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Have had swollen nose and staph infection. Lump appeared. Should I go for surgery?

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Practicing since : 2005
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Hello, about five weeks ago I was picking at a small scratch on the left side bridge of my nose. Over the course of the next three days it became very red and swollen, my whole nose swelled up. I went to a dermatologist who said it was infected and prescribed sulfameth, but told me if it became more swollen to go to the ER, he did not want to risk the infection spreading to eyes or brain. The next morning my eyelids were swollen and cheeks were hard, I went to the hospital and they said it was a staph infection, a nasal swab was negative for mrsa (although it was not draining at that time so the drainage was never cultured. It is important to note that my newborn and I both had mrsa lesions directly after his birth in the hospital 7 months ago). They kept me overnight and I had iv's of both vancomycin and clindamycin..and then was sent home with ten days of oral clinda. My issue now is that the infection is essentially "gone" but I still have a non-painful lump at the site. It does not seem to be going down anymore. It is moveable but does not seem like it will ever drain, almost like scar tissue. It really bothers me. What are my options? Will it have to be surgically removed or could something like a steroid shot or fudicin cream help this?
Posted Sun, 2 Dec 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 9 hours later
Hi ,
Thanks for writing in.

Ive gone through your history and present complaints.

The swelling you are describing is most probably a hypertrophic scar or keloid.
Both are the result of the infection you had suffered.

It is unlikely that it will go away on its own.It is also unlikely to go by topical cream or ointment.Treatment for it would be intralesional steroid into the lump.Surgical treatment in not advisable as ,if it is keloid it can grow with double the size.
Intralesional steroid is a good option as it will flatten the lesion.A long acting steroid like Triamcilonone would be ideal.It has to be injected with a small insulin syringe into the bulk of the lesion.

Other modalities for the lesion would be cryotherapy with liquid nitrogen and CO2 laser.These treatments are available at dermatology clinics.

Hope this helps.

I will be available for any further clarification that you may need.

MD dermatology.

Above answer was peer-reviewed by
Follow-up: Have had swollen nose and staph infection. Lump appeared. Should I go for surgery? 17 hours later
Thank you very much. I went to see my dermatologist today and he concurred that it was likely a keloid scar. He injected it with a cortisone shot (I do not know the name/type). He said it will take one to two weeks for it to come down. I was hoping to see some results immediately, but in the last few hours it still looks the same- that is normal, correct?

Would ice packs or warm compresses help at all, or should I just leave it alone?

Thank you again for your help.
Answered by Dr. Sudarshan 14 hours later
Hi again,

Thanks for the details.
Its good to know that the diagnosis has been confirmed by your dermatologist.

Now that you have taken the injection,you should wait for 2-3 weeks to notice any change.It has a slow and prolong effect.Steroid will definitely show its effect.A 3 week period is needed for noticeable effects.
You should wait now and leave it alone.A review of swelling should be taken after the end of 3 weeks.If needed a repeat injection may be taken at that time.
Ice pack or warm compresses would not be needed.

Hope this makes things clear.

Wishing you good health.
If you are satisfied with the answer please accept it and rate it at the end.

MD Dermatology.
Above answer was peer-reviewed by
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