Phenytoin induced rhinophyma treated by excision and full thickness skin grafting

A 49-year-old man suffering from post-traumatic epilepsy presented with a severe rhinophyma probably induced by phenytoin. Initial surgical shaving was soon followed by recurrence, formation of intraepidermal cysts and persistent infection. Ultimate treatment by full thickness excision and a full thickness skin graft resulted in a pleasing cosmetic result. Radical excision of the affected skin followed by full thickness skin graft nasal reconstruction should be considered for cases of recurrent severe rhinophyma with inclusion cysts to eradicate chronic infection and improve cosmesis.