A 19-year-old White woman who was previously in good health, with no reported history of drug abuse, presented with progressive bilateral nasal airway obstruction, crusting, and saddle nose deformity over a 6-month period. The patient denied systemic symptoms, including oral ulcers, sicca, photosensitivity, dermatitis, or arthralgias. Her medical history had negative results for allergic rhinitis, asthma, chronic rhinosinusitis, epistaxis, nasal trauma, or surgery. Her family history was noncontributory. An in-office nasal endoscopy demonstrated synechiae bridging from the septum to the lateral nasal walls, polypoid changes, and yellow crusting bilaterally.