Diseases of the external nose (外鼻疾病)

Rhinophyma (肥大性酒渣鼻)

Clinical features:

Red nodular masses centred around the nasal tip in association with acne rosacea, usually seen in elderly men.

Management:

If unsightly, treat by dermabrasion or surgical shaving.

Lupus vulgaris (尋常狼瘡)

Aetiology:

Inoculation of the bacterium Mycobacterium tuberculosis, possibly through nose picking.

Clinical features:

Red/brown patches or nodules on the nasal or facial skin. Perforation of the cartilaginous nasal septum can occur, with scarring in long-standing cases.

Management:

Treatment is by antituberculous chemotherapy.

Lupus pernio (凍瘡樣狼瘡)

Clinical features:

Skin lesions other than erythema nodosum occur in 20% of patients with sarcoidosis. Lupus pernio is common and is frequently associated with bone cysts and chest disease.

Management:

Treat the underlying disease.

Malignant tumours (惡性腫瘤)

Clinical features:

Basal or squamous cell carcinomas present as warty or ulcerating lesions, rarely with lymphadenopathy. Melanomas are more rare.

Management:

Excision biopsy when possible; radiotherapy for larger tumours not involving bone.