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Case Reports
. 2012 Nov-Dec;87(6):903-5.
doi: 10.1590/s0365-05962012000600014.

Gnatophyma--a rare form of rosacea

Ana Carolina Lisboa de Macedo  1 , Fernanda Dias Pacheco Sakai, Rossana Cantanhede Farias de Vasconcelos, Artur Antonio Duarte
Affiliations
Case Reports

Gnatophyma--a rare form of rosacea

Ana Carolina Lisboa de Macedo et al. An Bras Dermatol. 2012 Nov-Dec.

Abstract
in English, Portuguese

Phyma is the last stage of rosacea and is due to chronic inflammation and edema. It can affect nose (rhinophyma), chin (gnatophyma), forehead (metophyma), ears (otophyma) and eyelids (blepharophyma). Rhinophyma is the most frequent location and there are few reports about gnatophyma. We report the case of a female patient, 41 years old, who had an infiltrated, erythematous, edematous plaque around the chin and lower lip for two years. Histopathology showed perivascular lymphocytic infiltrate, hypertrophied follicles and sebaceous glands, dilated vessels and fibrosis. She was treated with oral tetracycline, oral ivermectin and metronidazole cream with a satisfactory response. The clinical, histopathological and therapeutic response correlation confirmed the diagnosis of gnatophyma, a rare variant of phyma.

Fima é o estágio final da rosácea e ocorre devido ao edema e inflamação crônica. Pode acometer nariz (rinofima), mento (gnatofima), fronte (metofima), orelhas (otofima) e pálpebras (blefarofima). Rinofima é a localização mais encontrada e há raros relatos de gnatofima. Relataremos paciente feminina, 41 anos, que apresentava placa infiltrada, eritêmato-edematosa, em todo o mento e lábio inferior há dois anos. Histopatológico com infiltrado linfocitário perianexial e perivascular, folículos e glândulas sebáceas hipertrofiadas, vasos ectasiados e fibrose perianexial. Foi instituído tratamento com tetraciclina via oral, ivermectina via oral e metronidazol creme com resposta satisfatória. Através da correlação clínica, histopatológica e resposta terapêutica confirmou-se o diagnóstico da variante rara de fima, gnatofima.

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Conflict of interest statement

Conflict of interest: None

Figures

FIGURE 1
FIGURE 1
Infiltrated erythematous and edematous plaque on chin and lower lip, without other facial changes
FIGURE 2
FIGURE 2
Erythematous and edematous plaque on chin and lower lip. Skin looks like orange peel
FIGURE 3
FIGURE 3
HE – perianexal lymphocytic infiltrate, hypertrophied follicles, sebaceous glands and increased dilated vessels
FIGURE 4
FIGURE 4
HE- Outline of giant cell
FIGURE 5
FIGURE 5
Patient after treatment
See this image and copyright information in PMC

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