Nasal septal perforation

Differential Diagnosis

• Trauma
  • Surgical complications
  • Rhinotillexomania (nose-picking)
  • Foreign object
• Drugs
  • Recreational: cocaine, methamphetamines, ketamine
  • Therapeutic: vasoconstrictors, intranasal corticosteroids, bevacizumab
  • Other: soda ash, metal exposure (copper, arsenic, chromium, nickel)
• Neoplasms
  • Nasal carcinoma
  • Multiple myeloma
  • Non-Hodgkin lymphoma
  • NK cell lymphoma
• Rheumatologic diseases
  • Systemic lupus erythematosus
  • Granulomatosis with polyangiitis
  • Relapsing polychondritis
  • IgG4-related disease
  • Pyoderma gangrenosum
  • Takayasu arteritis
  • Rheumatoid arthritis
  • Mixed connective tissue disorder
  • Psoriatic arthritis
  • Systemic sclerosis
  • Cryoglobulinemia
  • Dermatomyositis
  • Sarcoidosis
  • Crohn disease
• Infections
  • Mycobacteria:
    • Hansen disease
    • Tuberculosis
    • Non-tuberculous mycobacteria
  • Fungi:
    • Histoplasmosis
    • Aspergillosis
    • Mucorales
    • Other molds
  • Other:
    • Syphilis
    • Mucocutaneous leishmaniasis