Over the past few weeks, a running series of little nuisance lupus symptoms suddenly took an unexpected turn. Lupus mouth and nasal ulcers are often the first sign of a brewing flare These ulcers often last as long as the flare.
The ulcers usually go away quickly if I can take prompt enough flare-evading steps. Once erupted, pesky oral and nasal lesions often last as long as a week to heal. My nasal ulcers have their favorite “spots” they like to appear, and usually, if there is only one nasal ulcer, it is almost certain to show up just inside the upper surface of my left nostril.
All through my recent trip to see family out-of-state, it was there and remained sore, even after the trip was over and we returned home. The stinging and burning usually associated with the nasal ulcer did not go away, either, and began to sting and become increasingly painful.
Eventually, a solid lump the size of a pea began forming, just underneath the skin where the nasal ulcer was healing, lodged firm and deep in the tissue between the upper nasal lining and the outside of the top of my nose. Nothing shows from the outside, so it is only detectible by touching the tip of my nose, just off center a quarter-inch.
Over about three weeks, the lump continued growing, becoming firmer and increasingly painful and stinging. It was time for the doctor!
Diagnosis? Sebaceous cyst!
Treatment plan? Antibiotics and “wait-and-see.”
Apparently, the nasal ulcer had damaged a pore opening in the lining of my nostril, and caused blockage and a resulting sebaceous cyst. The doctor explained that this is not uncommon, and with a disruption like a lupus skin lesion, not entirely unexpected. The nasal ulcer disrupted the pore’s normal function, and caused it to plug and begin acting awry.
The prescribed treatment is a two-month course of antibiotics. If the cyst doesn’t resolve on its own, the next level of normal treatment might include injection with steroids, lancing to express the collected keratin, and/or simple surgical removal of the hardened lining through the lanced opening. I learned from reading that this type of sebaceous cyst often will not resolve by draining alone. The whole thing and the thickened pore wall should be extracted, too, after any infection and inflammation is gone.
It was a relief to get a benign diagnosis, but the lack of an immediate fix to the stinging lump in the end of my nose was disconcerting. “Wait and see” is not easy for me!
So, for a little while I will live with one more invisible by-product of my lupus, a little stinging bump in the nose!