Apple-like nodules in the pharynx: pharyngeal lupus is characterized by the same insidious onset and painless development as lupus in other areas. When lupus occurs on the face or nose and the typical applesauce-like nodules occur in the pharynx, the diagnosis is easy, but a biopsy is still needed to confirm the diagnosis. What causes applesauce-like nodules in the pharynx? Applesauce-like nodules in the pharynx are usually secondary to the face and nose. The causative organism is a low virulence Mycobacterium tuberculosis. Pharyngeal lupus, like lupus in other areas, is characterized by an insidious onset and painless development. When lupus occurs on the face or nose and the typical applesauce-like nodules occur in the pharynx, the diagnosis is easy, but a biopsy is still needed to confirm the diagnosis. The course of the disease is extremely slow and patients often do not know when the disease starts. The symptoms are usually mild, with discomfort and mucus in the pharynx and slight difficulty in swallowing, usually without sore throat and in good general condition. The uvula is often the first site, followed by the tongue and palate arch and soft palate, but the tonsils are rarely invaded. It can be divided into four stages according to the clinical course. 1, submucosal infiltration stage mucosa is pale, swollen, slightly dry and shiny, and loses softness. 2.Nodular hyperplasia stage lupus nodules are pale red or yellowish in color, as large as millet, and most nodules are aggregated into granular lupus disease lesions, and the nodules on the lesions are sometimes not easily recognizable due to mucosal congestion, and coated with epinephrine solution, the nodules often show a typical applesauce color. The nodules in the ulcerative stage ulcerate and become ulcers, and the surface may be covered with white pseudomembrane. The ulcers are usually shallow, with raised edges containing nodules and often with granulation at the bottom. 4, scar formation period ulcers can often heal themselves and form a smooth scar, the uvula can be shortened by contraction of the soft palate.