A 38-year-old woman presents with central facial erythema, telangiectasias, papulopustules and episodic flushing for 2 years. She has no comedones. Her nose shows phymatous skin thickening. Which subtype of rosacea is she MOST likely in?

• A Subtype 1: Erythematotelangiectatic rosacea
• B Subtype 3: Phymatous rosacea ✓
• C Subtype 2: Papulopustular rosacea
• D Subtype 4: Ocular rosacea

Explanation

Phymatous rosacea (subtype 3) is characterised by skin thickening with irregular surface nodularities, most classic on the nose (rhinophyma), and may also affect chin, forehead, ears and eyelids. The patient demonstrates overlapping features (erythema, papulopustules) but the phymatous nasal change distinguishes this. Rhinophyma results from sebaceous gland hyperplasia and connective tissue overgrowth. It is more common in men. Treatment of advanced rhinophyma includes CO2 laser ablation or surgical shaving.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.