For 10 weeks, a 34-year-old woman had refractory sinusitis, epistaxis, painful sores in her mouth with erosions in the nasal cartilage and palate, and otitis media in the left ear. She was subsequently found to have Wegener granulomatosis after punch biopsy of the lesions showed necrotizing vasculi-tis that involved small vessels. The patient was treated with hemodialysis, intravenous prednisone, and cyclo-phosphamide. Although her oral lesions had begun to resolve, saddle-nose deformity developed.
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