Surgical treatment of rhinophyma associated with basal cell carcinoma: Report of four cases

Rhinophyma, the end stage in the development of rosacea, is characterized by sebaceous hyperplasia, fibrosis, follicular plugging, and telangiectasis. Although it is commonly considered a cosmetic problem, it can also cause gross airway obstruction. Many patients suffer psychic trauma as a result. Basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous carcinoma (SC) have been reported previously in association with rhinophyma. It would appear that the incidence of malignancy in rhinophyma is significantly greater than in the skin of normal noses. It is the purpose of this report to discuss and emphasize the need for histologic examination of all the surgically removed tissue in patients with rhinophyma. Early surgical treatment is advocated even in minimal rhinophyma, this can result in gratification for both the patient and the surgeon. Four illustrative cases are presented.