TONSILLAR KERATOSIS
Synonym: Mycosis Leptothrica
Tonsillar keratosis is characterized by appearance of multiple white projections from cryptal orifices of the tonsil, lymph follicles, the posterior and the lateral pharyngeal walls, posterior part of the tongue and glosso-epiglottic fold.
Aetiology:
- Usually affects young adults.
- Can progress over 2 to 3 years.
- Viral and fungal infective aetiology have been suggested.
- Nutritional deficiency.
Most common site:
Lateral glosso-epiglottic fold and posterior part of the inferior pole of the tonsil.
Pathology:
This condition usually affects the faucial and the lingual tonsils. During deglutition, the contraction of the muscles prevents food from coming with intimate contact with the surface. It thus permits these projections to grow. The horny projection breaks up into layers. Between these layers multiple organisms multiply and grow. The toxins released from these organisms are absorbed by the tonsillar tissue.
Clinical features:
Symptoms:
The symptoms in this condition are usually mild.
- Irritating tickling sensation in throat.
- Dry hacking cough.
- Patient may have history of chronic tonsillitis.
- Halitosis may be presenting symptom in some cases.
Signs:
Oral cavity shows hard, whitish, horny plugs. They may project from the tongue base and can be touching the epiglottis.
Treatment:
- If asymptomatic no treatment required.
- Antiseptic gargles help empirically.
- Horny masses can be removed by electrocautery. Three to four masses may be treated at each sitting at weekly intervals.
- Tonsillectomy is advised for chronic cases.
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