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Ulceration of the nasal dorsum: a rare cause?

Published online by Cambridge University Press:  28 January 2014

F Salim ,
A Joshi  and
C Hopkins
F Salim*
Affiliation:
ENT Department, Guy's Hospital, London, UK
A Joshi
Affiliation:
ENT Department, Guy's Hospital, London, UK
C Hopkins
Affiliation:
ENT Department, Guy's Hospital, London, UK
*
Address for correspondence: Mr Fakhruddin Salim, ENT Department, 3rd Floor, Southwark Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK E-mail: [email protected]
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Abstract

Introduction:

Non-healing ulcers can be caused by a number of conditions, including vascular disease, diabetes, malignancy and some infections. Drug-related ulcers are rare, and a high index of clinical suspicion is required for diagnosis, in parallel with exclusion of more sinister underlying causes.

Case report:

We present a patient with a complex medical background, who had a 10-week history of a non-healing ulcer on his nasal bridge. Inflammatory, autoimmune and malignant causes for the ulcer were excluded by histopathology.

Conclusion:

Nicorandil was deemed to be the most likely cause for the patient's ulcer. Nicorandil is an anti-anginal medication known to cause oral ulceration and skin lesions in the perianal and peristomal regions and around surgical wounds. However, there are no previously reported cases of facial ulcers. The ulcer required surgical debridement and healed completely within six months, following discontinuation of nicorandil. This case highlights the importance of having a high index of clinical suspicion regarding non-healing ulcers, and of considering drugs as an aetiological factor, especially in patients with a complex medical background who are taking numerous medications.

Keywords

NicorandilUlcerMucous Membrane Pemphigoid, BenignAdverse Effects
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 3 , March 2014 , pp. 289 - 291
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

Presented at the 141st Semon Club Meeting, 2 June 2011, London, UK

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