A CASE OF RHINOPHYMA

Abstract

Rhinophyma, a growth of the extenal nose, is characterized by hypertrophy and hyperplasia of the sebaceous glands.Author experienced a case of rhinophyma in a man of 74 years old, in which plastic operation with good results were obtained.
The operation was performed under local anesthesia.The growth was removed with a scalpel and the Thiersch's skin flap taken from his right thigh was applied to the wound surface.The end result proved satisfactory.
A histological investigation showed typical findings of rhinophyma, that is, hypertrophy and hyperplasia of the sebaceous glands, disturbances of circulation and reactive hyperplasia of the connective tissue.
Demodex folliculorum was found in the sebaceous duct and a casual relation between this parsite and rhinophyma holds quite an interest.
Several references were made of about 30 cases of rhinophyma hitherto reported.
a) Most of the patients are over 40 years old.
b) Rhinophyma is almost wholly restricted to males.
c) The relation between rhinophyma and alcoholic beverages may not be as close as it has been considered before.
d) A hereditary tendency is not remarkable.
As for the therapeutic procedure for this disease, radiation and hormone therapy are not so effective and a radical cure can be expected only by a surgical removal of the growth.
Operations of the rhinophyma are grossly divided into a partial excision and a decortication.Decortication is a method of paring the nose progressively so as to bring it to a normal form.A skin grafting is often applied to the wound surface.
A clinical prognosis of rhinophyma is good, however, some cases were reported in which carcinoma developed in the area of rhinophyma.