Hi & welcome, Minnietwo. I'd have been surprised, too, and annoyed! I looked this up---I was that curious
---and found that nasal PERFORATION can happen in lupus, especially when vasculitis is present. NARROWING can apparently be caused by many things, incl. Wegener's, relapsing polychondritis, chronic sinus infections, breaking one's nose, etc. So the doctor's "only 3" statement seems weird to me, and probably off the mark.
I have cutaneous vasculitis on my ankles, too. My dr. said it's no big thing UNLESS the skin ulcerates.
When do you expect your labs back? I hope you get clarity quickly. Where bloodwork isn't helpful enough, rashes can be deep-punch biopsied & subjected to immunofluorescent stain tests that light up in "lines" that are considered diagnostic of lupus. I had the skin tests---not a biggie for me because my rashes were on arms & back, not face. But I hope your answers come easier! Let us know how you're doing, OK? Warm wishes, Vee