张润东 王焱

    [摘要]玫瑰痤疮鼻赘期是玫瑰痤疮进展导致鼻部皮肤增厚、变硬、鼻部外观受损甚至呼吸道堵塞的时期。中国玫瑰痤疮患病率低于白种人，鼻赘改变相对少见。玫瑰痤疮鼻赘期的严重程度分级系统在全球范围内尚未确立统一标准，分级系统主要作用是评估治疗效果和预后。玫瑰痤疮一旦进展至鼻赘期，外科治疗是其唯一方式，包括CO2激光和铒激光、直接薄层切削、皮瓣或皮片移植、磨削术、划痕术、美容亚单位法等。对于外科治疗方法的选择要着重评估鼻软骨受损情况及病变合并癌变的可能，根据患者具体情况及医生临床经验进行综合考量，选择个性化的手术方案。

    [关键词]玫瑰痤疮；玫瑰痤疮鼻赘期；鼻赘；分级系统；激光治疗；磨削术；划痕术

    [中图分类号]R758.73+4? ? [文献标志码]A? ? [文章编号]1008-6455(2023)05-0198-04

    Progress in Grading and Surgical Treatment of? Phymatous Rosacea

    ZHANG Rundong，WANG Yan

    (Hospital for Skin Diseases， Institute of Dermatology， Chinese Academy of Medical Sciences & Peking Union Medical College，Nanjing 210042，Jiangsu，China)

    Abstract： Phymatous rosacea is the advanced stage of rosacea affecting nasal area and resulting in thickening and hardening of the nasal skin， disfigurement of the nasal appearance and even obstruction of the airway. The incidence of rosacea in China is lower than that of the Caucasic race and phymatous changes are rarer. There is no universal and golden standard of classification and grading system worldwide. The main applicable scenes of the system are evaluating treatment effects and disease prognosis. Once progressing to the rhinophyma change the only choice for the therapy of it is surgical treatment which includes CO2 and Erbium laser ......