Potato nose
Overview
Synonyms: rum nose, rhinophyma, rum-blossom, hammer nose, copper nose, toper's nose, potato nose, hypertrophic rosacea, brandy nose enlargement of the nose with dilation of follicles and redness and prominent vascularity of the skin; often associated with excessive consumption of alcohol
Symptoms
The list of signs and symptoms mentioned in various sources for Rhinophyma includes the 6 symptoms listed below: * Enlarged nose * Bulbous red nose * Bumpy nose * Enlarged nasal skin pores * Broken blood vessels on the nose * Pimples on the nose Note that Rhinophyma symptoms usually refers to various symptoms known to a patient, but the phrase Rhinophyma signs may refer to those signs only noticable by a doctor.
Causes
* Acne vulgaris –Common in adolescents, especially boys –Most common on face, chest, and upper back –Due to hormones, P. acnes, and comedogenic cosmetics –May be secondary to or exacerbated by medications (e.g., corticosteroids, phenytoin, lithium, isoniazid) and polycystic ovarian syndrome * Rosacea –Middle-aged to older adults –Papules and pustules in middle third of face, telangiectasia, flushing, erythema –No comedones –Often associated with ingestion of hot beverages, alcohol, or vasodilating medications * Miliaria (“heat rash”) –Burning, pruritic vesicles, papules, or pustules on covered areas, usually trunk and intertriginous areas * Gram-negative folliculitis –Klebsiella, Enterobacter, E. coli –May develop during antibiotic treatment of acne * Acne conglobata –Most severe form of acne –Deep nodules, cysts, ulcers, abscesses, sinus tracks, scars –Causes severe scarring and keloid formation if untreated * Acne fulminans –Severely destructive form of acne –Ulcerations, fever, arthralgia * Pyoderma faciale –Affects only adult women –Severe cysts and sinus tracks * Hidradenitis suppurativa –Pustules and cysts, often draining and very painful –Especially in axilla, groin * Malassezia folliculitis –Fungal infection –Occurs on back –No response to acne therapy
Diagnosis
Ask the patient when he first noticed the butterfly rash and if he has recently been exposed to the sun. Has he noticed a rash elsewhere on his body? Also, ask about recent weight or hair loss. Does he have a family history of lupus? Is he taking hydralazine or procainamide (common causes of drug-induced lupus erythematosus [LE])? Inspect the rash, noting any macules, papules, pustules, or scaling. Is the rash edematous? Are areas of hypopigmentation or hyperpigmentation present? Look for blisters or ulcers in the mouth, and note any inflamed lesions. Check for rashes elsewhere on the body.