Phymatous (or Rhinophymatous )rosacea is a sub type of Rosacea
Phyma means -A nodule ,swelling or small circle or rounded tumor or mass of the skin .
Phymatous means related to nodulary structures of skin which can manifest as abnormal skin contour like nodulary lesion or swelling mass .
Rhinophymatous means( Rhino means Nose) related to nasal skin that harm abnormally skin contour appeared as red visible mass or irregularities of nodules & vasculature associated with other type of rosacea.
Phymatous rosacea appeared in common site –
* Chin : It is called as gnathophyma
* For head : It is called as metophyma
* Eyelids : It is called as Blepharophyma
* Ears : Otophyma
Causes of Rhinophyma in Rosacea:
–Still now unknown cause
– It was posed of alcohol users in past time
Symptoms of Rhinophymatous rosacea:
-Thickening of nose skin
-Red ,blotchy areas in the mid- face
-Sometimes papules can be formed
-Roughly facial flushing
-suddenly pimples or acne like nodules can appeared almost mistaken for acne
-prominent sebaceous glands
-telangiectasia formed which is a swelling of tiny blood vessels on nose & cheeks
– Ocular rosacea can be formed
“The symptoms of Rhinophymatous rosacea can be worsened if they couldn’t be left untreated .They also may occur in cycles”
Changes features of nose when Rhinophyma appeared
At first you can be noticed that thickened outer layer of nasal skin & appeared reddish skin tone ,Gradually overgrowth into a swollen ,bulbous shape & many many oil glands with enlarged skin pores could be found & finally waxy ,rough ,yellow coloured appearance
Microscopic Appearance
Papulopustular lesions have appeared inflammatory cells which can be seen in microscope i i.e- both perivascular & peripilar including the superficial & mid – dermis infiltrate may includes as
-Few neutrophiles
-Lymphocytes
-&plasma cells
-demodex mites are present in 20-50% of cases
Positive stains :
Direct immunoflourescence occasionally shows immunoglobulin & complement
Treatment opted fantastic drugs
-Topical Metronidazole is well effective for papulopustular rosacea
– Topical Azithromycin ,azelaic acid ,minocycline can be used also
-Pimecrolimus 1%cream can be used effectively for steroid induced rosacea
