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Unlabelled: Rhinophyma is considered the end stage in the development of rosacea, with a clinical aspect characterized by sebaceous hyperplasia, fibrosis, follicular plugging, and telangiectasia. Although the treatment of rhinophyma typically has an aesthetic purpose, in some cases it also can help with nasal obstruction and eating difficulties caused by rhinophyma beyond the abnormal physical appearance that can cause social seclusion. Very few giant rhinophymas have been reported in the literature. In most cases full-thickness excision of the rhinophymatous tissue down to perichondrium and periosteum of the nasal osteocartilaginous framework followed by coverage of the residual defect with a full-thickness skin graft or local flap has been described in patients affected by giant rhinophyma. The poor results of this approach encouraged us to manage conservatively a very severe form of rhinophyma. We describe the case of a 62-year-old man who presented with a 12-year history of a progressively growing mass on the nose and with a history of nasal obstruction and eating difficulties. We advocate a careful tangential excision of the rhinophymatous tissue which allows the residual deep pilosebaceous appendages to reepithelialize as a safe method and provides a good cosmetic result with minimal scarring. To our knowledge this is the first case of a giant rhinophyma treated with conservative excision followed by secondary healing., Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A very rare case of bilateral intra-areolar polythelia with two nipples in each breast is presented. There were no other associated malformations and the patient's family history was normal. Surgical correction was performed for cosmetic reasons at the patient's request using transposition flaps in a Z-plasty design. The aesthetic and functional results were satisfactory.

Sturge-Weber syndrome (also called encephalofacial or encephalotrigeminal angiomatosis) is a rare neurocutaneous syndrome characterized by facial port-wine stains in the trigeminal nerve distribution area. An innovative treatment based on surgical and laser techniques of a patient affected with Sturge-Weber syndrome is reported. The aesthetic and functional results were satisfactory.