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Purpose <p>Nasal necrosis is a rare but potentially devastating manifestation of diverse conditions, including fulminant infection, immune-mediated vasculopathy, drug toxicity, neoplasia and device-related pressure injury. Surgical intervention is often prioritized; however, a subset of patients is managed non-surgically and evidence-based guidance remains limited. The objective is to systematically synthesize non-surgical etiologies, clinical patterns, diagnostic workup, and management strategies reported in cases of nasal necrosis.</p> Methods <p>A systematic search of PubMed, Scopus and ScienceDirect from inception to December 7, 2025 identified case reports and case series involving human patients with nasal skin or soft-tissue necrosis not primarily attributable to surgery or cosmetic procedures. Non-human studies, systematic reviews and non english records were excluded. Data on demographics, etiology, presentation, investigations, management and outcomes were extracted. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.</p> Results <p>Thirty-nine publications comprising 45 cases were included. Infectious etiologies were most frequent (44.4%), followed by mechanical or traumatic (20.0%), immune-mediated (13.3%), drug-induced (13.3%), neoplastic (6.7%), and congenital causes (2.2%). Isolated nasal involvement occurred in 57.8% of cases. Non-surgical management included antimicrobials, corticosteroids, immunosuppressive agents, anticoagulation, wound care, and adjunctive hyperbaric oxygen therapy, with better outcomes in cases where the underlying cause was identified early.</p> Conclusion <p>Nasal necrosis represents a heterogeneous clinicopathologic endpoint in which prompt etiologic diagnosis is critical for effective, organ-preserving dermatologic management.</p>

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Systematic review of non-surgical etiologies of nasal necrosis: evidence from case reports and case series

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月27日

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  • Marie Line Chedid,
  • Rima Mohammad Achraf Hariri,
  • Talia El Chaer,
  • Veronica Andrade Murillo,
  • Nancy Emmanuel

摘要

Purpose

Nasal necrosis is a rare but potentially devastating manifestation of diverse conditions, including fulminant infection, immune-mediated vasculopathy, drug toxicity, neoplasia and device-related pressure injury. Surgical intervention is often prioritized; however, a subset of patients is managed non-surgically and evidence-based guidance remains limited. The objective is to systematically synthesize non-surgical etiologies, clinical patterns, diagnostic workup, and management strategies reported in cases of nasal necrosis.

Methods

A systematic search of PubMed, Scopus and ScienceDirect from inception to December 7, 2025 identified case reports and case series involving human patients with nasal skin or soft-tissue necrosis not primarily attributable to surgery or cosmetic procedures. Non-human studies, systematic reviews and non english records were excluded. Data on demographics, etiology, presentation, investigations, management and outcomes were extracted. Methodological quality was appraised using Joanna Briggs Institute (JBI) tools.

Results

Thirty-nine publications comprising 45 cases were included. Infectious etiologies were most frequent (44.4%), followed by mechanical or traumatic (20.0%), immune-mediated (13.3%), drug-induced (13.3%), neoplastic (6.7%), and congenital causes (2.2%). Isolated nasal involvement occurred in 57.8% of cases. Non-surgical management included antimicrobials, corticosteroids, immunosuppressive agents, anticoagulation, wound care, and adjunctive hyperbaric oxygen therapy, with better outcomes in cases where the underlying cause was identified early.

Conclusion

Nasal necrosis represents a heterogeneous clinicopathologic endpoint in which prompt etiologic diagnosis is critical for effective, organ-preserving dermatologic management.