Nasal Vestibulitis and Nasal Furunculosis and Mucormycosis
Infection of the skin of the nasal vestibule is termed nasal vestibulitis. It may be secondary to constant rhinorrhea, nose-picking, or viral infections such as herpes simplex and herpes zoster. Foreign bodies frequently cause vestibulitis in children due
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2.4 Nasal Vestibulitis and Nasal Furunculosis and Mucormycosis
Nasal Vestibulitis and Nasal Furunculosis and Mucormycosis Infection of the skin of the nasal vestibule is termed nasal vestibulitis. It may be secondary to constant rhinorrhea, nose picking, or viral infections such as herpes simplex and herpes zoster. Foreign bodies frequently cause vestibulitis in children due to purulent discharge. Nasal furunculosis is Staphylococcus aureus infection of the hair follicles. Nose picking is a frequent cause of furunculosis. Topical and if necessary systemic antibiotics are prescribed. The patient should be instructed not to squeeze out pus from this area. Since the veins draining this area are valveless and directly join the cavernous sinus, there is a potential risk of spreading infection to the cavernous sinus via these facial veins. Eczema may also mimic vestibulitis. In these cases steroid base ointment may help the patient. In persistent vestibulitis, neoplastic diseases such as basal cell or squamous cell carcinoma should be kept in mind.
Fig. 2.4.2 If not treated, the infection in the nasal vestibule may spread to the upper lip. The upper lip on the right side appears hyperemic and edematous
Fig. 2.4.3 Furunculosis in the nasal vestibule with spread of the infection to the nasal tip and dorsum
Fig. 2.4.1 Nasal vestibulitis on the left side. Note the slight edema and hyperemia as well as excoriation of the skin on the left side
Fig. 2.4.4 Infection starting as nasal vestibulitis with spread of infection to the nasal dorsum and right periorbital area
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Chapter 2 Nose
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Fig. 2.4.6 Constant rhinorrhea and the need to wipe the nose due to allergic rhinitis have resulted in vestibulitis
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Fig. 2.4.7 Right alar rim. Basal cell carcinoma with slight hyperemia around it. In persistent vestibulitis, neoplastic diseases such as basal cell or squamous cell carcinoma should be kept in mind
Fig. 2.4.5 Venous drainage of the nose. (a) frontal view, (b) Lateral view. Since the veins draining this area are valveless and directly join the cavernous sinus, there is a potential risk of spreading infection to the cavernous sinus via these facial veins. This area of the nose is termed the danger triangle. Squeezing the pus from this area should be avoided
Fig. 2.4.8 Hyperemia and edema in the columella and nasal tip mimicking severe vestibulitis secondary to squamous cell carcinoma infiltration. The neoplastic lesion is filling the left nasal passage
2.4 Nasal Vestibulitis and Nasal Furunculosis and Mucormycosis
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Fig. 2.4.10 Mucormycosis in a child with leukemia. Gross tissue necrosis with a black eschar is characteristic of mucormycosis
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Fig. 2.4.9 Mucormycosis in a diabetic patient. Mucormycosis may infect different areas of the body, but the most frequent fatal form is the rhinocerebral form. (a) Necrotic areas on the face, (b) black necrotic areas in the nasal mucosa, (c) and after removal of necrotic area in the nose Fig. 2.4
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