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Itching near the wings of the nose. Diseases of the external nose. Couperose

The wings of the nose is one of the parts of the visible (outer) nose, which is shaped like a triangular pyramid. It is based on the nasal bone, cartilage, septum, and the frontal process of the upper jaw. From above pass the muscles providing mobility of wings. With their help, a person can compress and expand the nasal openings, delaying the wings downwards. The skin of the external nose is thick and inactive, because of the abundance of the sebaceous glands, it is often inflamed, flaky, sore. Itching of the nose wings can be a sign of various diseases - ARVI, rhinitis, allergies, demodicosis, herpes, seborrheic eczema and others.

Anatomy and function

The wings of the nose, along with other parts of the external nose, are the initial part of the respiratory system. The nasal openings are divided by a cartilaginous septum. The wings form the lateral and middle legs of the lower literal cartilage. Also inside can be found small additional sesamoid cartilage. The lower back sections of the nostrils form a fibrous loose connective tissue. Holds the entire structure of the upper lateral cartilage, which is attached to the nasal bone. The nasal cavity lines the mucous tissue. Communication with the central nervous system provides facial and trigeminal nerve (1 and 2 branches). Blood supply is through a number of arteries.

Due to the unique structure, the external nose performs a number of important functions:

warms airflow during nasal breathing;
detains microbes and dust;
plays the role of a voice resonator (gives an individual timbre, sonority);
allows you to distinguish odors.

Interesting fact. The nasal wings may have a different size and shape. European groups and Eskimos have narrow nostrils, and the population of southern countries has wide noses. It is noteworthy that with smaller absolute sizes, in women the nose is relatively wider than in men.

Diseases

On the wings of the nose, you can determine the state of the respiratory system. Normally, they should be wide open, mobile, pink.

Peeling, pain, rash, itching in the area of the wings - symptoms of skin diseases. Acne and black spots, which so often complain, are usually due to poor hygiene, poor nutrition, hormonal disorders.

Pain in the wings of the nose can be a sign of diseases of the upper respiratory tract, neuralgia, furunculosis. Sometimes the cause of pain is ailments in adjacent areas. So, with sunburn, pain from the tip of the nose often spreads to the wings.

Peeling, itching, redness

Itching and flaking in the area of the wings of the nose is the most common complaint. Similar symptoms are characteristic of many diseases, ranging from the common cold and ending with demodicosis and seborrheic eczema. So why the nasal wings itch and flake.

Frequent blowing of nose with rhinitis, including allergic. Mucous discharge causes irritation on the skin, after which it is easily injured by a handkerchief. The healing process is often accompanied by burning, itching, scaling.

Seborrheic, rarely idiopathic, microbial, professional eczema. Characteristic signs of the disease are small blisters, redness and peeling of skin. Often not only the wings are affected, but also other parts of the nose, face, and body.

Demodecosis. The causative agent is a microscopic skin mite. It feeds on sebum and is present in the body of 90% of the adult population. It is activated when immunity is weakened. Characteristic manifestations of demodicosis: skin redness, acne, peeling, itching. Tick hits the places where sweat accumulates.

Other reasons: severe dryness skin, improper care, chapping, avitaminosis (lack of vitamins and minerals).

Treatment is prescribed by a dermatologist after an examination. Antifungal agents are used for seborrheic eczema. Demodecosis is treated with anti-inflammatory, antibacterial drugs. In all cases, the administration of immunostimulants, vitamins and minerals, diet is shown. In order for the affected skin to recover faster, it is recommended that nasal wings be treated with anti-inflammatory, regenerating ointments. For example, it may be sulfuric, zinc or ichthyol.

Important. Dry scales should be removed with a cotton swab soaked in sea buckthorn or other oil, moisturizing cream. Do not comb or rub the affected areas.

Acne, black spots, acne

As already mentioned, the wing of the nose - the leader in the content of the sebaceous glands. Black dots occur due to their blockage. Sometimes the skin becomes inflamed and a pimple matures. This can happen with insufficient hygiene. However, the most common cause of black spots, enlarged pores and acne on the nasal wings is hypersecretion of the sebaceous glands. Excessive sebum secretion can trigger a hormonal surge. A vivid example - adolescents in puberty, unhealthy diet, excess weight.

To get rid of black spots and acne on the wings of the nose, it is necessary to take a set of measures.

To exclude from the diet pastries with cream, pastries, chocolate, smoked meats, as well as fatty, fried, salty dishes.
Eat more seasonal fruits and vegetables.
Treat lesion sites with anti-inflammatory, antiseptic agents.
Twice a day (in the summer of 3-5 times) cleanse the skin of the face.
If necessary, undergo a course of treatment with hormonal drugs.
Periodically do peels.

Council Quite often, the problem of the skin on the wings of the nose hides the disease digestive system. If redness, acne, desquamation or itching is often disturbed, then it is worth going to a consultation with a gastroenterologist.

It is also extremely unpleasant when it appears or on the wing of the nose. His treatment requires a special approach.

Pains

In the tissues of the human nose are nerve endings, therefore, in pathological processes, the wing of the nose can hurt. The following diseases can cause painful sensations.

Rhinitis (runny nose) and sinusitis (inflammation sinuses nose). Accompanied by mucosal edema, clear, copious or purulent secretions. In addition to the soreness of the wings, complaints may occur headacheweakness elevated temperature body.

Furunculosis. The main cause is staphylococcal infections. The furunculosis develops as follows: first, the nasal wing, when pressed, hurts a lot, swells, body temperature can rise, and breathing is difficult. Then, a purulent-inflammatory infiltrate forms around the hair follicle. When opening furunculosis, you can see a necrotic stem of greenish color. After rejection, the pain gradually disappears.

Mechanical damage. If the nasal wing is swollen and sore, this may indicate injury. At fracture, the painful sensations bother for more than 3 weeks, until a callus forms.

Neuralgic diseases. Paroxysmal pain in the nose or other parts of the face may indicate ganglionitis and ganglioneuritis.

Attention! Strong pain requires expert advice.

Herpes

Bubble formations inside or outside the wings of the nose are a sign of herpes. At first, itching, pain, slight swelling and redness may be troubling. Literally in a day, the skin or mucous in this place becomes covered with bubbles with a turbid liquid. After 3-4 days, they burst and turn into small ulcers. When healing, a crust is formed.

The causative agent of herpes is a virus. The sore is most often localized around the natural openings: the nose, mouth, genital area. After infection, the virus migrates to the nerve branches of the spinal cord. With a decrease in immunity, it is activated again.

Herpes on the wings of the nose passes independently. Emollient oils can be used to relieve symptoms. For extensive rashes, as well as for the first manifestations of herpes, it is recommended to use antiviral drugs: ointment Zovirax, Acyclovir, Panavir, as well as Famivir and Alaciclovir tablets.

The wings of the nose - quite a weak spot. The abundance of the sebaceous glands contributes to the development of various skin diseases. To avoid unpleasant symptomsshould be carefully hygiene, eat right, give up bad habits. For systematic complaints, severe pain, you need to consult a doctor.

Nose boil - spicy purulent inflammation hair follicle and sebaceous gland on the outer or inner surface of the wing of the nose, the tip of the nose, the skin of the nasal septum. Boils are most often located on the tip and wings of the nose, on the eve, near the nasal septum. Acute purulent-necrotic inflammation of several hair sacs and sebaceous glands with extensive necrosis of the skin and subcutaneous tissue of the nose is called the carbuncle.

Prevention of boil and carbuncle nose

Primary prevention - prevention of microtraumas and infection of the skin of the nose, the fight against contamination of industrial and domestic premises, personal hygiene.
Secondary prophylaxis - a set of measures aimed at preventing the recurrence of the boil of the nose and (or) its complications in people at risk; in patients with pustular skin diseases (pyoderma) in the nasal region and nasal vestibule (folliculitis, sycosis), in patients with diabetes, immunodeficiency states of various genesis.

Classification of the boil and carbuncle nose

In the development of the boil of the nose, as well as any acute purulent-necrotic inflammation of the hair follicle and surrounding tissues, usually distinguish two stages:
Stage I infiltration - local pain, hyperemia of the skin, the presence of a dense infiltration with a necrotic point in the center;
Stage II abscessing - necrotic tissue melting in the inflammation, thinning of the skin and fluctuation in the center of the infiltrate.

The etiology of boils and carbuncle nose

In the occurrence of the furuncle (carbuncle) of the nose, staphylococci play the leading role: S. aureus, S. epidermidis (opportunistic), S. saprophytics.
In addition to staphylococci, pustular skin diseases, particularly nasal furuncle, can cause streptococci, mainly - B-hemolytic streptococcus group A.

The pathogenesis of furuncle and carbuncle nose

The emergence and development of the boil of the nose is largely determined, on the one hand, by pathogenicity and virulence of pathogens, and on the other, by a combination of various exogenous and endogenous factors that form a predisposition to the development of a purulent process. The entrance gate of the infection is usually a violation of the integrity of the skin of the vestibule of the nasal cavity and external nose, which occurs during microtrauma (maceration, scratching); skin contamination (neglect of basic hygienic rules for everyday skin care of the face, the impact of production factors: coal, industrial cement dust, fuel and lubricants). In addition, hypothermia or overheating, which adversely affect the anti-infective resistance of the skin, may contribute to the occurrence of a furuncle of the nose.
A significant role in the pathogenesis of the furuncle of the nose is played by various endogenous factors, along with which the bactericidal properties of the sweat and secretion of the sebaceous glands lose their power, and the functional activity of the immune system is disturbed. These violations cause the persistence of the pathogen on the skin surface, the formation of a staphylococcal carrier state, the occurrence and recurrence of boils of the nose, as well as other localizations. In this regard, a highly unfavorable effect on the frequency of occurrence, course and prognosis of the boil of the nose have a genetically determined state, accompanied by immune deficiency; endocrine diseases, especially diabetes mellitus; hypovitaminosis, poor nutrition, diseases of the digestive system, etc.

Clinic boil and carbuncle nose

The boil is most often located on the tip and wings of the nose, on the eve of the nasal cavity, on the skin of the nasal septum. In most cases, the inflammatory process gradually develops, which is first located in the mouth of the hair follicle (ostiofollikulit), and then spreads into the depths. Within 1-2 days, the seal, hyperemia, puffiness of the skin is formed here, pain appears, aggravated by the tension of the facial muscles, chewing, examination of the nose (with anterior rhinoscopy). These changes are accompanied by headache, weakness, fever. From the side of peripheral blood, as a rule, there is a shift of the leukocyte formula to the left, an increase in the ESR.
Later, with a favorable course of the process, within 2–4 days, the density of tissues in the inflammatory focus decreases, softening occurs in the center of the infiltrate, a small amount of pus is released, the necrotic rod rejects, and the remaining cavity of the abscess is quickly cleaned and filled with granulations. As a rule, this decreases the intensity pain sensations, body temperature is normalized, the general condition improves.
In some cases, abscess formation of furuncle can occur - progression of inflammatory inflammatory changes, an increase in the area of tissue necrosis, thinning of the skin, the appearance of fluctuations.

Diagnosis of a boil and carbuncle nose

Physical examination

Hyperemia, edematous-infiltrative changes in the soft tissues of the external nose, the vestibule of the nasal cavity, the nasal face region.
When examining patients with a boil of the nose should be borne in mind a significant likelihood of developing septicemia and (or) septicopyemia. This is largely due to the extensive network of anastomoses between the superficial and deep vessels of the facial area located above the line that connects the earlobe and the corner of the mouth. In addition, there is a so-called dangerous triangle - the face area bounded by lines that connect the midpoint of the frontal-nasal suture (nasion) with the corners of the mouth. The outflow of venous blood from these anatomical zones is carried out along the angular vein, the internal orbital vein into the cavernous sinus. This circumstance creates real prerequisites for the spread of infection not only to adjacent anatomical zones: eyelids, orbit, but also to the base of the skull, intracranial veins and sinuses. Symptoms of phlebitis on the veins of the face are characteristic signs of a complicated course of the boil of the boil of the nose: pain, induration and sometimes redness along the affected vessel, swelling of the upper and lower eyelids, soft tissues of the infraorbital region, forehead, fever up to 38.5 ° C and higher, amazing chills, weakness. If septic cavernous sinus thrombosis occurs, a stormy infectious syndrome with fever, chills, sweating. In typical cases, there are dyscirculatory disorders (pastoznost, swelling of the periorbital region, injection of the conjunctival veins, chemosis, exophthalmos, congestive changes in the fundus).

Treatment of boils and carbuncle nose

Indications for hospitalization

The presence of a boil of the nose is an indication for hospitalization of the patient.

Non-drug treatment

With an increase in body temperature, bed rest, liquid food, restriction of movements of the facial muscles are prescribed. Physiotherapeutic methods of influence have anti-inflammatory and analgesic effects: Solux, UHF.

Drug treatment

The nature of the treatment depends on the stage. inflammatory process. At the initial stage (infiltration stage), careful rubbing of the skin around the inflammatory focus with 70% ethyl alcohol solution or 2% salicylic alcohol solution is indicated. In the first hours after the onset of infiltration, repeated lubrication of the pustules with 5% iodine tincture has a good effect.
Local antibacterial therapy consists of using preparations of fusidic acid (2% ointment), mupirocin (2% ointment).
The drugs of choice for systemic antibiotic therapy are cephalexin, oxacillin; alternative drugs - cefazolin, amoxicillin + clavulanic acid, vancomycin, linezolid.

Surgery

Surgical treatment is indicated for abscess formation of a boil. An autopsy of a formed abscess is performed under local infiltration anesthesia or under general (intravenous) anesthesia. An incision is made that passes through the center of the inflammatory infiltrate, and the edges of the abscess cavity are expanded with a mosquito-type hemostat or other similar tool. With abscess formation of furuncle and pronounced reactive phenomena from the adjacent tissues, contraception is superimposed. For the prevention of iatrogenic aesthetic disorders when making incisions in the external nose, one should focus on the natural folds of the skin, and when opening an abscess on the eve of the nasal cavity, avoid damaging the edges of the nostrils. After the evacuation of pus and detritus, drainage is introduced into the cavity (a strip of glove rubber), an aseptic bandage is applied, or the nasal vestibule is loosely packed using a hypertonic solution (10% sodium chloride solution) or antiseptic solutions.
Approximate periods of incapacity for work with an uncomplicated course of the disease are 7-10 days, in the presence of septic complications - up to 20 days or more.

Nose pain

Nose pain -this is a symptom that occurs during the development of most diseases of the nose and paranasal sinuses. Pain can be disturbed by damage to the skin, bone and cartilage of the skeleton of the nose, mucous membrane, nervous tissue. Only an experienced otorhinolaryngologist will be able to quickly determine why your nose hurts and prescribe the necessary treatment.

Causes and symptoms

If pain is localized outside, on the skin of the nose, it can be caused by any infection - the herpes virus, streptococcus (erysipelas), staphylococcus (can trigger an abscess formation), etc. Symptoms of incipient inflammation: soreness and redness of the skin, local edema (swelling) of tissues. Further, the formation of a rash, sores, suppuration.

Pain in the area sinus, sometimes very intense, occur if the runny nose is complicated by sinusitis. Pain in acute sinusitis is associated with a violation of the outflow of secretions from the paranasal sinuses. If amazed maxillary sinuses (sinusitis), the pain is localized in the upper jaw and nose of the nose, with the defeat frontal sinuses - in the frontal area. With the development of pansinusita (inflammation of all the paranasal sinuses) - in the frontal, parietal and even occipital regions. Pain in the sinuses is usually worse at night and in the morning, with palpation and percussion in the area of the paranasal sinuses.

If the nose hurts insidethen one of the causes of the symptom may be a traumatic injury (nose bruise or damage to the nasal mucosa). Sharp and chronic rhinitis can also sometimes be accompanied by pain in the nose, but they are not a mandatory and basic symptom of rhinitis.

A rather rare cause of pain in the region is a disease of the nerves (neuritis) or nerves (ganglia - ganglionitis). These pains are characterized by paroxysmal (from tens of minutes to days), high intensity, burning sensation, pressure, bursting. They give to other areas. For example, when neuritis of the nasal nerve is in the eye area, the corresponding half of the forehead. When the ganglioneuritis of the pterygopalatomy is in the region of the orbits, the upper jaw, and sometimes the teeth lower jaw, sometimes spread to the temple, occipital region, neck, scapula, forearm, shoulder and hand. Such pains are often accompanied by tearing, redness of one half of the face, watery abundant secretions, often from one half of the nose.

Treatment and Prevention

Treatment reduces, first of all, to identifying the causes and diseases that led to the occurrence of pain. Even if during a medical examination of the apparent causes of such pain is not detected, should continue the examination by specialists of other specialties - neurologists, maxillofacial surgeons, traumatologists, etc.

WHY HAVE NOSE WINGS?

Nose pains give a signal to the body that a certain disease has overtaken the nose and its wings. To establish the causes, you should consult your doctor in order to determine the causes of pain syndrome in a timely manner, as well as prevent complications and the transition to the chronic form.

WHICH DISEASES ARE THE CAUSES OF PAIN IN THE NOSE

Nerve endings are found in all tissues of the human nose, and in a state of arousal, any of the receptors works as painful. In order to understand why the wings of the nose hurt inside and to choose the appropriate treatment, it is necessary to classify it according to the reasons.

SINUSITIS

Pain in the nose occurs when acute inflammation paranasal sinuses - acute and chronic sinusitis. One of the examples of this disease is sinusitis, characterized by a delay of nasal secretions, narrowing of the nasal cavity, aching pain. The wings of the nose are less painful if the outflow of the contents of the nasal sinuses is facilitated. Sinusitis is characterized by a clear localization of pain and a temporary dependence of the pain syndrome. Usually in the morning and at night the patient experiences a special malaise. Here it is important to determine why the wing of the nose hurts, if this is a cause of chronic or acute sinusitis, you should immediately take measures to cure the inflammatory process.

RHINITIS

The wings of the nose hurt with various forms of rhinitis. Common rhinitis accompanied by inflammation of the mucous membrane. Despite the seeming simplicity of the disease, it can become a favorable background for the development of more serious diseases. Rhinitis species, allergic and hypertrophic, often cause great inconvenience to the patient. The clinical signs of these diseases are sneezing, nasal congestion and persistent nasal discharge, uncontrolled tears, redness of the eye area, dry mouth, pain when pressing on the wing of the nose.

WHEN A PAIN NOSE SYNDROME APPEARS WITHOUT COLD

Not always only infectious diseases cause pain in the nose. Why is it that the nose wing is swollen and sore when pressed? There are a number of reasons for this.

FURUNCULOSIS

Diseases of the skin, for example, furunculosis, often provoke pain and inside the nose. Often a person has the feeling that the entire head, its temporal and frontal areas are covered with pain. When you press on the affected area, the pain increases dramatically, and inflammation of the skin of the wings of the nose is accompanied by tension, sometimes large-scale edema, fever and redness. Visual inspection often reveals a narrowing of the nasal passage.

MECHANICAL DAMAGE

As a result of blows, falls, bruises, there is usually a violation of the integrity of the tissues. The wing of the nose is swollen, it is acutely sore - these are the first signs of injury. If it is a fracture, then the pain syndrome is present for at least three weeks before the formation of callus.

SUNBURN

Sometimes the pain is triggered by an ordinary sunburn. Under the influence of ultraviolet, the epithelium is destroyed, after which the nose tip begins to ache at the beginning, and then the pain spreads to the wings. Such symptoms occur with frostbite.

Neurological diseases

Often the cause of pain in the area of the nose are neuralgic diseases of the facial part. People have acute, paroxysmal pain in the nose, jaw area, teeth, eye sockets. These are the main signs of ganglionitis or ganglioneuritis. Painful sensations often capture other areas as well: temples, ears, occipital part, neck area, shoulder blades, upper limbsstarting from the hands and ending with the shoulder.

SYNDROME OF THE RESOURCE NERVE

Burning pain occurs with Charlin syndrome or nasolabial nerve. It has a pressing, strongly arching nature and covers the areas of the eyes, forehead. The pain syndrome with such diagnoses gives the most concern at night. Worst of all, an attack can last from several tens of minutes to several days. Teenage diseases such as acne or acne alone does not manifest painful sensations. At the same time complicated bacterial infection with suppurations, the wings of the nose begin to ache. Herpes has similar manifestations, in which the wings and the tip of the nose affected by the virus are primarily affected. The pain is accompanied by severe itching and has a dull character.

WHICH SPECIALIST WILL HELP WITH PAINS IN THE NOSE

If pain occurs in the area of the nose, you should immediately contact a specialist who can correctly diagnose the disease. The nose is a very important organ that is able to provide full breathing for normal human life. Sometimes pain is not only discomfort, but can cause some health-related complications. If the cause of pain is nasal injury, then the first visit should be made to the traumatologist. For all other ailments associated with pain in the area of the nasal wings, patients are usually sent to a specialist otolaryngologist.

Nose pain. Causes, treatment.

Sinusitis

Pain in the nose occurs in acute inflammation of the paranasal sinuses - acute and chronic sinusitis. One of the examples of this disease is sinusitis, characterized by a delay of nasal secretions, narrowing of the nasal cavity, aching pain. The wings of the nose are less painful if the outflow of the contents of the nasal sinuses is facilitated. Sinusitis is characterized by a clear localization of pain and a temporary dependence of the pain syndrome. Usually in the morning and at night the patient experiences a special malaise. Here it is important to determine why the wing of the nose hurts, if this is a cause of chronic or acute sinusitis, you should immediately take measures to cure the inflammatory process.

Rhinitis

The wings of the nose hurt with various forms of rhinitis. The usual runny nose is accompanied by inflammation of the mucous membrane. Despite the seeming simplicity of the disease, it can become a favorable background for the development of more serious diseases. Rhinitis species, allergic and hypertrophic, often cause great inconvenience to the patient. The clinical signs of these diseases are sneezing, nasal congestion and persistent nasal discharge, uncontrolled tears, redness of the eye area, dry mouth, pain when pressing on the wing of the nose.

When there is pain in the nose without a cold

It is not always only infectious diseases that cause pain in the nose. Why is it that the nose wing is swollen and sore when pressed? There are a number of reasons for this.

Furunculosis

Mechanical damage

Sunburn

Neuralgic diseases

Often the cause of pain in the area of the nose are neuralgic diseases of the facial part. People have acute, paroxysmal pain in the nose, jaw area, teeth, eye sockets. These are the main signs of ganglionitis or ganglioneuritis. Painful sensations often capture other areas: temples, ears, occipital part, neck area, shoulder blades, upper limbs, starting from the hands and ending with the shoulder.

Nasolabial nerve syndrome

Burning pain occurs with Charlin syndrome or nasolabial nerve. It has a pressing, strongly arching nature and covers the areas of the eyes, forehead. The pain syndrome with such diagnoses gives the most concern at night. Worst of all, an attack can last from several tens of minutes to several days.
Such teenage diseases, such as acne or acne, are not in themselves painful. At the same time complicated by bacterial infection with suppurations, the wings of the nose begin to ache. Herpes has similar manifestations, in which the wings and the tip of the nose affected by the virus are primarily affected. The pain is accompanied by severe itching and has a dull character.

Which specialist will help with nose pain

In the following video - answers to questions on the treatment of frontal sinusitis and sinusitis:

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Couperose

Permanent redness of the skin of the external nose depends on many factors and can cause, especially in women, mental disorders.

The tip of the nose turns red, starting at the junction of the nasal bones with triangular cartilages. Redness can have different shades: from pink to bright red and dark blue. It may be temporary, appearing due to mental stress, after eating, blowing nose, or permanent, only changing its intensity.

Constant couperosis is difficult to treat, as it may be necessary to eliminate the newly formed vessels. Effective application of cryotherapy. Persons with disorders of the vascular system, in particular with vegetative-vascular dystopia, should be prescribed general treatment. Repeated redness of the nose always needs pathogenetic therapy.

Rhinophyma

Rhinophyma is characterized by hypertrophy of the skin of the wings, tip and back of the nose in the form of individual lobular elevations. The skin appears enlarged and tortuous blood vessels and enlarged openings of the sebaceous glands, from which the secret is easily secreted Rhinophyma predominantly affects older men. Most often rhinophyma occurs in alcohol abusers.

In addition, rhinophyma occurs in individuals who work for a long time in the open air and are constantly under the influence of adverse weather conditions. Disorders caused by rhinophyma, are reduced mainly to a cosmetic defect, especially with tubercular hypertrophy, which stands out sharply on the background of the face with its color. The disease is usually benign, although in isolated cases the transition of rhinophyma into a malignant tumor is described.

The most effective surgical treatment of rhinophyma. Apply decortication, wedge resection and subcutaneous extirpation. Decortication consists in cutting hypertrophied parts with a scalpel. The sebaceous glands should be preserved so that the epithelium of their excretory ducts after the operation forms a covering for the exposed surface during the operation. Good effect can be obtained after reusable cryotherapy.

Sycosis

Sycosis (sicosis) is a purulent inflammation of the hair follicles of the vestibule of the nose without necrosis. The cause of the disease is a pyogenic infection (most often Staphylococcus aureus), which penetrates the follicles and causes the formation of an infiltrate with its subsequent suppuration. In the region of the nasal vestibule, small pustules are formed, filled with purulent contents, which after cutting the pustules dry up in the form of yellow crusts pierced by hair.

The skin around the pustules is in a state of inflammation and therefore appears red, infiltrated. In the case of progression of the process, individual pustules may merge and sycosis becomes similar to eczema. Most often, sycosis occurs when there is a permanent source of purulent discharge from the nasal cavity or paranasal sinuses.

The disease is long lasting, prone to recurrence. The spread of infection from one follicle to another is facilitated by peeling off the crusts with your fingers.

Patients complain of dryness, burning, itching, pain in the tip and vestibule of the nose, and with a large concentration of crusts - the difficulty of nasal breathing.

Treatment should consist primarily in eliminating the underlying cause of the disease. The skin around the nasal vestibule is wiped with 2% salicylic alcohol, lotions from antiseptic and astringent agents are used. 2-3 times a day, the damaged surface is smeared with ointments: gentamicin, Lorinden-C, levomycol, flucinar, Bactroban. For a better purification of the vestibule from the crusts, it is advisable to introduce gauze turunda with a solution of proteolytic enzymes. From physiotherapy shows the local purpose of the UFO. With significant sycosis, subcutaneous administration of staphylococcal native toxoid is indicated.

Eczema

Eczema is an acutely occurring erythemal-vesicular inflammation, accompanied by itching of damaged skin, which over time acquires a chronic course with a tendency to frequent relapses.

Most often localized at the entrance to the nose. At the same time there is a significant thickening of the skin, ce redness, the appearance of bubbles with plasma, which over time can dry out, crack and fester. Drying bubbles contributes to the accumulation of crusts. The course of eczema is acute and chronic. The acute form has 3 phases: erythematous (redness and swelling of the skin), erosive (weeping stage) and squamous (peeling stage).

If the excretory processes take place without bubbles, then the skin becomes wet. Contribute to the occurrence of eczema permanent serous or purulent discharge from the nose (rhinorrhea). We should not forget that eczema entering the nose may be one of the manifestations of common eczema. Bacteriological examination finds Staphylococcus aureus. The leading symptoms are pain in the nose, itching, redness and swelling of the entrance to the nose, crusts, scratches, cracks, vesicles with serous contents, skin weeping, nasal vestibule. The general condition of the body is unchanged.

The treatment is long and consists in eliminating the causes and factors contributing to the occurrence of this disease. Reconstruction of the paranasal sinuses (in the presence of sinusitis), adenotomy, hyposensitization and general strengthening therapy are carried out. Apply lotions with a 2-3% solution of resorcinol, a 3% solution of tannin, yellow mercury ointment, Lassar paste, corticosteroid ointments, and synthomycin emulsion.

Furuncle and carbuncle nose

Nose furuncle is one of the most common diseases in ENT practice. This purulent inflammation of the hair follicles and sebaceous glands with partial necrosis and suppuration of the adjacent tissues. A furuncle occurs on the inner surface of the wings of the nose, at the lower edge of the entrance to the nose, bordering the upper lip, and near the tip of the nose, t. in places where hairs and sebaceous glands are concentrated.

The most common cause of the development of a nose boil is the introduction of a staphylococcal infection through minor injuries, often inflicted by the patient proper, during manipulations in the nose. In addition, a furuncle of the nose may be a manifestation of common furunculosis (for example, in patients with diabetes mellitus).

First, the boil is manifested by a limited hyperemia with skin tension, its central part rises conically above the common surface. When touched in this place, the patient feels severe pain. In the area of the boil, a swelling of the skin develops, which can spread depending on the localization of the boil, not only on the nose, but also on the upper lip, cheek, and sometimes the entire half of the face.

When anterior rhinoscopy is performed on the skin of the nasal vestibule, a limited hyperemic elevation is determined, sometimes the pus on the apex and the swelling of the tissues around the infiltrate appear through. Sometimes within 3-5 days abscessing occurs, followed by rejection of the rod and necrotic fiber. The moment of opening the boil is accompanied by a sharp pain in the nose, which often radiates to other parts of the head. Body temperature is usually subfebrile, but can significantly increase, the patient’s general condition deteriorates. A regional lymphadenitis develops, affecting the posterior and middle submandibular lymph nodes.

When the carbuncle quickly forms a painful infiltration with several purulent-necrotic heads. The patient's condition deteriorates dramatically, chills appear, a significant increase in body temperature, pronounced regional lymphadenitis.

The furuncle and carbuncle of the nose should be considered very serious diseases due to possible occurrence severe complications: phlegmon of the orbit, meningitis, thrombosis of the cavernous sinus with sepsis. The main way of spreading the infection is the veins, which are much larger in the nasal region than the arteries, and they are placed more superficially. Different outflow directions create the possibility of spreading, infection to different parts of the face and brain department the skull.

The cause of the spread of infection and the development of severe orbital and intracranial complications can be careless manipulations in the affected area. With the development of phlebitis along the angular and facial veins appear painful strands of infiltrated tissue with hyperemia and cyanosis of the skin, the spread of edema far beyond the boundaries of the infiltrate. The saphenous veins are dilated and diverge radially.

There are marked intoxication, heat body weakness, leukocytosis with a left shift, increased ESR.

With a mild course (in the initial stage of the boil) outpatient treatment is allowed. Antimicrobial and antiinflammatory agents are used in the form of ointments, which are applied in a thin layer on the inflamed skin of the nose on the outside and on the side of the vestibule 2-3 times a day. Effective lotion with propolis alcohol extract, the use of UV and laser (helium-neon) irradiation, UHF. Inside prescribed antibiotics, with pronounced pain phenomena - analgesics. For the prevention of venous thrombosis, the appointment of acetylsalicylic acid is indicated.

With significant inflammation with increased body temperature, deterioration of general condition, headache or pain in the eye on the side of the boil, edema outside the external nose, development of regional lymphadenitis and signs of complications, emergency hospitalization is shown. Many patients are prescribed conservative treatment, including the entire arsenal of intensive care.

For the prevention of the development of thrombophlebitis of the veins of the face, patients are additionally prescribed anticoagulants of direct or indirect action (under the control of a coagulogram), intramuscular administration of proteolytic enzymes is indicated.

It is not necessary to quickly open up furuncles (carbuncles), and only in the stage of abscess formation with insufficient outflow of purulent masses, surgical intervention should be used. Perform a cross-shaped incision with excision of necrotic tissue. Turunds are introduced into the wound with a solution of dioxidine, Dimexidum or a hypertonic solution of sodium chloride. Given the cosmetic requirements, the incision should be made as far as possible from the inside of the nose.

DI. Zabolotny, Yu.V. Mitin, S.B. Bezshapochny, Yu.V. Deeva