A 72-year-old white woman presented with a 6-month history of an erythematous plaque on the left nasal tip. Initially, she was treated for suspected rosacea with oral minocycline hydrochloride (100 mg/d) and 0.75% metronidazole topical cream (once a day), without benefit. The lesion persisted and began growing rapidly over the couple of months before her presentation to the dermatology clinic.
On physical examination, there was a 3.4 × 2.8-cm, erythematous, slightly hyperkeratotic and boggy plaque with an irregular border that was not tender to palpation (Figure 1). There was no head or neck lymphadenopathy, and no nasal or oral mucosal involvement was noted. A biopsy specimen was obtained (Figure 2).
Yoon J, Santa Cruz DJ, Sengelmann RD. Enlarging Red Plaque on the Nose of an Elderly Woman. Arch Dermatol. 2002;138(6):831-836. doi:10.1001/archderm.138.6.831