The authors report two cases of bullous rashes with an ENT onset: 1. a benign mucosal pemphigoid; 2. a pemphigus vulgaris. On the basis of these cases, they indicate the need to consider the possibility of bullous lesions in the presence of any persistent erosion of the nasal or bucopharyngeal mucosa, the diagnosis of which should be dominated by the identification of a possible pemphigus, the prognostic and therapeutic consequences of which remain serious. The clinical onset may be confined for a long period to the E.N.T. musoca. It may present with dysphagia and pain, or sometimes by simple epistaxis. The commonest diagnostic errors are aphthous ulcers and candidiasis which may, in the case of the latter, be associated with bullous lesions. They also report the possible problems which may result from endoscopic manoeuvres in the case of pemphigus. Any persistent erosion of the mucosae in the E.N.T. area should be evaluated by diagnostic cytology which would offer positive identification of pemphigus.

Adult↗

PubMedDate not supplied

[Management of severe epistaxis caused by so-called vascular or hypervascular tumors].

The authors begin by recalling the various tumoral conditions responsible for severe epistaxis. They differentiate between: angiomas and pseudo-tumoral angiomatous formations, vascular or so-called vascular tumours and hypervascularized tumours. In an emergency, immediate tamponage is essential. Treatment is also preventive: a gentle clinical examination and biopsies in the operating theatre. Particular stress should be laid on the contribution of super-selective arteriography which enables embolization to be carried out during the investigation. Embolization is particularly advocated, notably in cases of naso-pharyngeal fibroma, when there is a tumoral projection obstructing the pterygo-maxillary fossa or when there is considerable vascularization stemming from a branch of the external carotid other than the internal maxillary. Whatever the situation, any embolization, if it is to be permanently effective should be followed within 48 to 72 hours by surgical excision.

Embolization, Therapeutic↗