 |
|
 |
|
|
|
May 2002
Case submitted by Youn W. Park, MD and
James Eley, MD
|
|
|
CASE:
A 24-year-old woman presents with an erythematous swelling
of the nostril area. The patient admits that she has a habit
of blowing her nose frequently. For discomfort and an itching
sensation, she has found application of Vaseline somewhat
helpful. An examination of the rest of the nasal cavity after
a clearing of the vestibular crust reveals only slight erythematous
mucosa.
|
| What is your diagnosis? |
| |
|
|
|
Nasal vestibulitis is a common infection among
adults. Nose picking, excessive cleaning or rubbing of the nostril
with a handkerchief or facial tissue, or vigorous blowing of
the nose (habits that are often denied by the patient) causes
a break, fissure, or ulceration of the protective epithelial
lining of the vestibule. This provides a portal for entry by
Staphylococcus microbes that are almost always resident
in the area, causing recurrent inflammation. The typical symptoms
include pain, tenderness, crusting inside the vestibule, swelling,
and erythema. Abscesses can form in the hair follicles, especially
if hairs are plucked. Topical mupirocin may be applied three
times a day for two weeks. Application of heat also may be beneficial.
The condition will not improve, regardless of treatment, until
the habit or habits that caused it are stopped. The nasal vestibule
should not be manipulated or squeezed because venous drainage
from the area can lead to cavernous sinus thrombosis. |
Dr. Park is clinical professor of otolaryngology at Northeastern
Ohio Universities College of Medicine and attending physician
in the section of otolaryngology at Akron General Medical Center,
Akron, Ohio. Dr. Eley is attending physician in the department
of family practice at Akron General Medical Center.
|
|
