A 70-year-old man presented with a pearly papule on the left nasal tip. A shave biopsy confirmed the clinical suspicion of a basal cell carcinoma. A few days after the biopsy, he developed a “usual cold sore ” at the left upper lip, which was soon followed by painful erosion and crusting of the biopsy area, and rapidly progressed to involve the entire left nasal ala, tip, sidewall, and mucosa as well as the left upper lip (Figure, A). Owing to his history of herpes labialis and the clinical suspicion of a secondary infection, he was empirically treated with acyclovir and doxycycline. Viral cultures were not performed, and bacterial culture demonstrated methicillin-sensitive Staphylococcus aureus.
Ellis LZ, Prado R, Francis S, Lee LA. Bell Palsy Following a Minor Dermatologic Procedure. Arch Dermatol. 2012;148(2):268–269. doi:10.1001/archdermatol.2011.2099
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