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Rhinophyma Less commonly, rosacea can develop Rhinophyma where the shape and size of the nose changes All images on this page are sourced from DermNet | Dermatology Resource (dermnetnz.org) R.C 24-05-24 Referral Guidelines Severe unresponsive disease for consideration of isotretinoin Refer to Plastic Surgery for consideration of laser or surgical therapy: Rhinophyma Severe Telangiectaisa Refer to Ophthalmology for associated keratitis