Lupus of the pharynx is often secondary to facial and nasal lesions. The causative agent is the low-virulence subcutaneous nodule bacillus.

bubble_chart Clinical Manifestations

The disease progresses extremely slowly, and patients often do not know when it began. General symptoms are mild, often including throat discomfort and a sticky sensation, with slight difficulty swallowing. There is usually no sore throat, and the overall condition is relatively good. The uvula is often the first site affected, followed by the palatoglossal arch and soft palate, but the tonsils are rarely involved. The clinical course can be divided into four stages.

1. Submucosal infiltration stage: The mucosa appears pale, swollen, slightly dry, and shiny, losing its softness.

2. Nodular hyperplasia stage: Lupus nodules are pale red or pale yellow, about the size of foxtail millet. Multiple nodules aggregate to form granular lupus lesions. The nodules on the lesions may sometimes be difficult to distinguish due to mucosal congestion, but applying adrenaline solution often reveals the typical apple-jelly color.

3. Ulceration stage: The nodules ulcerate, forming ulcers that may be covered with a white pseudomembrane. The ulcers are generally shallow, with raised edges containing nodules and often granulation tissue at the base.

4. Scar formation stage: The ulcers often heal spontaneously, forming smooth scars. The uvula may shorten due to contraction of the soft palate.

bubble_chart Diagnosis

Lupus of the pharynx is similar to lupus in other locations, characterized by an insidious onset and painless progression. When lupus occurs on the face or nose, and typical apple-jelly nodules appear in the pharynx, the diagnosis is straightforward, but a biopsy is still required for confirmation. This condition must be differentiated from pharyngeal subcutaneous nodules and late-stage (third-stage) syphilis.

The main treatment is systemic therapy, commonly used drugs include streptomycin, isoniazid, rifampicin, and para-aminosalicylic acid. Nutritional improvement is essential, with the administration of various vitamins and calcium supplements. Maintaining oral hygiene, keeping the local area clean, and timely medication are crucial. With appropriate treatment, the prognosis is favorable.