Midline nasal destruction in cocaine abusers.

Journal Article (Journal Article)

Idiopathic midline destructive disease (IMDD) is a diagnosis of exclusion in patients who manifest midline nasal necrosis with no specific etiology such as infection, tumor, or Wegener's granulomatosis. Recently, a group of cocaine abusers has been identified that manifests a syndrome that mimics IMDD, but is less fulminant in its course. To better define the natural history of this syndrome, we reviewed the medical records, radiographs, and pathologic material from five such patients treated at the University of California, Los Angeles. Other causes of midline nasal destruction were excluded in each patient on the basis of histopathology, cultures, and laboratory tests. Biopsy material, available in four patients, demonstrated inflammation and necrosis without vasculitis. Treatment was conservative in four of the five patients, using antibiotics, local care, debridement, and cessation of cocaine use. During the follow-up period, progressive disease developed in one of the five patients, requiring radiation and steroid therapy. We conclude that the treatment of midline nasal destruction in cocaine abusers should initially be conservative, once other etiologies have been systematically excluded.

Full Text

Duke Authors

Cited Authors

  • Sercarz, JA; Strasnick, B; Newman, A; Dodd, LG

Published Date

  • November 1991

Published In

Volume / Issue

  • 105 / 5

Start / End Page

  • 694 - 701

PubMed ID

  • 1754253

International Standard Serial Number (ISSN)

  • 0194-5998

Digital Object Identifier (DOI)

  • 10.1177/019459989110500510


  • eng

Conference Location

  • England