PMC6346896_01
Patient with nasal skin necrosis on day of admission to the Internal Medicine department
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Two days before hospital admission, the patient noticed a small purplish spot on the tip of her nose that progressively increased to a necrotic cutaneous lesion associated with local paraesthesia, without areas of ulceration (Fig. 1).
Skin biopsy (haematoxylin and eosin stain). Small-sized vessels of the papillary dermis (A) and reticular dermis (B) occluded with homogeneous eosinophilic material corresponding to fibrin (arrows). There is no evidence of vasculitis on vessel walls
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Nasal skin necrosis after 3 days of methylprednisolone (1 g/day). The peripheral areas of the lesion have improved
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Thirteen days after hospital admission, the patient had recovered with total re-epithelialization of the necrotic area, after treatment with methylprednisolone (1 g/day for 3 days), followed by slow tapering of prednisolone, and anticoagulation (Figs. 3 and 4).
Evolution of skin necrosis over 13 days under hypocoagulation and immunosuppression
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Thirteen days after hospital admission, the patient had recovered with total re-epithelialization of the necrotic area, after treatment with methylprednisolone (1 g/day for 3 days), followed by slow tapering of prednisolone, and anticoagulation (Figs. 3 and 4).