The presentation and expression of multisystem disease is diverse. The onset of systemic diseases such as systemic lupus erythematosus (SLE), scleroderma, dermatomyositis (DM), polymyositis (PM), and rheumatoid arthritis (RA) may occur with symptoms in a variety of organ systems, sometimes typical and sometimes unusual. The eventual course of the disease may include involvement of yet other organ systems. While otorhinolar-yngeal manifestations of systemic rheumatic diseases are not among the most common hallmarks of these diseases, they can be quite characteristic and their recognition and management can be of considerable importance (1).

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