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Clinical Challenge
August 1, 2019

Desquamatory Lesions of the Upper Aerodigestive Tract Mucosa

Author Affiliations
  • 1Department of Anatomy, University of Mons, Mons, Belgium
  • 2Department of Otorhinolaryngology–Head and Neck Surgery, CHU de Lille, Lille, France
JAMA Otolaryngol Head Neck Surg. 2019;145(10):967-968. doi:10.1001/jamaoto.2019.1990

A man in his 30s was referred to the department of Otorhinolaryngology–Head & Neck Surgery for a medical history of severe dysphagia and dysphonia. The patient reported fever and rhinorrhea in the few days preceding the emergency consultation. He did not take medication over the past 3 months. There was no relevant family medical history. At the clinical examination, the patient had several macules and desquamatory lesions on the mucosa of the oral cavity, lips, and penis, and he had hemorrhage lesions of the eye sclera (Figure). The skin of the patient was unremarkable. The nasofibroscopy results showed generalized desquamatory lesions of the upper aerodigestive tract mucosa affecting the laryngeal and vocal fold mucosa (Figure). There was no dyspnea and the airway was clear. The patient revealed that he had a similar but less severe clinical event 5 years previously. At that time, no diagnosis was found and the lesions disappeared following treatment with corticosteroids. Dermatopathologic analysis, biology, serology, and biopsy were performed.