Pharyngokeratosis: causes, symptoms, diagnosis, treatment

This disease has long been part of the group of pharyngomycosis, having many similarities with these common diseases of the pharynx and oral cavity. Actually, however, it stands alone as an etiology and pathogenesis, and only in 1951 the Polish doctor J. Baldenwiecki described it as an independent chronic nosological form with clearly defined symptoms. The clinical picture of this mysterious disease is characterized by spontaneous keratinization of the integumentary epithelium of the lymphadenoid formations of the pharynx, especially in the crypt region of the palatine tonsils, from which dense whitish-yellow spines seem to grow extremely tightly to the surrounding tissues. When they are detached, a bleeding surface remains. The same formations also appear on the surface of the lingual tonsil, on the granules of the posterior pharyngeal wall and even in the throat part of the pharynx, while in those places where hyperkeratosis occurs, the ciliated cylindrical epithelium metaplanses into a multilayer flat epithelium. The horny areas of the epithelium persist for several weeks or months, then spontaneously, as they arose, disappear. Most often this disease occurs in young women.

The cause of pharyngokeratosis. The cause of the occurrence of pharyngokeratosis has long been the subject of discussion. In the second half of XX century. The scientists agreed that this disease is the result of a sluggish current inflammatory-reactive process similar to other similar conditions, such as the laryngeal pachydermia, the leukoplakia of the oral mucosa, and the black hairy tongue. Bacteriological studies showed the absence of Leptotrix buccalis, while at the same time the rod of Friedlander was very often found. According to many authors, this microorganism, which is very rare in the normal pharynx and oral cavity, can play a role in the pathogenesis of pharyngokeratosis. When histopathological examination, small islands of cartilaginous or bone tissue were found in the amygdala capsule and in the crypt epithelium. The keratin formed in crypts prolapses out of the crypts outward, giving the amygdala the appearance of a mace studded with spines.

Symptoms and clinical course of pharyngokeratosis. Subjective symptoms are insignificant: mild paresthesia, sensation of IT, small dysphagia. The disease is found most often by chance when examining the pharynx. It does not give complications.

The diagnosis is based on the endoscopic picture and the inexpressiveness of the clinical course. Differentiate from other mycoses of the pharynx and in particular from leptotriksom, with which this disease has been identified for many years. The final diagnosis is established by microscopic examination or biopsy.

Treatment of pharyngokeratosis. Relatively effective application of local effects on individual foci of keratosis (preparations of iodine, silver nitrate, galvanocaustic 10-12 foci per week, diathermocoagulation, cryosurgery). It is noticed that after the physical removal of the majority of the "colonies" other, not accumulated accumulations of pathological formations begin to disappear. When most of them are stopped, tonsillectomy is shown, as a result of which pathological foci also disappear in other places of the pharynx, in particular, on the lingual tonsil. This fact indicates that the foci of the onset and spread of the disease are the palatine tonsils.

[1], [2], [3], [4]