Next Page

Differential Diagnosis

The differential diagnosis of nasal scleroma includes diseases of such diverse etiology as leprosy, syphilis, yaws, mucocutaneous leishmaniasis, South American blastomycosis (paracoccidioidomycosis), and rhinosporidiosis. Pathologists should note that the lepra cell of lepromatous leprosy can resemble the Mikulicz cell seen in scleroma (the Fite-Faraco acid-fast stain distinguishes the lepra cells). Wegener's granulomatosis (the lethal midline granuloma of the upper respiratory tract) as well as lymphoma and primary or metastatic epithelial and mesenchymal neoplasms may also mimic scleroma. Large biopsy specimens are usually necessary for the pathologist to distinguish between these entities. In patients with advanced laryngotracheal scleroma, intrinsic or extrinsic neoplasm must be differentiated. The simultaneous involvement of the nose in most cases will suggest the true diagnosis.

Back to the Table of Contents

Copyright: Palmer and Reeder
Tropical Medicine Mission Index of Diseases About Tropical Medicine Tropical Medicine Home Page Tropical Medicine Staff