Porcine Nose Associated With Cocaine Use: A Report of Two Cases

Cocaine is a commonly abused illicit substance frequently administered through intranasal inhalation. Its potent vasoconstrictive effects are well recognized and can result in significant ischemic damage to the sinonasal mucosa. A known complication of chronic intranasal cocaine use is the development of cocaine-induced midline destructive lesions, often leading to perforation of the nasal septum and adjacent structures. Although the destructive sequelae of cocaine use are well documented in the literature, nasal hypertrophy has not been widely reported. In this study, we describe 2 patients with a history of intranasal cocaine use who presented with similarly pronounced nasal enlargement characterized by a porcine appearance. Histopathologic evaluation in both cases revealed features mimicking squamous cell carcinoma, highlighting the potential for diagnostic confusion in such presentations.