On examination, he is noted to have rhinophyma. What is the SINGLE most likely diagnosis?


#1

A 58 year old man complains of nose disfigurement. He has a history of facial erythema
particularly of the cheeks and nose. Red papules and pustules have been erupting at
intervals over the last 10 years. He notices that his face becomes flushed commonly after consumption of alcohol. On examination, he is noted to have rhinophyma. What is the SINGLE most likely diagnosis?
A. Eczema
B. Acne rosacea
C. Pemphigus vulgaris
D. Dermatomyositis
E. Tinea versicolor
Acne rosacea
Rosacea is a common rash, usually occurring on the face, which predominantly affects
middle-aged (age range 40 to 60 years old) and fair skinned people.
Clinical features:

  • Red papules and pustules on the nose, forehead, cheeks and chin
  • Frequent blushing or flushing
  • Red face due to persistent redness and/or prominent blood vessels -
    telangiectasia
  • Aggravation by sun exposure and hot and spicy food
  • Fibrous thickening causing rhinophyma → Rhinophyma is an enlarged nose
    associated with rosacea which occurs almost exclusively in men
    For a diagnosis to be confirmed the erythema should have been present for at least
    three months
    Note: Flushing after alcohol or spicy food is a hint usually put in exams