Erosive pustular dermatosis of the scalp presenting as herpes zoster.

A 30 year old man was referred to this department with an intractable obstruction in one nasal cavity and catarrh of indeterminate duration. Inspection of his nose showed that one nasal cavity was normal; the other, however, was filled by a large polyp and mucopus. An x ray film of the paranasal sinuses showed a metallic radio-opaque area in the nasal cavity resembling a bullet (figure). The man's nose was examined under general anaesthesia. Many polyps and a bullet were removed and the ipsilateral maxillary antrum drained. Apparently he had sustained multiple gunshot wounds to the chest and thighs about 10 years previously. He had not had facial injuries so the bullet must have entered through the anterior nostril. There was no damage to the nasal septum or the turbinal bones, and at review his nose appeared completely normal.-c WASSON, otolaryngology department, Ulster Hospital, Northern Ireland