Abstract
A 73-year-old man is referred for evaluation of a nasal ulceration (Fig 6). The lesion had been present for more than 3 years and was resistant to multiple courses of systemic antibiotics, topical and oral steroids, and surgical debridement. He denied any prior or current trauma to the site but did state that the area was very pruritic. Multiple biopsies have revealed ulceration and were nonspecific. Bacterial, fungal, and acid-fast bacilli cultures have been repeatedly negative.14.Which of the following is the most likely diagnosis? (Choose single best response.)a.Basal cell carcinomab.Wegener's granulomatosisc.Pyoderma gangrenosumd.Trigeminal neurotrophic ulcere.Chronic intranasal drug abuse15.The disorder is commonly associated with which of the following? (Choose single best response.)a.CSF rhinorrheab.Trigeminal neuralgiac.Inflammatory bowel diseased.Previous x-ray therapye.Supraventricular tachycardia16.The ulceration is secondary to (Choose single best response.)a.malignancyb.granulomatous inflammationc.habitual pickingd.poor wound healinge.irritant17.The majority of these cases are associated with a history of (Choose single best response.)a.radiationb.schizophreniac.kidney transplantd.inflammatory bowel diseasee.trigeminal ablation18.The best therapy for this disorder is (Choose single best response.)a.surgical repairb.drug rehabilitationc.prosthesis applicationd.cyclophosphamidee.cyclosporine
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