Nasal Vestibular Furunculosis: Questions Raised by This Common But Under-Recognized Nasal Mucocutaneous Disorder

Abstract

Nasal vestibular furunculosis is a mucocutaneous disorder commonly seen in the
general population. Despite its prevalence in clinical practice, it has been inconsistently described
and labeled in the medical literature. We present a case of nasal vestibular furunculosis presenting
as recurrent exquisitely tender unilateral erythema and edema of the nasal tip. This symptom
complex responded rapidly to topical intranasal mupirocin ointment treatment after having
previously failed other treatments including a topical intranasal triple antibiotic ointment and oral
doxycycline. This case is instructive as it describes a heretofore under-recognized, but not
uncommon, mucocutaneous clinical entity that has been linked to more serious head and neck
infections and likely has relevance to the intranasal carriage of Staphylococcus aureus. We review
the limited published literature on this mucocutaneous disorder including its nosology and propose
future lines of investigation for better defining its clinical significance and pathogenesis.