BACKGROUND. Rosacea is a disorder characterized by erythematous papules, pustules, and telangiectases involving the nose, chin, cheeks, and forehead that may progress to rhinophyma. Although the etiology of rosacea remains unclear, a common theme in pathogenesis is vasodilation. Rosacea has been associated with both idiopathic flushing as well as that induced secondarily. OBJECTIVE. To report clinical and histologic features of rhinophyma that developed in association with a longstanding cavernous hemangioma. RESULT. The patient is a 57‐year‐old Hispanic man with a congenital port‐wine stain that had developed into a nodular, cavernous hemangioma over the course of years. Clinically, in the site of the angioma there was marked soft‐tissue overgrowth with sebaceous hyperplasia. These changes were confined to the angiomatosis areas and were sharply demarcated from the surrounding normal skin. Histologically, there was marked fibroplasia; numerous small cysts, some with focal rupture and inflammation; dilated follicular ostia; and prominent sebaceous gland hyperplasia in addition to numerous ectatic blood vessels, which were a component of the hemangioma. In contrast, normal‐appearing skin adjacent to this site revealed only normal sebaceous glands and no fibroplasia. Treatment consisted of CO2 laser excision of the nodular components of the hemangioma with a tightly focused beam, followed by resculpting of the natural facial contour with laser abrasion of hypertrophic soft tissues with a broad, unfocused beam. The treated area healed well, with a skin tone of a more natural color than the original hemangioma. CONCLUSION. Our findings suggest that rhinophyma may develop secondary to the vasodilation seen in large hemangiomas and that the CO2 laser offers excellent treatment for both the vascular and stromal components of the lesion. We describe a patient with a large port‐wine stain with cavernous components and associated rhinophyma. We suggest that the long‐standing vasodilation secondary to the hemangioma was responsible for its development. Treatment with CO2 laser proved effective for both the hemangiomatous elements and the rhinophyma and is a valuable therapeutic option for lesions such as these. 1993 American Society for Dermatologic Surgery, Inc.
|Original language||English (US)|
|Number of pages||7|
|Journal||The Journal of Dermatologic Surgery and Oncology|
|State||Published - Mar 1993|
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