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The granulomatous diseases are affections characterized by the presence of the granuloma, a result from the organism defense and wound healing process. It can be classified in two types: specific (hanseniasis, leishmaniasis and tuberculosis) and non-specific (Wegener's granulomatosis and sarcoidosis) . The otolaryngologist can play two important roles in the care of patients with systemic medical disorders first seen with head and neck symptoms. The first role is to diagnose these disorders based on clinical findings in the head and neck. tluough a high index of suspicion for these diseases. The second role is, in collaboration with a rheumatologist or infectious disease specialist, to manage head and neck manifestations of these diseases. In some regions the infectious diseases are frequent, with specific granuloma, such as hanseniasis, cutaneo-mucous leishmaniasis, tuberculosis and rhinoscleroma. This relates to the social environment where these patients live, with strong poverty and consequent people's undernutrition, household agglomeration and more concomitant diseases, which allows for a major dissemination of such diseases .