AMR SeriesGiant RhinophymaWang, Yan MD, PhD*; Allen, Philip W. MB, BS, FRCPA†Author Information *Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China †Department of Anatomical Pathology, SA Pathology at Flinders Medical Centre, Bedford Park, SA, Australia Case ID and source: AMR #75, case 1. FMC: SF-19-0006787. Case contributed by P.W.A., SA Pathology at Flinders Medical Centre, Bedford Park, SA, Australia. The authors have no funding or conflicts of interest to disclose. Reprints: Philip W. Allen, MB, BS, FRCPA, Department of Anatomical Pathology, SA Pathology at Flinders Medical Centre, Bedford Park 5042, SA, Australia (e-mail: firstname.lastname@example.org). All figures can be viewed online in color at www.anatomicpathology.com. Advances In Anatomic Pathology: November 2020 - Volume 27 - Issue 6 - p 422-424 doi: 10.1097/PAP.0000000000000282 Buy Metrics Abstract A 42-year-old woman presented with a clinically obvious giant rhinophyma. The protocol of the unit handling the case mandated that all lesions amenable to biopsy should have a core biopsy before any definitive surgery, but the unnecessary biopsy was not representative and suggested an incorrect diagnosis of perifollicular fibroma. The lesion was excised. The sections showed dilated hair follicle pores on the skin surface, squamous lined hair follicles plugged with keratin, prominent sebaceous glands, perifollicular inflammation without granulomas, intradermal budding of hair follicle basal cells, and extensive hypocellular, mildly edematous fibrous tissue with slightly dilated, thin-walled vessels and a few chronic inflammatory cells. These fully representative sections confirmed the diagnosis of giant rhinophyma, suggesting that preoperative core biopsies of this condition are unnecessary and may be misleading. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.