Associated Medical Findings

The skin should be checked for rashes, lesions, or evidence of insect bites. The head and neck should be examined for masses, signs of trauma, or postoperative scars. The auricle and ear canal should be examined thoroughly for vesicles, ulcers, or other lesions. The tympanic membrane should be checked for perforation, drainage, or cholesteatoma. Infections, neoplasms, and evidence of prior otological surgery should be sought while examining the middle ear. The oral cavity and pharynx should be checked for masses, ulcerations, fissuring of the tongue, and other lesions. The parotid should always be palpated for tumors and inspected for inflammation. If nonsuppurative parotitis, uveitis, and mild fever are found, Heerfordt's disease, a variant of sarcoidosis, may be present. Endocrinological function should be evaluated, because diabetes insipidus or other evidence of pituitary dysfunction can signify neurosarcoidosis. If there is incomplete eyelid closure, the cornea should always be checked for ulceration or infection, because loss of vision from exposure keratitis can occur.


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