Keratosis Pharyngis is a medical condition where

keratin Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. Alpha-keratin (α-keratin) is a type of keratin found in vertebrates. It is the key structural material making up scales, hair, nails, feathers, ho ...

grows on the surface of the

pharynx The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus and trachea (the tubes going down to the stomach and the lungs). It is found in vertebrates and invertebrates, though its struc ...

, that is the part of the throat at the back of the mouth. Keratin is a protein that normally occurs as the main component of hair and nails. It is characterized by the presence of whitish-yellow dots on the pharyngeal wall, tonsils or lingual tonsils. They are firmly adherent and cannot be wiped off. The surrounding region does not show any sign or inflammation or any other symptoms that make affect the rest of the body. Inverted follicular keratosis 1 (3059309003)

Inverted follicular keratosis 1 (3059309003)

Signs and symptoms

Signs and symptoms of an individual with this condition will display horny excrescences on the surface of the tonsils, pharyngeal wall, or

lingual tonsils The lingual tonsils are a collection of lymphatic tissue located in the lamina propria of the root of the tongue. This lymphatic tissue consists of the lymphatic nodules rich in cells of the immune system (immunocytes). The immunocytes initiate th ...

. They appear as white or yellowish dots (projections). These excrescences are the result of

hypertrophy Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.Updated by Linda J ...

and

ization of

epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...

. These so-called "dots" are firmly adherent to the area in which they reside and cannot be wiped off. There is no accompanying inflammation or any constitutional symptoms thus, it can be easily differentiated from acute follicular tonsillitis. There is no pain involved however, some discomfort or irritation of the throat may be felt. Removing the tonsils altogether may be a better option if irritation and discomfort is unbearable. * Discomfort * Painful swallowing * Irritation of the throat

Causes

There is no specific cause of this disease. Epithelial and

fungal A fungus ( : fungi or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, separately from th ...

debris collects in the follicles in the pharynx which could be a sign of a potential cause. The main thing to know about this condition is that it can reappear.

Diagnosis

An ENT specialist or otolaryngologist will be able to confirm the diagnosis as well as provide any necessary treatment if required. The ENT will use an instrument called a

laryngoscope Laryngoscopy () is endoscopy of the larynx, a part of the throat. It is a medical procedure that is used to obtain a view, for example, of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during ge ...

in order to push the tongue down and in order to lift up the

epiglottis The epiglottis is a leaf-shaped flap in the throat that prevents food and water from entering the trachea and the lungs. It stays open during breathing, allowing air into the larynx. During swallowing, it closes to prevent aspiration of food in ...

which is the small flap in the back of the throat that covers the windpipe. The epiglottis opens during breathing but closes during swallowing in order to prevent choking. The ENT will then use an instrument to remove any visible small growths or they will use a swab to sweep over the growth and send it to a lab where it can be examined for further testing.

Mechanism/Pathophysiology

A microscopic examination of the swab test that is taken from the walls of the pharynx will reveal thickened, keratinized,

squamous epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellula ...

and may appear lobulated pedunculate. The sizes may vary from small to large. A larger growth or an accumulation of small growth can determine how a person may feel since any growth can be uncomfortable in the back of the throat. This is determined to be one of the main contributions of this condition.

Prevention/Treatment

This disease may show spontaneous regression and may not require any specific treatment except for reassurance to the patient. To aide with any discomfort, gargling or taking lozenges would be temporarily beneficial. Avoid smoking or tobacco usage at all costs. Removing the tonsils altogether would be a last resort procedure if all else fails.

Prognosis

There is no prognosis due to the rarity of this condition.

Keratosis Keratosis (from '' kerat-'' + '' -osis'') is a growth of keratin on the skin or on mucous membranes stemming from keratinocytes, the prominent cell type in the epidermis. More specifically, it can refer to: * actinic keratosis (also known as solar ...

pharynges appears without an apparent cause and disappears spontaneously with or without treatment. Most cases usually go away on their own. There is no long-term impact of this condition and although reoccurrence can occur, it is actually very rare. The disease usually shows spontaneous regression.

Epidemiology

Due to a lack of awareness and studies, prevalence in a particular population or sex is unknown.

Research

There is very little research on this condition. One patient who was diagnosed with Keratosis Pharyngis had white spots on the base of the

tongue The tongue is a muscular organ (anatomy), organ in the mouth of a typical tetrapod. It manipulates food for mastication and swallowing as part of the digestive system, digestive process, and is the primary organ of taste. The tongue's upper surfa ...

and on the pharynx, and hurt a little when swallowing. No treatment was found to help, but the condition went away by itself eventually. A similar study was conducted about keratin expression in normal esophageal epithelium and squamous cell carcinoma of the esophagus. To sum it up, the molecular weight was taken of squamous cell carcinoma in the esophagus and normal esophageal epithelium using a

immunoblot The western blot (sometimes called the protein immunoblot), or western blotting, is a widely used analytical technique in molecular biology and immunogenetics to detect specific proteins in a sample of tissue homogenate or extract. Besides detect ...

analysis The squamous tissue which had keratins weighed more than the normal epithelium. Future research can be conducted in a similar way as the above study had done. A swab of the keratin growth in the pharynx can be compared to the regular tissue in the pharynx. This can determine many differences under a microscope.

References

{{Reflist Conditions of the mucous membranes