J Rhinol.  2018 May;25(1):55-58. 10.18787/jr.2018.25.1.55.

Saddle Nose Deformity as a Result of an Aseptic Nasal Abscess Accompanied by Ulcerative Colitis and Pyoderma Gangrenosum

• Chang J

• KMID: 2412923
• DOI: http://doi.org/10.18787/jr.2018.25.1.55

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes granulomatous inflammation in the mucous membrane of the intestinal tract, especially in the colon. Additionally, UC can be accompanied by extraintestinal manifestation (EIM). EIM of UC includes cutaneous lesions such as pyoderma gangrenosum, and rarely, systemically occurring aseptic abscesses (AA) have been reported in a few cases. Nasal involvement of UC as an extraintestinal manifestation of IBD is rare, and few reports of nasal mucosa and septal cartilage involvement have been documented in the literature. However, aseptic nasal abscess involving septal cartilage associated with UC and pyoderma gangrenosum resulting in saddle nose deformity have not been reported. The author presents a case of a 52 year-old woman with UC and pyoderma gangrenosum and an aseptic abscess in the nasal septal cartilage resulting in saddle nose deformity, which was corrected by augmentation rhinoplasty.

Keyword

Saddle nose deformity; Aseptic abscess; Ulcerative colitis; Pyoderma gangrenosum

MeSH Terms

Abscess*
Cartilage
Colitis, Ulcerative*
Colon
Congenital Abnormalities*
Female
Humans
Inflammation
Inflammatory Bowel Diseases
Mucous Membrane
Nasal Mucosa
Nose*
Pyoderma Gangrenosum*
Pyoderma*
Rhinoplasty
Ulcer*

Figure

• 

  Fig. 1 Colonoscopy shows severe mucosanguineous exudates and spontaneous bleeding from the ulcerative lesion in the edematous mucous membrane of the colon with relative rectal sparing.

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  Fig. 2 Pyoderma gangrenosum on the right leg.

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  Fig. 3 Contrast enhanced paranasal sinuses computed tomography (CT). There was no residual abscess other than mild edema of the nasal septum in the axial image.

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  Fig. 4 Nasal endoscopic finding showed missing septal cartilage. There was small amount of remaining cartilage in the perpendicular plate inside the intact septal mucosa.

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  Fig. 5 The Frontal, three-quater, and lateral views of a 52 year-old woman with ulcerative colitis. A: The saddle nose deformity due to middle vault collapse. B: The saddle nose deformity corrected through augmentation rhinoplasty.

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