title: Gnatophyma and otophyma.
abstract: BACKGROUND
  Phymas are slowly progressive, disfiguring disorders of the face and ears that represent the end stage of rosacea. The most common phyma is rhinophyma, yet similar swellings may occur on the chin (gnatophyma), forehead (metophyma), one or both ears (otophyma), and eyelids (blepharophyma).
  
  
  OBJECTIVE
  Unlike rhinophyma, otophyma is rarely seen. We report two rare phymas: a case of gnatophyma and a case of otophyma.
  
  
  METHODS
  A 56-year-old African American man presented with a history of bumps on his chin that had begun about 7 years earlier. Physical examination was remarkable for lobulated plaques on the chin, coalescing into hypertrophic nodules and dilated pores. A 73-year-old African American male presented with bilateral cauliflower-like earlobe growths for the past 17 years.
  
  
  RESULTS
  A skin biopsy was performed for each patient demonstrating cystic follicular dilatation with keratin plugging, dermal scarring, psoriasiform epidermal hyperplasia, and chronic inflammation of some of the follicles.
  
  
  CONCLUSIONS
  This case report describes a relatively rare gnatophyma and otophyma. Surgical management is well accepted as the best mode of therapy to treat rhinophyma and is becoming a first-line treatment for all phymas.
authors.affiliation: Division of Dermatology, Department of Medicine, David Geffen Schoool of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Navid
authors.initials: N
authors.lastname: Ezra
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Greco
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Haley
authors.forename: Melvin W
authors.initials: MW
authors.lastname: Chiu
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D004427:Ear Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012393:Rosacea / Q000175:diagnosis*; D012867:Skin / Q000473:pathology*