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April iotaderma (#278)
JAAD ONLINE: IOTADERMA IOTADERMA #279 We all know that spider bites are nasty and quite painful events. Do you know why spider bites are so painful? Robert I. Rudolph, MD, FACP Answer will appear in the JAAD Online section of the June issue of the Journal.
APRIL IOTADERMA (#278) Question: Can you name at least 5 diseases that can cause the nasal deformity called ‘‘saddle nose?’’ Answer: While the most common etiology is nasal trauma, saddle nose can be associated with many diseases, including sarcoidosis, leprosy, congenital syphilis, granulomatosis with polyangiitis (formerly Wegener granulomatosis), relapsing polychondritis, and squamous cell carcinoma.1-3 Another important cause to consider is cocaine abuse (often associated with nasal septum perforation).4 A number of other conditions can also manifest this finding. Saddle nose occurs because the bridge of the nose is lost, and the fullness of the nose decreases considerably. The depressed area may be caused by the loss of both bony and cartilaginous components of the dorsal surface of the nose. A multitude of plastic surgical techniques can often be effective in restoring the cosmetic appearance of the nose. REFERENCES 1. Durbec M, Disant F. Saddle nose: classification and therapeutic management. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131:99-106. 2. Shimamura S, Yokogawa N, Murata K, Yamaguchi T, Uchida K, Eishi Y. Saddle nose with sarcoidosis: ‘‘a great imitator’’ of relapsing polychondritis. Mod Rheumatol. 2016;20:1-5. 3. Graham HE, Connolly C, Pahal GS, Stafford FW. ‘Saddle nose’ deformity caused by advanced squamous cell carcinoma of the nasal septum. BMJ Case Rep. 2014;2014. 4. van der Poel NA, Schot LJ, Menger DJ. Local complications of intranasal cocaine abuse: diagnostic and therapeutic guidelines [in Dutch]. Ned Tijdschr Geneeskd. 2013;157:A6035.
Robert I. Rudolph, MD, FACP
e185
APRIL IOTADERMA (#278) Question: Can you name at least 5 diseases that can cause the nasal deformity called ‘‘saddle nose?’’ Answer: While the most common etiology is nasal trauma, saddle nose can be associated with many diseases, including sarcoidosis, leprosy, congenital syphilis, granulomatosis with polyangiitis (formerly Wegener granulomatosis), relapsing polychondritis, and squamous cell carcinoma.1-3 Another important cause to consider is cocaine abuse (often associated with nasal septum perforation).4 A number of other conditions can also manifest this finding. Saddle nose occurs because the bridge of the nose is lost, and the fullness of the nose decreases considerably. The depressed area may be caused by the loss of both bony and cartilaginous components of the dorsal surface of the nose. A multitude of plastic surgical techniques can often be effective in restoring the cosmetic appearance of the nose. REFERENCES 1. Durbec M, Disant F. Saddle nose: classification and therapeutic management. Eur Ann Otorhinolaryngol Head Neck Dis. 2014;131:99-106. 2. Shimamura S, Yokogawa N, Murata K, Yamaguchi T, Uchida K, Eishi Y. Saddle nose with sarcoidosis: ‘‘a great imitator’’ of relapsing polychondritis. Mod Rheumatol. 2016;20:1-5. 3. Graham HE, Connolly C, Pahal GS, Stafford FW. ‘Saddle nose’ deformity caused by advanced squamous cell carcinoma of the nasal septum. BMJ Case Rep. 2014;2014. 4. van der Poel NA, Schot LJ, Menger DJ. Local complications of intranasal cocaine abuse: diagnostic and therapeutic guidelines [in Dutch]. Ned Tijdschr Geneeskd. 2013;157:A6035.
Robert I. Rudolph, MD, FACP
e185