Rhinophyma in a patient with rosacea. The patient also suffers from meibomian gland disease, chronic acne, lid distortion, chronic blepharitis, chronic dry eye. The upper photograph reveals thickening and hypertropic changes of the connective tissue of the nose, Rhinophyma and facial telangiectasias with recurrent papules, pustules, and mid-facial erythema. The lower images reveal meibomian gland distortion, and eyelid telangiectasia.