(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Epistaxis

Sarcoidosis is a chronic multisystem granulomatous disease that has a predilection for pulmonary and upper respiratory tract involvement. Because the initial signs and symptoms of sarcoidosis may be identical to those of other forms of chronic sinonasal inflammatory disease, these patients will often first seek treatment from an otolaryngologist. We present a series of 28 patients whose primary symptoms was involvement of a sinonasal tract. A new staging system is proposed to categorize the severity and sites of involvement and to guide the aggressiveness of therapy. Sarcoidosis should be considered in the differential diagnosis of inflammatory sinonasal disease.

Topics: Adult; Beclomethasone; Chronic Disease; Constriction, Pathologic; Diagnosis, Differential; Edema; Epistaxis; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasal Obstruction; Nose Deformities, Acquired; Nose Diseases; Paranasal Sinus Diseases; Prednisone; Sarcoidosis; Tissue Adhesions; Triamcinolone Acetonide

Topics: Administration, Topical; Adolescent; Adult; Aerosols; Aged; Anti-Inflammatory Agents; Beclomethasone; Chronic Disease; Clinical Trials as Topic; Epistaxis; Female; Glucocorticoids; Histamine H1 Antagonists; Humans; Male; Middle Aged; Nasal Mucosa; Placebos; Respiratory Therapy; Rhinitis, Allergic, Seasonal; Sneezing; Time Factors

Intranasal steroid sprays are fundamental in the medical management of inflammatory rhinological conditions. Side effects are common, but these may be related to the method of application rather than the medication itself.. A survey was distributed to patients using intranasal steroid sprays at the ENT out-patient clinic at Aberdeen Royal Infirmary over three months. This evaluated the spray technique used, side effects and compliance.. Of 103 patients, 22 patients (21.4 per cent) reported side effects, including nasal irritation and epistaxis. Of the 20 patients with epistaxis, 80 per cent used an ipsilateral hand technique (p = 0.01). Thirty patients demonstrated poor compliance because of lack of symptom improvement or side effects. Seventy-seven per cent of this group used the ipsilateral hand technique.. Patients who used their ipsilateral hand to apply the intranasal steroid spray were more likely to develop epistaxis and have poor compliance than those who used other techniques. Patients who struggle with compliance because of side effects should avoid this method of intranasal steroid application.

Topics: Administration, Intranasal; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Beclomethasone; Epistaxis; Female; Fluticasone; Humans; Male; Medication Adherence; Middle Aged; Mometasone Furoate; Nasal Sprays; Rhinitis; Surveys and Questionnaires; Young Adult

Crohn's disease (CD) is a chronic inflammatory disease that affects both the small and large intestine in approximately 40% of cases, solely the ileum or the colon in 30% and 25%, respectively. The remaining locations of the gastrointestinal (GI) tract are involved in percentages ranging between 0.5 and 5%. The appearance of the disease outside the GI tract is an exceptional event. In the present case, the authors report the history of a male patient suffering from CD involvement of almost the entire digestive system plus the nasal mucosa. This latter event emerged after repeated episodes of epistaxis, the demonstrations of histologic nasal features similar to those of intestinal CD, and the remission after treatment with beclomethasone. Since in literature less than a decade of cases of nasal location of CD was described, it is of prime importance to highlight that in CD patients, the occurrence of repeated episodes of epistaxis should prompt a consideration in the differential diagnosis of nasal location of the disease.

Topics: Adult; Anti-Inflammatory Agents; Beclomethasone; Crohn Disease; Epistaxis; Humans; Male; Nasal Mucosa; Nose Diseases; Recurrence