Severe nasal cutaneous necrosis following an arthropod bite: surgical management and reconstruction

Arthropod bites are usually benign; however, severe cutaneous necrosis is a rare complication that may result in significant tissue loss, particularly when the face is involved. We report the case of a 19-year-old woman who developed progressive nasal cutaneous necrosis following a presumed arthropod bite. Despite initial medical treatment, the lesion worsened, requiring surgical necrosectomy followed by delayed split-thickness skin graft reconstruction. Histopathological examination supported the diagnosis of a severe arthropod bite reaction. Early recognition of necrotic arthropod bite reactions and timely surgical management are essential to prevent extensive tissue loss. Appropriate reconstructive strategies can achieve satisfactory functional and aesthetic outcomes, even in rare facial localizations.