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2019年7月9日星期二

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. 



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