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Chronic pharyngitis. Non specific 1- Chronic simple pharyngitis. Specific 1- Scleroma 2- Syphilis 3- Tuberculosis. Chronic pharyngitis. Etiology : 1-Recurrent acute pharyngitis 2- Mouth breathing 3- Smoking & spirits 4- GERD. Chronic simple pharyngitis. Symptoms :

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Chronic pharyngitis

Non specific

1- Chronic simple pharyngitis

Specific

1- Scleroma

2- Syphilis

3- Tuberculosis

Chronic pharyngitis


Chronic simple pharyngitis

Etiology :

1-Recurrent acute pharyngitis

2- Mouth breathing

3- Smoking & spirits

4- GERD

Chronic simple pharyngitis


Symptoms :

- History of repeated attacks of sore throat

- Throat irritation (hemming نحنحه&hawking تنخيم)

Signs:

- Catarrhal, mild hyperaemia of the pharyngeal mucosa

- Hypertrophic, scattered nodules on the posterior pharyngeal wall

Treatment: of the cause


Chronic pharyngeo-oesophagitis

Plummer Vinson's Syndrome

Paterson Brown-Kelly Syndrome


Answer

This middle aged female presented with gradually progressive dysphagia

1- the patient is most probably suffering from

PLUMMER VINSON SYNDROME.

2- you should proceed to the following investigations:

A- Blood Picture (Hypochromic Anemia)

B- gastric secretion (achlorohydria

C- Barium Swallow (web)

  • This middle aged female presented with gradually progressive dysphagia

    1- the patient is most probably suffering from………….

    2- you should proceed to the following investigations:

    A-

    B-

koilonychia

Angular Stomatitis

Atrophic Glossitis


Plummer-Vinson or Paterson-Kelly syndrome presents as a classical triad of dysphagia, iron-deficiency anemia and esophageal webs

Age: Middle age

Sex: 90% in females

Etiology: Un-clear, may be

  • iron deficiency anemia

  • Vitamin deficiency

  • or autoimmune processes

    Pathology: Atrophy of :

    Pharyngeal

    Esophageal &

    Gastric mucosa


Symptoms classical triad of dysphagia, iron-deficiency anemia and esophageal webs

General

Pharyngeal

Weakness, fatigue, and dyspnea

are Secondary to iron deficiency

anemia

Signs

General

Pharyngeal

Koilonychia

Spleenomegaly

Pallor

Angular stomatitis

Glossitis

Atrophic glazed mucosa of the

hypopharynx

Dysphagia, if present, is typically

intermittent and limited to solids.

It is usually felt in the throat


Investigations classical triad of dysphagia, iron-deficiency anemia and esophageal webs

Complications

Treatment

- Stricture at the cicopharyngeal

Sphincter

- Pre-cancerous: postcricoid

carcinoma &esophageal carcinoma

Blood picture:hypochromic anemia

Gastric secretion: achlorohydi due to atrophy of gastric mucosa

Barium swallow

Hypopharyngoscopy

Iron & vitamine supply

Repeated endoscopic dilatation

Regular follow up for early detection of

postcricoid carcinoma &esophageal

carcinoma

Web


Chronic specific
Chronic Specific classical triad of dysphagia, iron-deficiency anemia and esophageal webs

  • Scleroma

  • Tuberculosis

  • Syphilis


Pharyngoscleroma see rhinoscleroma for more details
Pharyngoscleroma classical triad of dysphagia, iron-deficiency anemia and esophageal websSee Rhinoscleroma for more details

Clinically

  • Atrophic

  • Nodular

  • Fibrotic

Etilogy:

Secondary to Rhinoscleroma

Dry glazed mucosa

Pink indurated non ulcerating ,

painless nodules

Shortened uvula

Pharyngeal Stenosis


Tuberculous pharyngitis
Tuberculous pharyngitis classical triad of dysphagia, iron-deficiency anemia and esophageal webs

Etilogy:

Secondary to Pulmonary Tuberculosis

Clinically

  • Pallorof the mucosa

  • Typical ulcers

Painful

Superficial

Shallow

Undermined edge

Caseous floor


Syphilitic pharyngitis
Syphilitic pharyngitis classical triad of dysphagia, iron-deficiency anemia and esophageal webs

Single painless indurated papule

Secondary :

-Hyperaemic mucosa

-Mucous patches

-Snail track ulcers

Primary:Chancre, rare in the pharynx

Tertiary:Gumma

Pinkish rubbery swellings

--►typical ulcer

Deep punched out edge

Necrotic dirty yellow floor


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