ABSTRACT
ENT complications may constitute a life-threatening emergency, as in arthritis of the crico-arytenoid with associated vocal cord dysfunction. The key to assessment is a whole patient screening review of systems and general examination by the ENT specialist, as well as good ENT assessment by the physician or paediatrician. ENT management needs to be in conjunction with an expert specialist rheumatology or paediatric rheumatology team depending on the age of the patient. Many of the rheumatological conditions are immune-suppressive in themselves, as are the drugs, including steroids, used to treat the conditions. ENT infections may be increased in these situations. In terms of ENT features, the mucosal inflammation may present with swollen red tongue and lips, cracked lips, and angular stomatitis enough to make swallowing impossible. Systemic sclerosis is caused by a combination of low-grade inflammation with increased fibrosis in soft tissues and in blood vessels.
