INTRODUCTION
Rhinophyma, considered the culmination and most severe manifestation of acne rosacea, is a chronic, disfiguring dermatological disorder that may result in adverse psychological, functional, and cosmetic issues.1,2 The presentation of this phymatous subtype of rosacea is typically characterized by nodular hypertrophy of the alae and nasal tip, inflammation, telangiectasias, and erythema.3 Other forms of phymatous rosacea include gnathophyma, otophyma, blepharophyma, and metophyma.2 Although the pathogenesis is not fully understood, Demodex folliculorum, androgenic influence, vitamin deficiency, and vasodilator stimuli are thought to be contributing factors to the progression of rhinophyma.2,4-7 The pathologic process and the histopathology, however, are well described.8-10
Although acne rosacea is more prevalent among women (3:1), rhinophyma is more commonly found among men (20:1).1,2,11-13 Similarly, a significant discrepancy in the occurrence of rhinophyma exists between darker skin types (Fitzpatrick IV–VI) and lighter skin types (Fitzpatrick I–III), with reported cases among Fitzpatrick V–VI being exceptionally uncommon.2,10,14-16 We present a case of a 62-year-old Fitzpatrick V woman with a case of rhinophyma (Figure 1) who was successfully treated with fractional CO2 laser resurfacing of the nose. This rare case demonstrates the efficacy of fractional CO2 lasers to safely treat rhinophyma in patients of color, while improving their health, well-being, and cosmetic appearance.
Although acne rosacea is more prevalent among women (3:1), rhinophyma is more commonly found among men (20:1).1,2,11-13 Similarly, a significant discrepancy in the occurrence of rhinophyma exists between darker skin types (Fitzpatrick IV–VI) and lighter skin types (Fitzpatrick I–III), with reported cases among Fitzpatrick V–VI being exceptionally uncommon.2,10,14-16 We present a case of a 62-year-old Fitzpatrick V woman with a case of rhinophyma (Figure 1) who was successfully treated with fractional CO2 laser resurfacing of the nose. This rare case demonstrates the efficacy of fractional CO2 lasers to safely treat rhinophyma in patients of color, while improving their health, well-being, and cosmetic appearance.
