Otophyma is the term used to describe
sebaceous gland hypertrophy and hyperplasia of the pinna. It is
usually considered to be the end stage of rosacea. This disorder is
considered to be a chronic cutaneous disorder of unknown etiology.
Phyma is a greek word meaning “growth”.
Usually it is caused by sebaceous gland hyperplasia and hypertrophy
of the surrounding fibrous tissue. These Phymas are named according
to the site of affliction.
Rhinophyma – when nose is affected.
Gnatophyma – When chin is affected
Metophyma – when forehead is involved
Otophyma – When pinna is involved
Blepharophyma – When eyelids are
Otophyma or rosaceous lymphoedema can
either be unilateral / bilateral. Eventhough Rosacea is a common
cutaneous disorder of unknown etiology affecting females otophyma is
The diagnosis of otophyma is made
purely on clinical basis. Biopsy is necessary to differentiate this
from similar looking diseases like lupus, carcinoma and angiosarcoma.
Histopathology reveals hyperplasia and hypertrophy of sebaceous
glands. The ducts of these glands appear dilated, convoluted and
plugged. There is also associated proliferation of fibroblasts and
presence of bacteria and inflammatory cells. Demodex folliculorum
mite is commonly seen.
Early lesions which happen to be
hyperemic respond to oral antibiotics like tetracycline and
metronidazole. Late stages may require surgery.
Full thickness excision with split
Full thickness excision with full
Decortication – partial
excision / shaving of the lesion. Cryo surgery has also been used
in decortication procedures.