Cocaine-induced midline destructive lesion: an unfavorable evolution.

(A) Clinical photography of hard palate perforation and (B) Computed tomography image of midline facial destruction from a patient with cocaine-induced midline destructive lesion. The clinical manifestations of CIMDL are chronic nasal obstruction, hyposmia, nasal septum perforation, necrotizing ulcers, dysphagia, oro-nasal reflux, and facial pain [[2]]. Palate perforation differentiates cocaine-induced midline destructive lesions from granulomatosis with polyangiitis. [Extracted from the article]