ABSTRACT
Phymas are slowly progressive, disfiguring disorders of the face and ears that represent
the end stage of rosacea, a common centrofacial dermatosis. Phymas are probably caused
by the sequelae of chronic edema and its related connective tissue and sebaceous gland
hypertrophy. Rhinophyma is the commonest among them. Analogous swellings may occur
on the chin (gnatophyma), forehead (metophyma), one or both ears (otophyma), and eyelids
(blepharophyma). Although rhinophyma has been traditionally associated with alcoholism,
there is no evidence to support this association. Four variants of rhinophyma (glandular,
fibrous, fibroangiomatous, actinic) can be recognized on clinical and histological
basis. The development of skin cancer, such as basal cell carcinoma or squamous cell
carcinoma, in rhinophyma appears to be a matter of accidental coincidence of different
diseases. Although phymas are best treated surgically, they may be a worthwhile indication
for nonsurgical treatment modalities such as systemic isotretinoin. Phymas do not
resolve spontaneously.
KEY WORDS
Rosacea - rhinophyma - gnatophyma - metophyma - otophyma - blepharophyma
