Histopathologic evaluation revealed granulation tissue and fibrinous exudate. There were acute and chronic inflammation, necrosis, foci of hemorrhage, and polarizable fibers.
Given the histopathologic findings, the possibility of a trauma-induced lesion was raised. On questioning, the patient's family members recalled the patient applying a suction tube to his nose. The patient admitted to frequent scratching of his nose because of a "stuffed-up" sensation. He was found to have abundant cellular debris and dried blood under his left thumbnail (Figure 3).
A Nonhealing Ulcer on the Face. Arch Dermatol. 2000;136(1):113-118. doi: