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External nose diseases: furunculosis, eczema, sycosis, erysipelas, frostbite

Nasal furunculosis

Nasal furunculosis often develops with immunodeficiency, suffering from General furunculosis, enteric diseases, and in children with exudative diathesis, rickets. Predispose to its occurrence habit to pick your nose, squeeze blackheads, as well as the frequent acute respiratory infections, sinusitis, skin diseases. The cause of nasal furunculosis is often staphylococcus, causing an inflammatory reaction when injected into the sebaceous glands and hair bags. The most frequent localization of furuncle — the wings of the nose, its vestibule, as well as the upper lip and nasolabial folds.

Nasal furunculosis is often located on the wings, in vestibule of the nose, upper lip and nasolabial fold.

Symptoms of nasal furunculosis

In mild nasal furunculosis in the first 2 days there are redness, slight swelling and soreness. General condition of the patient varies little, the temperature is normal or subfebrile. On the 3-4th day in the center of the infiltrate is formed by a rod, after the discharge of which the recovery occurs. Sometimes the process (nasal furunculosis) reaches only the stage of infiltration, and then undergoes involution. Severe nasal furunculosis is accompanied by a pronounced soreness infiltration, soft tissues edema of not only the nose, but the cheeks, upper lip, lower (less top) eyelid, eyes to the same side. Deteriorating patients general condition, increased body temperature, decreased appetite, a headache, increased regional lymph nodes, children become whiny. In the blood analysis is marked leukocytosis (to 15.0*109/l), erythrocyte sedimentation rate (ESR) is increased to 35 mm/h.

The diagnosis of nasal furunculosis usually does not cause difficulties. Sometimes nasal furunculosis course is reminiscent of abscess of the nasal septum, nose dorsum cyst suppuration, acute etmoidit, upper jaw periostitis. From nasal furunculosis complications are marked angular vein phlebitis and thrombosis, veins of the face, orbit, upper lip, cheeks, forehead and jaw area, orbit phlegmon, subperiosteal abscess of the orbit, retrobulbar abscess, cavernous sinus thrombosis, meningitis, brain abscess.

The development of these nasal furunculosis complications due to the peculiarity of the face blood supply, presence of a large number of anastomoses between the face superficial and deep veins and brain veins. So, perhaps the spread of infection through angular and orbital veins of the nasal vestibule in the cavernous sinus and the meninges. Especially dangerous is the development of intracranial complications from boil at the nose vestibule, since the infection through the superficial veins of the nosal dorsum flows into the ophthalmic vein, which, entering into the cranial cavity, directly flows into the cavernous sinus. Among other complications should be called pneumonia, sepsis, kidney failure and etc.

Severe nasal furunculosis is accompanied by a painful infiltrate, edema of the soft tissues of the nose, cheeks, upper lip, lower (sometimes upper) eyelid, the eye on the same side.

 

Nasal furunculosis treatment

In milder forms of nasal furunculosis used sulfonamides (Sulfadimethoxinum, etc.), hyposensitizing drugs (diphenhydramine, suprastin, pipolfen, chloride and calcium gluconate, vitamins). In severe forms course of nasal furunculosis administered massive doses of antibiotics, and sometimes produce a plasma transfusion from a rate of 5-10 ml per 1 kg of body weight. At the same time prescribed immunobiological preparations — staphylococcal toxoid and antifagin. In children of school age the initial dose is 0.2 ml of 1 every 3 days, with each injection the dose is increased to 0.1 ml; only 3-10 injections.

Perform autohaemotherapy (2 to 6 ml) through the day, desensitizing, dehydration and detoxification therapy (magnesium, glucose). Apply proteolytic enzymes, anabolic hormones, anticoagulants (heparin, fibrinolysin). Prescribe an antibiotic containing ointment. In order to prevent auto-infection surrounding skin rubbed with boric, salicylic or camphor alcohol.

Prescribed physiotherapy — local ultraviolet irradiation (UVI), current UHF, Solux. In order to avoid boils traumatizing in infants hands should be immobilized. Pressure on nasal furunculosis, squeezing him or incision is unacceptable. If persistent course of boils patient examined for diabetes mellitus, tuberculosis.

 

Nasal eczema

Nasal eczema (atopic dermatitis) is characterized by diffuse hyperemia, edema, weeping, severe itching. The process is often extended from the face on the nasal vestibule, combined with eczema of the head, diathesis, rhinitis, rhinosinusitis, foreign body of the nasal cavity. Remove crusts from the nose with a finger, frequent wiping, blowing the nose contribute to the spread of the infection and appearance of eczema.

 

Nasal eczema treatment

Together with the dermatologist to identify and eliminate the irritant allergen, which contributed to the emergence of the disease, establish a rational diet (restricting carbohydrates and proteins). Locally applied Oxycort (oxytetracycline+hydrocortisone), tampons with indifferent oil, powders, pastes (with zinc). Drying effect with weeping forms of eczema have lotions of a 1% solution of resorcinol.

 

Nasal sycosis

Purulent-inflammatory process in Nasal sycosis affects the hair follicles of the skin and surrounding tissues in the vestibule of the nose. Often a similar process exists in the upper lip and chin. Nasal sycosis may be caused by staphylococcus and fungus trihofitonom when infection occurs from dogs and cats (parasitic nasal sycosis). It is necessary to exclude demodicosis.

 

Nasal sycosis treatment

For the treatment of nasal sycosis necessary hair removal, restorative therapy, emollient ointments.

 

Nasal erysipelas

The etiological factor in occurrence of nasal erysipelas is the Streptococcus, predisposing - cracks and abrasions on the nasal vestibule. In the region of the anterior part of the nose appear hyperemia, infiltration. The temperature rises to 40 °C. Erysipelas is characterized by hyperemia of the mucous membrane, its swelling and tenderness at the bullous form - by the presence of bubbles. Sometimes in the inflammatory process involved paranasal sinuses. Often erysipelas spread on the face around the nose.

 

Nasal erysipelas treatment

In the treatment of nasal erysipelas prescribed nasal ultraviolet irradiation physiotherapy, streptocide, antibiotics, restorative therapy.

 

Nasal frostbite

Nasal frostbite is rare, mostly in debilitated, anemic children. Inadequate blood circulation in peripheral parts of the body creates a predisposition to frostbite.

There are 4 grades of the nasal frostbite:

  • grade I nasal frostbite — swelling and cyanosis of the skin
  • grade II nasal frostbite — bubbles formation
  • grade III nasal frostbite — skin necrosis
  • grade IV nasal frostbite — cartilage necrosis

 

Symptoms of nasal frostbite

At the beginning of frostbite appear blanching of the skin of the tip of the nose, reduced sensation, or slight pain, which children often don't notice. Upon further cooling the skin becomes insensitive (numb), bluish-red, painless.

 

Nasal frostbite treatment

At the grade I nasal frostbite frostbite topically applied heat (compresses), Oxycort (oxytetracycline+hydrocortisone), rubbing alcohol. Formed by nasal frostbite bubbles reveal. In severe cases of the nasal frostbite conduct general and local anti-inflammatory treatment.