Sunday, October 22, 2006

Teenager with a Red Nose

This 14 year-old girl has had a red nose for the past two years. It followed as severe sunburn. Her nose never looks normal. Occasionally, there are small cysts with bleeding and purulent drainage.

I have seen this picture occasionally in teenagers. It looks like a rosacea variant. I'd also consider demodex.

Your suggestions are anticipated and will be welcome.


  1. Tough case. Would consider Minocycline 100mg po bid along with topical kwellada in case of role of demodex. If no response, can consider oral itraconazole/ketoconazole. Would advise patient that a few things may need to be tried before the right answer comes up. IPL or pulse-dye laser may even be quite helpful.

  2. This patient has few spots of acne vulgaris on top of red skin.I can see also reddnes of cheeks and even ear???I do not think that reddness is related to rosacea by any means.This is probably related partly to a congenital anomaly.It is very difficult to treat but laser therapy could be helpfull
    khalifa sharquie

  3. Abbas AlshammariOctober 26, 2006

    I am totally in agreement with Prof. Sharquie that rosacea is a remote possibility.The presence of scattered papules and pustules on other parts of her face in addition to small cysts and purulent discharge on the nose as stated in the history may be due to manipulated acne with inflammation and redness.Oral minocycline plus topical soothing agent to start with is a good idea.

  4. Patrick KennyNovember 03, 2006

    I,ve seen this entity,and treat it like Rosacea with topical

  5. Is there anything been of help? I have exactly the same redness on my nose and can't find anything that helps.

    1. This may be an entity called "Nasal Vestibular Folliculitis." If is is mupirocin ointment intranazally can be of value, Best to see a dermatologist and bring in a reference on NVF (you can find online -- R. Sontheimer, Dermatology Online Journal.


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