Nasal Vestibulitis

A low-grade infection of the anterior nasal vestibule will cause chronic irritation, crusting, and sometimes bleeding. The examination typically shows mild erythema, cracking, and yellow crusting just inside the nostril, but it may be fairly normal. The etiology is usually Staphylococcus aureus but may be fungal. Herpetic infections are typically more severe and not as protracted. Treatment is with OTC topical antibiotic ointment (without neomycin because of patient sensitivity) and avoidance of irritating the area. If symptoms continue, methicillin-resistant S. aureus (MRSA) infection is possible and should respond to mupirocin ointment. Continued symptoms require ENT consultation.

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