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Images of Memorable Cases: Case 123

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk. E-mail the authorsEdited By: Frederick Moody

http://rup.rice.edu/memcases-button.jpg

Case_123-pres1-1.jpg

This 42-year-old cocaine addict complained of longstanding nasal stuffiness and recurrent epistaxis. On examination, he had crusting and ulceration of the nasal mucosa, perforation of the nasal septum, and a hole in his soft palate.

Compulsive nasal insufflation of pulverized cocaine can damage the nasal mucosa and lead to ischemic necrosis of the septal cartilage and ultimate perforation of the nasal septum. The same mechanism presumably accounts for the palatal abnormality shown in the image. Differentiating these cocaine-induced lesions from those of limited Wegener’s granulomatosis can be difficult, particularly if the patient does not readily admit to substance abuse.

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Definition of a lens

Lenses

A lens is a custom view of the content in the repository. You can think of it as a fancy kind of list that will let you see content through the eyes of organizations and people you trust.

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Lens makers point to materials (modules and collections), creating a guide that includes their own comments and descriptive tags about the content.

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Tags are descriptors added by lens makers to help label content, attaching a vocabulary that is meaningful in the context of the lens.

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