Nasal vestibulitis refers to a diffuse inflammation of the nasal vestibular skin, which can be categorized into acute and chronic forms.
Etiology
Increased nasal secretions, as seen in conditions such as acute and chronic rhinitis, sinusitis, nasal foreign bodies, allergic rhinitis, and specific infections of the nasal cavity and sinuses, can irritate the skin of the nasal vestibule and lead to inflammation.
Prolonged exposure to irritants such as harmful dust, including tobacco, animal hair, cement, and asbestos, can contribute to the condition.
Habits such as nose-picking or rubbing the nasal vestibule can cause damage to the skin of the nasal vestibule, resulting in secondary infection. This is more likely to occur in individuals with diabetes.
Clinical Manifestations
Inflammation is more pronounced in the lateral part of the nasal vestibule and may occur unilaterally or bilaterally.
In the acute phase, symptoms include pain in the nasal vestibule, localized redness and swelling of the skin, tenderness, and, in severe cases, skin erosion or cracking with thin scabs. Inflammation may extend to the skin of the upper lip in more serious cases.
In the chronic phase, symptoms involve itching, dryness, and a foreign body sensation in the skin of the nasal vestibule, often accompanied by burning and tenderness. The affected skin may thicken, nasal hair may become sparse due to shedding, and scabs may adhere to the surface.
Diagnosis and Differential Diagnosis
The diagnosis is generally straightforward based on clinical presentations. However, nasal vestibulitis must be differentiated from nasal vestibular eczema. The latter is often a localized manifestation of generalized eczema and is characterized by more intense itching, frequently seen in children with sensitive or allergic constitutions. Additionally, conditions such as syphilis and tuberculosis should be excluded.
Treatment
Treatment of the underlying conditions such as nasal or sinus diseases is crucial. Avoiding harmful irritants and discontinuing habits like nose-picking are important.
In the acute phase, warm compresses with physiological saline can be applied, along with the use of topical antibiotic ointments. Physiotherapy may also be employed.
In the chronic phase, a 3% hydrogen peroxide solution can be used to remove scabs and pus, followed by the application of antibiotic ointments. For cases with significant exudation, a 5% zinc oxide ointment may be applied.
Once symptoms such as nasal discharge are resolved through the treatment of rhinitis, sinusitis, allergic rhinitis, or after patients stop nose-picking, nasal vestibulitis often resolves spontaneously. Persistent nasal vestibular skin lesions may require consultation with a dermatologist.