What Causes Red Dot On Wharton's Ducts In A Patient With Dysautonomia?

Posted on Fri, 31 Jul 2015

Question: Hi . I am a 29 year old female. with a history of dysautonomia. I do not smoke , and I only drink alcohol occasionally socially. Recently I noticed a red dot on my whortons duct. when I take my tongue and rub against it ; it has a burning sensation. Theres actually a few very small red dots, almost like Petechiae it does NOT look like a canker sore there is no white area whatsoever. when I touch it , it almost feels kind of flappy, almost like theres extra skin on it? other than the redness and petechiae there is no other discoloration. it has been like this for a few weeks but the very mild burning just started. I guess I am just nervous and scared. I do not want it to be cancer. Now I have had in the past had one Chalezion removed from my eye (benign) and I did have a cyst from my uvula removed about 3 years ago that has been there forever, also benign. I am unaware if that can be related. So Does this sound worrysome? or benign? something that will go away ? what COULD it be

my only history is dysautonomia (POTS syndrome) though I am in the middle of being worked up for an unknown autoimmune disease , though one doctor thinks I could have autoimmune and another is certain I have EDS type III . My ANA at its highest was 1:160 and no antibodies whatsoever . or high inflammation markers (esr, cpk)

I wanted to give you my history in case that could clue in .

Answered by Dr. Sumit Bhatti (5 hours later)

Brief Answer:
Rule out Sjogren's Syndrome.

Detailed Answer:
Hi,

Thank you for your query.

1. I am not sure if you are referring to the Wharton's (submandibular) duct or the Stensen's (parotid) duct as it is easier to touch the tongue to the latter.

2. I would initially treat this as a benign inflammation with either a wait & watch or antibiotics such as Clindamycin with anti inflammatory medication.

3. If this does not subside , it is possible to have salivary and lacrimal (tear) gland problems due to anti developing anto immune disorder which are known to be associated with POTS.

4. Salivary flow measurement, MRI Sialography, Sialendoscopy and biopsy are possible investigations that may be done.

5. Overall, this should be a minor issue in comparison to the effects of POTS, EDS and side effects of your current medication.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar