Gnatophyma: a rare form of rosacea

Abstract

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.

Two Cases of Gnatophyma, an Unusual Form of Rosacea

“…The patients reported here are both female and also have lesions exclusively on the chin. This kind of localization can be attributed to chronic inflammation of rosacea causing lymphatic system failure and lymphedema [7]. Associations between dental or periodontal foci and rosacea have been reported to occur rarely; a significant improvement in rosacea after a dental treatment was reported [8].…”

New developments in the treatment of rosacea – role of once-daily ivermectin cream

“…34 Gnatophyma, a rare variant of phymatous rosacea involving the chin, was treated with oral ivermectin, oral tetracycline, and metronidazole cream with satisfactory results ( Table 1 ). 35 …”

Solitary plaque on the chin

“…Rosacea is a common disease affecting mostly middle-aged women and is manifested by transient or persistent erythema, telangiectasia, edema, papules, and/or pustules on the face, most typically in the centrofacial area. [ 1 2 ] The etiology is unknown. However, it is postulated that tissue damage, oxidative stress, decreased superoxide dismutase, and production of vasoactive substances such as serotonin, prostaglandins, and substance P are involved in the pathogenesis of rosacea.…”

“…Other factors known to be involved include opioid peptides, Helicobacter pylori infections, Demodex brevis , and Demodex folliculorum . [ 2 3 ]…”

“…Rhinophyma is the most common form of phyma affecting nose while other rare sites include chin (gnatophyma), forehead (metophyma), ears (otophyma), and eyelids (blefarophyma). [ 2 3 ] Very few cases of gnatophyma have been reported in the scientific literature. [ 2 ]…”