Diseases of Head & Neck Flashcards
What is rhinitis?
Inflammation of the nasal cavity
Viral and bacterial causes of rhinitis?
Viral –> RSV, para-influenza, coronaviruses
Bacterial –> haemophilus infleunzae
Most common cause of rhinitis?
Inhaled allergen/hypersensitivity reaction (hayfever)
What common allergens trigger hayfever?
pollens, animal dander, dust mites, mold
What is sinusitis?
Inflammation of paranasal sinuses
Clinical features of sinusitis?
Blockage of draining orifices can lead to blockage and abscess formation
What can severe cases of sinusitis lead to?
meningitis, cerebral abscess, cranial osteomyelitis
What are nasal polyps?
- Soft, fleshy polypod lesions with a myxoid or mucoid appearance
- May be unilateral or bilateral, single or multiple
What is the cause behind nasal polyps?
Due to chronic allergic irritation or infection of nasal cavity & sinuses
What is rhinorrhoea?
Runny nose
What is Samter’s triad?
a) nasal polyps
b) asthma
c) aspirin intolerance
What cell type may predominate in polyps of infectious origin?
Neutrophils
Cell composition of nasal polyps?
Mixed chronic inflammatory cell infiltrate predominantly composed of eosinophils (mainly in allergic), plasma cells, and lymphocytes.
Structure of nasal polyps?
Surface respiratory epithelium with underlying oedematous stroma
What is oral lichen planus?
- Oral manifestation of Lichen planus (a non-infectious inflammatory mucocutaneous condition)
- Often presents as a chronic dermatologic disease but also commonly affects the oral mucosa.
- Up to 35% of patients with LP have only oral manifestations.
Gender distribution of oral lichen planus?
Female > male
What is a lichenoid drug eruption?
Also called drug-induced lichen planus, is an uncommon cutaneous adverse effect of several drugs. It is characterized by a symmetric eruption of flat-topped, erythematous or violaceous papules resembling lichen planus on the trunk and extremities.
What are the 3 forms of oral lichen planus?
- Reticular (papular, plaquelike)
- Erythematous (atrophic)
- Erosive (ulcerative or bullous) in buccal mucosa and tongue
Which disease is ‘Wickham striae’ seen in?
Lichen planus, typically in the oral mucosa
What are Wickham striae?
Wickham striae are whitish lines visible in the papules of lichen planus and other dermatoses, typically in the oral mucosa. The macroscopic appearance shows hypergranulosis.
Clinical features of oral lichen planus?
- Interlacing white striae (Wickham striae)
- Skin itchy, violaceous papules, blisters particularly on palms and soles
Histological findings in oral lichen planus?
- Basal keratinocytes damage and hydropic degeneration –> Civatte bodies
- Lichenoid tissue reaction pattern characterised by basal cell damage
- Inflammatory infiltrate in the interface/junction between epithelium and stroma
- Epithelium acanthosis or atrophy and saw tooth rete ridges
Treatment for oral lichen planus?
- Topical steroids
- Antifungal treatment if superimposed fungal infection (e.g. candidiasis)
Why can epiglottitis be life threatening?
Can lead to airway obstruction