Table 1: Laboratory results.
Two days prior to ER presentation the patient came to the outpatient ENT clinic complaining of skin edema, nasal tip necrosis (Figure 2) associated with needle prick sensation, and on/off nasal obstruction. She had no nasal discharge, no paroxysmal nocturnal dyspnea, no smell loss, nor cough. On examination, there was midfacial necrotizing lesion localized to dorsum of the nose with exposed cartilage, with surrounding erythema and inflammation. The lesion started as pustule with pus and underlying facial erythema localized to central face. No joint pain no rash, no hematuria, hemoptysis