Rhinophyma: A Report of Two Patients Managed With Electrosurgery

Rhinophyma is a chronic cutaneous condition secondary to rosacea that primarily affects the nose, leading to a bulbous and enlarged appearance. We report two cases of rhinophyma in 65- and 76-year-old men with long-standing rosacea evolving for more than 10 years. Both patients presented with progressive nasal enlargement, erythema, and nodular hypertrophy that had worsened over the previous five to seven years, leading to significant cosmetic and psychosocial impairment. The diagnosis was clinical. Surgical treatment was performed in both cases, including electrosurgical excision in one patient, allowing effective removal of hypertrophic tissue with good hemostasis and nasal remodeling. Postoperative care combined light-emitting diode photobiomodulation with adapted wound dressings and topical healing agents according to the stages of wound healing. Outcomes were favorable, with marked aesthetic improvement, reduction of nasal hypertrophy, and improved quality of life in both patients. Rhinophyma may significantly impair quality of life because of its progressive and disfiguring nature. Early management of rosacea with appropriate medical treatment is essential to limit progression; however, advanced hypertrophic forms may require therapeutic escalation to surgical approaches such as electrosurgery. In such cases, electrosurgical remodeling associated with appropriate postoperative wound care can provide favorable functional and aesthetic outcomes.