From the Guidelines
Nasal erythema is primarily caused by inflammation of the nasal mucosa, which can be due to various factors, including infections, allergies, and environmental irritants.
Causes of Nasal Erythema
- Infections: Bacterial, viral, or fungal infections, such as sinusitis, can cause nasal erythema 1, 2.
- Allergies: Allergic rhinitis (AR) and nonallergic rhinitis (NAR) can lead to nasal erythema, with NAR being associated with vasomotor rhinitis (VMR) and eosinophilic nonallergic rhinitis (NARES) 3.
- Environmental Irritants: Exposure to strong smells, tobacco, paint, or cleaning solutions can trigger nasal erythema in some individuals 3.
- Other Factors: Gastroesophageal reflux disease (GERD) and immunodeficiency have also been suggested as potential causes of sinusitis and nasal erythema 2.
Clinical Signs and Symptoms
Nasal erythema is often accompanied by other symptoms, such as:
- Nasal congestion
- Purulent rhinorrhea
- Post-nasal drainage
- Headache
- Cough
- Sinus tenderness on palpation
- Mucosal erythema
- Purulent nasal secretions
- Increased pharyngeal secretions
- Periorbital edema 1, 2.
From the Research
Causes of Nasal Erythema
- Nasal erythema can be a symptom of rosacea, a chronic cutaneous disorder characterized by erythema, telangiectasia, and inflammatory lesions 4
- Risk factors for nasal rosacea include male gender, obesity, and alcohol use 5
- Family history of rosacea can also be a risk factor for nasal phymatous changes, a subtype of rosacea characterized by swelling and erythema of the nose 5
- Allergic rhinitis, an immunoglobulin E-mediated process, can also cause nasal erythema, although it is typically accompanied by other symptoms such as nasal congestion, runny or itchy nose, and sneezing 6
- Rhinophyma, an advanced stage of rosacea, can also cause nasal erythema, as well as hypertrophy of the nasal soft tissues, telangiectasias, nodules, and lobules with a bulbous appearance 7
Subtypes of Rosacea
- Erythematotelangiectatic rosacea is the most common subtype of rosacea, characterized by persistent erythema and telangiectasia 8, 4
- Phymatous rosacea is a subtype of rosacea characterized by swelling and erythema of the nose, and can be further subdivided into nasal phymatous changes 5
- Rosacea can also be classified into different subtypes based on the location and severity of the lesions, including non-nasal, intermediate, and nasal rosacea 5, 8