Dermatology Department, Dermatological Procedures Unit, Bordeaux University Hospital, Hôpital Saint-André, 1, rue Jean Burguet, 33000 Bordeaux, France.
Dermatology Department, Dermatological Procedures Unit, Bordeaux University Hospital, Hôpital Saint-André, 1, rue Jean Burguet, 33000 Bordeaux, France.
Ann Dermatol Venereol. 2021 Sep;148(3):172-176. doi: 10.1016/j.annder.2021.02.004. Epub 2021 Jun 24.
Treatment of rhinophyma consists primarily of destructive procedures. There is currently no consensus regarding treatment. In this study, we propose an algorithm based on a cohort of 25 patients and a literature review.
This was a retrospective study conducted between January 2016 and December 2018. The cosmetic outcome was evaluated by 2 independent assessors based on pre- and postoperative photographs. Patients were ranked according to the severity (mild, moderate, severe) of their rhinophyma. The different surgical methods used were cold blade excision or rhinoshave, electrosurgery or monopolar diathermy knife (MDK), and carbon dioxide laser (CO laser), either alone or in combination with another technique. All patients were contacted after the procedure to evaluate their satisfaction and to investigate for adverse effects.
Twenty-five patients were included retrospectively: 7 with mild rhinophyma (5 were treated by MDK, 1 by fractional CO laser, and 1 by cold-blade excision and TCA solution), 11 with moderate rhinophyma (2 were treated by MDK, 9 by continuous CO laser), and 7 with severe rhinophyma (2 were treated by MDK, 5 by MDK plus CO laser). Cosmetic outcomes were deemed good or excellent in 80% of cases, and 84% of patients were fully satisfied with the result. We observed 5 cases of hypertrophic scarring, 2 cases of hypopigmentation, 3 cases of notching of the nasal ala, and 7 cases of prolonged erythema, most of which were caused by the MDK technique.
A wide range of treatment options are available for rhinophyma. We suggest the use of cold-blade excision and trichloroacetic acid or fractional carbon dioxide laser for mild rhinophyma, continuous and pulsed CO laser for moderate rhinophyma, and MDK for severe rhinophyma.
酒渣鼻的治疗主要采用破坏性方法。目前尚无关于治疗的共识。在这项研究中，我们基于 25 名患者的队列和文献复习提出了一种算法。
这是一项回顾性研究，于 2016 年 1 月至 2018 年 12 月进行。根据术前和术后照片，由 2 名独立评估者评估美容效果。根据酒渣鼻的严重程度（轻度、中度、重度）对患者进行排名。使用的不同手术方法包括冷刀切除或鼻刮术、电外科或单极电刀（MDK）以及二氧化碳激光（CO 激光），单独或联合使用另一种技术。所有患者在手术后均进行联系，以评估他们的满意度并调查不良反应。
回顾性纳入 25 名患者：7 名轻度酒渣鼻患者（5 名患者接受 MDK 治疗，1 名患者接受分数 CO 激光治疗，1 名患者接受冷刀切除和三氯乙酸溶液治疗），11 名中度酒渣鼻患者（2 名患者接受 MDK 治疗，9 名患者接受连续 CO 激光治疗），7 名重度酒渣鼻患者（2 名患者接受 MDK 治疗，5 名患者接受 MDK 联合 CO 激光治疗）。80%的病例美容效果良好或优秀，84%的患者对结果完全满意。我们观察到 5 例肥厚性瘢痕形成，2 例色素减退，3 例鼻翼切迹，7 例红斑持续时间延长，其中大部分是由 MDK 技术引起的。
酒渣鼻的治疗方法多种多样。我们建议对于轻度酒渣鼻，使用冷刀切除和三氯乙酸或分数 CO 激光；对于中度酒渣鼻，使用连续和脉冲 CO 激光；对于重度酒渣鼻，使用 MDK。
