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Occasionally, a marked hypertrophy of the nasal tissues and enlargement of the sebaceous glands develop in patients with acne rosacea, resulting in a large, bulbous nose. To this condition, the name rhinophyma is applied. The nasal enlargement may appear simultaneously with the onset of acne rosacea but more frequently it develops several years later. Involvement of areas other than the nose is rarely seen, although Sams1 reports a case with marked tumefaction of the chin, and mentions several cases where tissues adjacent to the nose were involved. Rhinophyma rarely occurs in women. All six cases treated at the Cleve-land Clinic since 1930 have occurred in men.

A specific etiological factor for the parent disease, acne rosacea, has not been definitely discovered. Among the contributing causes have been mentioned excessive use of alcohol, liver disease, constipation, folliculitis of the face, exposure, substitution of cleansing creams for soap and water, and focal infection2.

Ayres and Anderson3 reported 77 cases of acne rosacea and pityriasis folliculorum in which large numbers of Demodex folliculorum were found in the pustules. There was a marked reduction in the number of parasites and remarkable improvement or cure following the application of an antiparasitic ointment. They believe they have discovered a significant etiological factor for acne rosacea.

The following case illustrates a typical rhinophyma and a type of treatment which, in our experience, has given a very satisfactory result.

Report of Case

The patient was a white, single man, 41 years of age, who came under observation in. . .



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