Shatkin Samuel, Shatkin Michael, Smith Katherine, Beland Leah E, Oppenheimer Adam J
Department of Plastic Surgery, Aesthetic Associates Centre, Buffalo, USA.
Department of Plastic & Reconstructive Surgery, Aesthetic Associates Centre, Buffalo, USA.
Cureus. 2018 Apr 25;10(4):e2536. doi: 10.7759/cureus.2536.
Rhinophyma is the final stage in the evolution of acne rosacea, a common vasoactive dermatosis. Individuals with rhinophyma present with a typical, disfiguring nasal appearance consisting of bulbous enlargement, erythema, and telangiectasia with a sebaceous, oily skin surface. This classic appearance permits a facile diagnosis but may also lead the physician to overlook a coexistent malignancy. We report the occurrence of a diffuse large B-cell lymphoma (DLBCL) arising synchronously with a marked rhinophyma. A wide local excision of the malignancy was performed, and the defect was reconstructed with forehead flaps. The rhinophyma was treated with a skin graft and cheek flaps. Following surgery, chemotherapy was used to manage the systemic disease. This case demonstrates the necessity for clinical scrutiny in the diagnosis and treatment of rhinophyma. It is imperative to entertain a high degree of suspicion when non-typical changes are observed within a rhinophymatous lesion or in adjacent areas of the nose.
酒渣鼻性鼻赘是常见的血管活性皮肤病——酒渣鼻演变的最后阶段。患有鼻赘的个体表现出典型的、毁容性的鼻部外观，包括球根状肿大、红斑和毛细血管扩张，皮肤表面呈皮脂性且油腻。这种典型外观便于诊断，但也可能导致医生忽略同时存在的恶性肿瘤。我们报告了一例与明显鼻赘同时发生的弥漫性大B细胞淋巴瘤（DLBCL）。对恶性肿瘤进行了广泛的局部切除，并用额部皮瓣修复缺损。鼻赘采用皮肤移植和颊部皮瓣治疗。手术后，使用化疗来控制全身性疾病。该病例表明在鼻赘的诊断和治疗中进行临床仔细检查的必要性。当在鼻赘病变或鼻子相邻区域观察到非典型变化时，必须高度怀疑。
