Acne Rosacea Nose Phymatous

Subtype 3: Phymatous rosacea

Phymatous rosacea includes thickening skin, irregular surface nodularities, and enlargement. The term rhinophyma is used when these signs occur on the nose. Rhinophyma is the most common presentation, but phymatous rosacea may occur in other locations, including the chin, forehead, cheeks, and ears.

The disease begins with persistent erythema. Telangiectasias and or prominent vessels appear and may become extensive. Papules and pustules form and the disease becomes chronic. Dermal infiltrates accumulate into nodular masses.

Rhinophyma represents a severe complication of rosacea. Clinically, the nose of the affected patients, usually men, appears red, irregularly swollen, and bulbous, with prominent pilosebaceous dilated pores and telangiectasias. Multiple, firm, or soft, smooth-surfaced, red nodules and cysts can be observed.

The nose becomes enlarged and may have a grotesque appearance. Patients with this subtype may have dilated, follicles in the phymatous area. Large amounts of sebaceous material can be expressed from the dilated pores. Small cysts may be numerous.

Unfortunately, some people associate rosacea and rhinophyma with alcohol abuse; however, many patients who have rosacea neither drink alcohol nor report alcohol as a trigger for their rosacea.