Rhinophyma : Surgical Management in Central South High Specialty Hospital of Pemex in Mexico City

Abstract

The term rhinophyma is derived from the greek: “rhinis” = nose and “phyma” = growth. Rhinophyma is a skin deformity characterized by benign and slowly progressive nose growth condition due to hypertrophy of the sebaceous glands that can cause important morphologic changes. Evidence hasrevealed that this condition predominantly affects caucasian males between the 5th and the 7th decade. No specific cause has been directly associated, being considered as a multifactorial disease. Although etiology remains unknown, it may be classified as an end-staged or stage IV also known as fimatous rosacea. Rhynophyma is diagnosedon a clinical basis, signs include chronic edema, local inflammation, hyperplasia and fibrosis of the sebaceous glands and dermis that lead to the characteristic irregular lobulated thickening of the skin nose. Surgery is considered the ideal treatment of this disease. There are many other nonsurgical treatments described for mild to severe cases, however, surgical resection is the best alternative for an optimal result. Nowadays there is no surgical technique considered the gold standard. The goal of our paper is to describe the surgical and reconstructive management of patients with rhynophyma treated in the Central South and High Specialty Hospital of PEMEX in Mexico City. A total of 8 patients underwent surgery with looped electrosurgical tangential excision followed by sand paper polish for surface smoothing and finally wound coverage by using in vitro-cultivated allogenic human keratinocytes dressings. The procedure was made as an outpatient surgery with no complications and achieving excellent functional and aesthetics outcomes. Keywords