Lipoma is a hypertrophy of the structures forming the tip of the nose, and varies very much in size and appearance. It is occasionally sessile and wart-like; at others pedunculated; again a mere clubbing of the tip, or an immense pendulous mass hanging over the mouth. The growth is usually limited to the tip, but cases have occurred in which it has extended upwards until vision is seriously interfered with. It is oftener met with among drunkards, a modified form being the traditional “bibulous nose”. Preceding the development of lipoma, we frequently have an acne rosacea, in a severe form and of long standing, and the integument, and soft parts undergo a sort of hypertrophy, or more strictly speaking, the action is heteroplastic. The mucous crypts and follicles being first at fault, are found enlarged, accompanied by much infiltration of the connective tissue. The structure, when fully developed, is hard and gristly, when cut into, in places cartilaginous – of a dusky-red or purple color, greasy to the touch, and compressible without pain. A striking peculiarity may be said to be, that the mucous membrane and cartilages are never involved, and the growth is entirely external. The term lipoma is an unfortunate one, as it really means an encysted fatty tumor, and the present instance fat does not in any way enter the composition of the growth.
The treatment is often mechanical, but in a few cases, if not large or of very long standing, remedies have produced striking results.
Baryta carb. – Lipoma in old persons of intemperate habits; scurf under the nose; troublesome dryness of the nose; fluent coryza, with feeling of stoppage.
Graphites.-Painful dryness of the nose, with black sweaty pores externally; dry scurfs in the nose, with frequent discharge of thick, yellow fetid mucus.
Mercurius.-Red, shining swelling of the nose, with itching; greenish, fetid pus discharge from nose.
Nitric acid.-Lipoma like condyloma, with a disagreeable odor on inhaling; dry nose; pricking or sticking in nose like a splinter.
Sulphur.-In old cases, with lobulated arrangement, and no subjective symptoms.