A 48-year-old woman was presented to our clinic with a history of a tumoural lesion on both ears for 9 months. Microscopic examination revealed dermal fibrosis and oedema, dilated follicular infundibula, perivascular and perifollicular lymphocytic infiltration, diffuse dermal telangiectasia and multiple hypertrophic sebaceous glands (Fig.). Phymatous rosacea is often defined as the end stage of rosacea, characterised by skin thickening and surface nodularities.