male. In 19 cases information about sex was not available [8-14, 20, 25].…”

“…Tangential shaving [28][29][30]32] with or without Mohs' micrographic surgery was usually followed by either skin graft [11,18,21,29,30] or compressive garments, whereas in those cases in which more aggressive surgery [15] was required, either local flaps [19,21,23,29] or nasal prostheses [16,26] were chosen depending on the health condition of the patient. Seldom was the surgical approach combined with radiation therapy (RT) [22,26]; in three cases RT was administered alone [27,33]. Tissue vaporization with carbon dioxide laser was used in two cases [24,28].…”

“…Clear margins during surgical removal of extended tumors may be obtained with intraoperative histologic analysis (case 2 of our series) as well as Mohs' micrographic surgery [29,31]. Even if radiotherapy has been largely criticized as a treatment option for rhinophyma due to its association with secondary skin malignancies [3,41], Plenk [27] has emphasized its use in treating both conditions (rhinophyma and concurrent malignancy) in a single operative step.…”

The treatment of rhinophyma with excision and full-thickness skin graft

“…It is also known as "potato nose" or "whiskey nose" in public [9]. This uncommon disease is especially seen in Caucasian males between the ages of 45-60 and the incidence is 12 times higher in men when it is compared to women [10][11][12]. Genetic factors, alcoholism, and increased steroid hormon levels are being accused in etiology but there is no proven relationship between them.…”