Basal Cell Carcinoma and Rhinophyma: A Novel Treatment Option

Objective: Resection of basal cell carcinoma (BCCA) from a background of advanced rhinophyma can present a reconstructive challenge, thus a novel surgical treatment option is presented. Report a case of concurrent rhinophyma and BCCA, review the literature, and discuss surgical options available.

Method: A review of the literature reveals only 12 reported cases of concurrent BCCA and rhinophyma since 1955, all describing occult discovery of BCCA. This is the first reported case of known BCCA complicated by rhinophyma.

Results: The traditional repair options after excision of BCCA from the nasal tip include healing by secondary intention, skin grafting, and local flap rotation. In patients with rhinophyma, these options are less than ideal. As a novel alternative, wide local excision of the lesion with intra-operative frozen section margin control was carried out, followed by single-stage tangential excision and dermabrasion of the nasal skin involved with rhinophyma. Negative margins were obtained, symmetry and homogeneity of the nasal skin was achieved, and the patient was very pleased with the results. Before and after photo documentation and representative histologic sections will be presented.

Conclusion: The reported synchronous presence of known BCCA and rhinophyma is exceedingly rare. This case demonstrates that both cancer cure and an optimal aesthetic result can be achieved by this novel treatment option.