Cases reported "Rhinophyma"

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1/24. Mohs' surgery as an approach to treatment of multiple skin cancer in rhinophyma.

    BACKGROUND: skin cancer arising within a rhinophyma is rare, less than would be expected from the coexisting chronic active inflammatory process. In rhinophyma, multiple coexisting tumours of different histologic types present an unusual challenge and have never been described in the literature. OBJECTIVE: The treatment approach to multiple tumours occurring in rhinophyma, utilizing Mohs' surgery, is reported and discussed. PATIENT: The case of a 64-year-old farmer with basal cell carcinoma, squamous cell carcinoma, and basosquamous carcinoma occurring in the setting of longstanding rhinophyma is described. CONCLUSION: skin cancer, especially basal and squamous cell carcinoma, diagnosed simultaneously in a rhinophyma creates a challenge; the enlarged, inflamed, and hypertrophied tissue masks their margins. In our opinion, Mohs' micrographic surgery is the treatment of choice and should be primarily considered in view of the malignant potential of these tumours, as is shown by the substantial tumour extension in the case described.
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ranking = 1
keywords = nose
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2/24. Application of artificial dermis prior to full-thickness skin grafting for resurfacing the nose.

    Two patients with nasal skin defects resulting from excision of rhinophyma and multiple angiofibromas were treated with artificial dermis followed by full-thickness skin grafts taken from the postauricular region. The secondary skin grafts took completely in both patients, and the postoperative results were excellent. Although a two-stage operation is required, application of artificial dermis prior to full-thickness skin grafting is a reliable method for resurfacing the nose.
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ranking = 5.1011736274003
keywords = nose, nasal
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3/24. Conventional cold excision combined with dermabrasion for rhinophyma.

    A 65-year-old man, farmer by occupation, presented with redness and gradual enlargement of the nose. Examination revealed marked nodular enlargement of the nose and loss of normal nasal contours. Sebaceous material could be expressed from widened pores. The patient was diagnosed as rhinophyma of moderate degree. He was treated with cold knife excision combined with dermabrasion. A literature scan revealed that currently there is no evidence of superiority of much popular laser surgery over conventional cold knife surgery combined with dermabrasion for rhinophyma. Conventional surgery is time-tested, and it does not require expensive equipment or special training.
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ranking = 3.1011736274003
keywords = nose, nasal
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4/24. phenytoin induced rhinophyma treated by excision and full thickness skin grafting.

    A 49-year-old man suffering from post-traumatic epilepsy presented with a severe rhinophyma probably induced by phenytoin. Initial surgical shaving was soon followed by recurrence, formation of intraepidermal cysts and persistent infection. Ultimate treatment by full thickness excision and a full thickness skin graft resulted in a pleasing cosmetic result. Radical excision of the affected skin followed by full thickness skin graft nasal reconstruction should be considered for cases of recurrent severe rhinophyma with inclusion cysts to eradicate chronic infection and improve cosmesis.
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ranking = 0.1011736274003
keywords = nasal
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5/24. Angiosarcoma arising on rhinophyma.

    We report an 82-year-old man who presented with a tumor which had developed over the previous year on the right nasal ala of a rhinophyma. Histopathological, immunohistochemical, and electron microscopic study confirmed the diagnosis of angiosarcoma on the head and neck. He was treated with radiotherapy of the tumor and cervical adenopathy, which developed later. The possible etiological and pathogenetic role of lymphedema due to inflammatory flares of rosacea on the nose is discussed, together with the histological and immunohistochemical data leading to the diagnosis of this tumor.
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ranking = 1.1011736274003
keywords = nose, nasal
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6/24. methods and results of rhinophyma treatment.

    rhinophyma is a disfiguring soft-tissue hypertrophy of the nose. It is an uncommon disease that primarily affects Caucasian men in the fifth to seventh decades of life. Nine cases from the authors' series and a comparison of results following various treatment modalities are presented. Eight of the patients were Caucasian and one was African American. Excision of the diseased tissue with a scalpel or Goulian dermatome using loupe magnification provided the safest means of preserving the underlying sebaceous gland fundi that permit spontaneous re-epithelialization with the least scarring.
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keywords = nose
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7/24. rhinophyma: plastic surgery, rehabilitation, and long-term results.

    Rhinophymas are characterized by slowly progressive enlargement of the nasal skin that will not resolve spontaneously. The usual indication for treatment has plastic cosmetic and functional reasons, above all in advanced cases with an obstruction of the nasal respiration or reduction of the visual field. Treatment of rhinophyma consists of surgical removal of the hyperplastic alterations. It should always be carried out by an experienced rhinosurgeon, because of possible complications and injury to the more deeply situated nasal structures. Different surgical procedures have been described, such as excision with primary suture or extirpation with plastic covering of the defect by free transplants, subcutaneous rhinophyma resection, as well as decortication with peeling off the proliferations, dermal abrasion, or dermal shaving. In addition, there are various abrasion procedures with abrasive cylinders, burrs, or wire brushes. The methods of exfoliation and abrasive polishing can be effectively combined. Care should be taken to preserve follicular epidermal islets from the more deeply situated layers of the skin. The follicular epithelium left behind is the point of departure for re-epithelization of the wound surface. If decortication is too deep, injuries to the perichondrium or the nasal cartilage may arise, leading to cosmetically unattractive scar formations and necessitate plastic surgery. The author's own method, which involves a combined procedure with peeling or dermal abrasion, remodeling with abrasive cylinders, as well as preoperative injection into the nasal tumor masses and a subsequent covering of the wound area with fibrin glue, is shown with reference to several examples of more than 60 cases. The cosmetic and long-term results are excellent.
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ranking = 0.50586813700151
keywords = nasal
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8/24. Excision of rhinophyma with high-frequency electrosurgery.

    BACKGROUND: rhinophyma is an uncommon progressive disfiguring process of the lower nasal region that most commonly affects middle-aged white men. It is characterized by painless hyperplasia of the sebaceous and subcutaneous tissues, in the end stage, resulting in a bulbous nodular telangiectatic nose. Surgical modalities of treatment include electrosurgery, laser ablation, dermabrasion, cryosurgery, scalpel excision, and others. OBJECTIVE: We present two patients with rhinophyma who were treated with the Ellman Surgitron using high-frequency current. methods: Two patients with significant rhinophyma and associated subcutaneous abscesses underwent excision with the Ellman Surgitron using high-frequency electrosurgery with a wire loop. The sebaceous hypertrophy was shaved down to the level of the normal skin surface. RESULTS: This technique provided a quick, efficient, bloodless operative field with a good cosmetic result and pain-free postoperative recovery. photographs were taken at regular intervals to document the healing process. CONCLUSION: The Ellman Surgitron uses high-frequency current to achieve a bloodless field in the treatment of rhinophyma. This enabled efficient and quick removal of hypertrophied tissue with a good cosmetic result and an essentially pain-free recovery. This radiofrequency device is well suited for the outpatient setting and offers advantages over the other modalities used to treat rhinophyma.
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ranking = 1.1011736274003
keywords = nose, nasal
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9/24. A case of sarcoidosis mimicking rhinophyma.

    A 54-year-old man presented with symmetric, bulbous, nodular enlargement of his nasal tip and ala. At first inspection, the changes appeared to be consistent with rhinophyma, but biopsy revealed noncaseating granulomata consistent with sarcoidosis. His laboratory, radiographic, and functional studies were consistent with systemic involvement of his disease.
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ranking = 0.1011736274003
keywords = nasal
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10/24. Angiosarcoma of the face resembling rhinophyma.

    We report the case of a 69-year-old man who had a persistent lesion develop on his nose during a 1-year period of time that was diagnosed as rhinophyma. Despite laser treatment the lesion continued to grow. Histopathology and immunohistochemical studies were consistent with cutaneous angiosarcoma. rhinophyma-like features should be considered as an unusual clinical manifestation of cutaneous angiosarcoma.
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ranking = 2
keywords = nose
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