Pachyderma

Pachyderma, caused by laryngitis sicca: Series of 3 photos

Pachyderma (1 of 3)
Pachyderma, here referring to the heaped up mucosa in the interarytenoid area, in a patient with laryngitis sicca.

Pachyderma (2 of 3)
Adducted (voicing) position. Note that the pachyderma does not interfere with closure of the cords. In this case, the pachyderma does not directly affect the patient’s voice, which is typical, but the more generalized inflammatory condition (see the redness of the cords) does.

Pachyderma (3 of 3)
Narrow-band lighting. This shows some stippled vascular markings, often seen with chronic inflammation or HPV infection.

Elephant skin: Series of 1 photo

Elephant skin (1 of 1)
The namesake of this phenomenon of rough or thick mucosa: elephant skin!

Literally, “elephant skin.” Used in laryngology to refer to rough or thick mucosa. Most often seen in the interarytenoid area and is thought to be indicative of acid reflux or, sometimes, chronic bacterial infection. Pachyderma does not typically affect the voice, though the underlying cause of the pachyderma can (e.g., chronic inflammation from acid reflux or chronic bacterial laryngitis). In such a case, the true vocal cords themselves appear intensely red.