WEGENER'S GRANULOMATOSIS.

Wegener's granulomatosis is a clinical condition that may first present with the skin lesions of periarteritis nodosa and later develop symptoms referable to the upper respiratory tract, or the reverse may happen, as in my third case. Which ever may be its mode of presentation, it is very important that, where skin lesions are present, the nose and throat be thoroughly examined. Both sites allow careful and detailed observation to be made of the progress of the disease. If Wegener's granulomatosis is constantly in the back of one's mind when making a differential diagnosis of the condition with diffuse lesions, it surely must be treated earlier, and, in consequence, with greater success. The aids to diagnosis are biopsies of the skin, muscle and granulomatous lesions of the respiratory tract. The E.S.R. is invariably high, the albumen-globulin ratio is reversed, and the gammaglobulins are raised. The treatment of choice is a cortisteroid drug. If, however, there is excessive destruction of the midline facial tissue, then radical surgery, irradiation and a corticosteroid should be employed. [ABSTRACT FROM AUTHOR]