Reconstruction of Nasal Defect Caused by Rhinophyma with Excision and Full Thickness Skin Graft: A Case Report
DOI:
https://doi.org/10.35790/msj.v8i1.62805Keywords:
rhinophyma; nasal defect reconstruction; full-thickness skin graftAbstract
Abstract: Rhinophyma is a benign hypertrophic thickening and edema of the nasal pyramid skin caused by the growth of sebaceous glands, underlying connective tissue, and blood vessels. It is a fairly uncommon nasal disorder, affecting the nasal soft tissues and leading to nasal architecture disturbance, airway obstruction, and nasal aesthetic unit deformity. In cases of severe rhinophyma, surgical management is the first line of treatment, and full thickness skin graft (FTSG) is an additional option. This paper reports a nasal reconstruction with excision of rhinophyma, followed by FTSG as a defect reconstruction in Manado. A 53-year-old man complained about breathing, feeding, and nasal deformity problems for the last three years. About 25 years ago, the patient initially noticed a slowly thickening of the nose skin. Patient works for the army and gets a lot of sun exposure. Its bulk at presentation obstructed the nares (stage IV of rosacea) and insulted the appearance. The patient underwent surgical excision with a knife to shave off the aberrant tissue, with electrocauterization of the bleeding spots, followed by a FTSG from the left retroauricular as a donor site to cover the defect with good result. The diagnosis of rhinophyma was validated by histological analysis of the specimens. In conclusion, rhinophyma representing stage IV of rosacea, gives the nose and the rest of the face an unsightly appearance. It can be effectively treated with surgical excision and FTSG. Postoperative follow-up and supervision are necessary to ensure the optimal healing outcomes and that the patient is more confident with the result in concerns with functionality as well as appearance.
Keywords: rhinophyma; nasal defect reconstruction; full-thickness skin graft
References
1. Chellappan B, Castro J. Management of severe rhinophyma with electrocautery dermabrasion – A case report. Int J Surg Case Rep. 2020;72(1):511-4. Doi: 10.1016/j.ijscr.2020.06.039
2. Al Hamzawi NK, Al Baaj SM. large rhinophyma treated by surgical excision and electrocautery. Case Rep Surg. 2019;2019:2395619. Doi:10.1155/2019/2395619
3. Dick MK, Patel BC. Rhinophyma. Treasure Island (FL): StatPearls Publishing. August 8, 2023. Accessed August 8, 2023. https://www.ncbi.nlm.nih.gov/books/NBK544373/
4. Cabrini G, La Torre P, Buonamico A, Quaternato G, Neri L, Neri G. A case report of giant rhinophyma. Otorhinolaryngol Head Neck Surg. 2019;4(1):1-3. Doi: 10.15761/ohns.1000194
5. Merigo E, Cella L, Oppici A, Fornaini C. Laser-assisted surgery and bioscaffold for the treatment of rhinophyma. Indian J Dermatol Venereol Leprol. 2018;84(5):629-31. Doi: 10.4103/ijdvl.IJDVL_781_16
6. Chauhan R, Loewenstein SN, Hassanein AH. Rhinophyma: prevalence, severity, impact and management. Clin Cosmet Investig Dermatol. 2020;13(2):537-51. Doi:10.2147/CCID.S201290
7. Zheng YP, He XF, Zhang YF, Geng LX, Zhang HM, Wan H, et al. Five-blade scratcher for treating severe rhinophyma: A retrospective study. World J Clin Cases. 2024;12(20):4180-90. D oi:10.12998/wjcc.v12.i20.4180
8. Fink C, Lackey J, Grande DJ. Rhinophyma: A treatment review. Dermatol Surg. 2018;44(2):275-82. Doi: 10.1097/DSS.0000000000001406
9. Ramsdell WM. Two alternative approaches to “treating severe rhinophyma: a stepwise approach.” Dermatologic Surgery. 2023;49(2):208-9. Doi: 10.1097/DSS.0000000000003686
10. Torresetti M, Scalise A, Di Benedetto G. Acellular dermal matrix for rhinophyma: Is it worth it? A new case report and review of literature. Int J Surg Case Rep. 2019;59(1):120-3. Doi: 10.1016/j.ijscr.2019.05.013
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mendy Hatibie, Marselus A. Merung, Priscillia Kalitouw, Stevy Suoth, Toby H. Wiranegara
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
