This rare endemic disease has been found in Panama Bolivia, Guiana, Jamaica and other parts of the West Indies and in some of the Pacific islands, especially the island of Guam, where it has existed for at least 150 years and involves 2 per cent. or more of the natives. It is characterized by a destructive ulceration of the soft palate, pillars or uvula, with secondary involvement of the hard palate, nasal cavity. larynx and the cutaneous surface of the face. Systemic involvement is usually mild, although the destructive process may run an acute or chronic course and terminate with simple scarring or extensive mutilation following wide destruction of tissue. It is progressive, taking from one to several years for its development.
Etiology, Pathology and Diagnosis – Gangosa is rare in the very young or very old. Pure blooded natives are those usually afflicted. The condition is transmissible by direct contact but there is no uniform opinion as to the causative organism. Where patients have been segregated, the disease has been much diminished and there is every reason to believe that it is not related to syphilis, blastomycosis, lupus vulgaris, actinomycosis or rhinoscleroma. Histologically it closely resembles tuberculosis and the process is probably granulomatous in nature.
Prognosis and Treatment – Unless modified by treatment the disease continues indefinitely, although it never kills. The treatment is unsatisfactory but calls for segregation, improved hygiene, antiseptics and deodorants, of which a 1 per cent. potassium permanganate solution is the best. Cauterization of the involved mucous membranes, local application of tincture of iodin, the X-rays and mild fulguration have all been recommended.