Treatment and Prognosis Treatment consists of symptomatic care for mild cases with anti-inflammatory agents. Dapsone has also been used with success. More severe cases, especially those with potentially life-threatening complications require steroids or even immunosuppressive agents. Azothiaprime, cyclophosphamide, methotrexate, and cyclosporin A have all been used in efforts to control the course of this disease. Natural history is unpredictable and may have an episodic, smoldering or fulmanent course.
Anemia is a poor prognostic indicator for all ages.
Poor prognostic indicators for patients less than 50 years or age include saddle-nose deformity, arthritis, laryngotracheal strictures, vasculitis, and microhematuria. For patients older than 50 years old, the number of disease manifestations correlated with survival. He had three previous EC visits for these problems and had been treated for presumed gastritis and bilateral external otitis with Pepcid and Cortisporin Otic drops, but had not experienced relief of his symptoms. He was admitted to the hospital for further evaluation. On admission he incidentally reported a 30 pound weight loss, nightly chills, dizziness, hearing loss, and painful conjunctivitis.