JAMA. 1919;72(24):1734-1735. doi:10.1001/jama.1919.02610240022006.
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Rhinophima is the most advanced stage in the development of acne rosacea, characterized by marked hypertrophic changes in the cutaneous and subcutaneous tissues of the nose, producing a firm, reddish or purplish lobulated, and, in extreme cases, pendulous tumor masses. This condition is frequently so disfiguring and repulsive as to prevent the person afflicted with it from earning a livelihood or mingling in society, and it is in just such cases that surgery offers the only means of relief.

The pathologic changes which lead up to this condition may well be divided into three stages. The first stage is marked by a simple venous engourgement. The second stage shows the veins and the capillaries permanently enlarged. In the third stage, there is an enormous hyperplasia of the connective tissue elements of the skin, and the sebaceous glands are so enlarged that the nose presents a honeycombed and unsightly appearance.



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