Inflammatory myofibroblastic tumor on intercostal nerve presenting as paraneoplastic pemphigus with fatal pulmonary involvement.

J Korean Med Sci. 2007 Aug;22(4):735-9

Authors: Lee DH, Lee SH, Sung JK

Inflammatory myofibroblastic tumors (IMTs) are benign neoplasms that can occur at different anatomic sites with nonspecific clinical symptoms. A 48-yr-old woman presented with a 2-month history of a relapsed oral ulcer, progressive dyspnea, and a thoracic pain induced by breathing. A tumorous mass was noticed in the right costodiaphragmatic recess on chest computed tomography and magnetic resonance imaging, and the patient underwent a right costotransversectomy with excision of the tumor, which originated from the 12th intercostal nerve. Histology and immunohistochemistry showed that the tumor was an IMT of the intercostal nerve. The patient's postoperative course was not favorable; dyspnea persisted after surgery, and a progressive pulmonary compromise developed. The cause of the respiratory failure was found to be bronchiolitis obliterans, which in this case proved to be a fatal complication of paraneoplastic pemphigus associated with an IMT. This case of IMT of the spinal nerve in the paravertebral region is unique in terms of its location and presentation in combination with paraneoplastic pemphigus, which is rare. A brief review of the heterogeneous theories concerning the pathogenesis, clinicopathological features, and differential diagnosis of this disease entity is presented.

PMID: 17728520 [PubMed - in process]

Mucocutaneous lesions of Behcet's disease.

Yonsei Med J. 2007 Aug 31;48(4):573-85

Authors: Alpsoy E, Zouboulis CC, Ehrlich GE

Behcet's disease is particularly prevalent in "Silk Route" populations, but it has a global distribution. The diagnosis of the disease is based on clinical criteria as there is as yet no pathognomonic test, and mucocutaneous lesions, which figure prominently in the presentation and diagnosis, may be considered the diagnostic hallmarks. Among the internationally accepted criteria, painful oral and genital ulcers, cutaneous vasculitic lesions and reactivity of the skin to needle prick or injection (the pathergy reaction) are considered hallmarks of Behcet's disease, and often precede other manifestations. Their recognition may permit earlier diagnosis and treatment, with salutary results. This paper describes the various lesions that constitute the syndrome and focuses on those that may be considered characteristic.

PMID: 17722228 [PubMed - indexed for MEDLINE]

[Recurrent oral ulcer: clinical characteristic and differential diagnosis]

Rev Chilena Infectol. 2007 Jun;24(3):215-9

Authors: Toche P P, Salinas L J, Guzmán M MA, Afani S A, Jadue A N

Recurrent aphthous stomatitis (RAS), are common inflammatory lesions of the oral mucous, usually round or ovoid, circumscribed by erythematous haloes with a yellow-grey floor and mostly painful. The RAS has reached an incidence about 20% in general population, present on any aged group, especially adolescents and young adults. Etiopathogenesis of RAS is not entirely understood. Some factors involved include immune system anomalies, infections, nutritional deficiency, mucous traumatism, food or contact allergy, autoimmunity illness and cancer; together with psychiatric, genetic and environment agents. In this article, main clinical features, etiology related factors, differential diagnosis and initial study of patients consulting for RAS are presented.

PMID: 17554441 [PubMed - indexed for MEDLINE]

Oral ulcers: three questions on their physiopathology.

Minerva Stomatol. 2007 May;56(5):293-302

Authors: Campisi G, Compilato D, Cirillo N, Ciavarella D, Panzarella V, Amato S, Lo Muzio L

Ulcers and/or erosions can be the final common manifestation, often clinically indistinguishable, of a wide and complex spectrum of conditions including traumatic lesions, infectious, vesiculo-bullous, neoplastic and gastrointestinal diseases. Their formation represents the final outcome of a complex and finely orchestrated phenomenon involving both epithelial lining and chorion. Reduction of blood flow, cytokine production, cell death, wound repair, all participate to the dynamic process which we define as ''ulcer''. However, little is known about the mechanisms which crucially contribute in determining the phenomenology of ulcer, and some questions still remain unsolved. This paper aims to explain the pathophysiology of oral ulcers attempting to answer three questions: the mechanism of ulcer development, the site of appearance, and the factors which determine the severity and healing time of ulcerative lesions.

PMID: 17529916 [PubMed - indexed for MEDLINE]

Primary tuberculosis of the tongue: a case report.

J Contemp Dent Pract. 2007;8(4):74-80

Authors: Garg RK, Singhal P

AIM: The purpose of this article is to report a rare case of primary tuberculosis of the tongue. BACKGROUND: Tuberculosis is an infectious, chronic granulomatous disease that can involve almost any organ in the body, but primary lesions are usually confined to the lungs. Oral lesions are an infrequent occurrence in tuberculosis, and tuberculosis of the oral cavity is often a consequence of active pulmonary tuberculosis. Although primary tuberculosis in the oral cavity has been documented, it is a rare occurrence. REPORT: A 42-year-old male patient presented with chief complaints of severe pain and ulceration on the ventrolateral surface of the left side of the tongue, measuring about 1.25 x 1.50 cm with surrounding erythema and induration of one-month duration. The ulcer was initially painless but became painful later with increased severity over time. The sore tongue caused difficulty in eating, drinking, swallowing, and even talking. The patient also complained of malaise for some duration, but there was no history of fever, cough, weight loss, and his bladder-bowel habits were normal. An excisional biopsy differentiated the lesion from squamous cell carcinoma and confirmed the diagnosis. SUMMARY: Even though primary tuberculosis in the oral cavity is a rare finding, it must be included in the differential diagnosis of mucosal lesions. This case provides a clinical example of the importance of this inclusion for the well being of the patient and for the community due to the communicable nature of the disease.

PMID: 17486190 [PubMed - indexed for MEDLINE]

Oral aphthous-like ulceration due to tiotropium bromide.

Med Oral Patol Oral Cir Bucal. 2007 May;12(3):E209-10

Authors: Vucicevic Boras V, Savage N, Mohamad Zaini Z

Unwanted side-effects of a drug therapy are well known to oral medicine specialists and other colleagues. Usually they manifest itself as dry mouth, taste disturbances, various allergic or toxic reactions on the lips and/or in the oral cavity. However, the list of the drugs which might induce unwanted reactions is everyday becoming longer as more and more drugs are introduced on the market. Certain problems when diagnosing and reporting unwanted side effects of the drugs exist as only accurate method of diagnosis is repeated drug use in controlled clinical setting where fatal consequences due to the anaphilactic shock could be avoided. We report a side effect reaction to tiotropium bromide (Spiriva) cap used with HandiHaler manifesting itself as an oral ulceration in a 65 yrs old male. On the third day of drug intake the patient developed oral ulceration two times in a period of few months. Other medications he has been using for several years. To our knowledge this is a first report as an oral side-effect of this drug used for treatment of chronic obstructive pulmonary disease (COPD).

PMID: 17468716 [PubMed - indexed for MEDLINE]

Factitial pemphigus-like lesions.

Med Oral Patol Oral Cir Bucal. 2007 May;12(3):E205-8

Authors: Zonuz AT, Treister N, Mehdipour F, Farahani RM, Tubbs RS, Shoja MM

The maxillofacial region is rarely subjected to self-inflicted conditions such as factitious disease. Nasal ulceration, facial emphysema, periorbital ecchymosis, mandibular subluxation, gingival and mucosal ulceration, dental and salivary gland pain and glossopharyngeal neuralgia have been reported as possible manifestations of factitious disease. We report a case of a young woman who presented with unilateral bullous and ulcerative oral and erythematous facial lesions that were initially diagnosed as pemphigus vulgaris but was later determined to be secondary to self-inflicted injuries. To the best of the authors knowledge, this clinical scenario has not been previously reported in the context of a factitious disease and, therefore, may be considered in the differential diagnosis of oral vesiculobullous disorders.

PMID: 17468715 [PubMed - indexed for MEDLINE]

What may underlie recurrent purpura fulminans?

Med J Aust. 2007 Apr 2;186(7):373-5

Authors: Kennedy KJ, Walker S, Pavli P, Hallam L, Hemmings C

A woman presenting with recurrent purpura fulminans was eventually found to have inflammatory bowel disease. We suggest the inflammatory state resulted in a deficiency of functional protein C.

PMID: 17407438 [PubMed - indexed for MEDLINE]

Traumatic ulcerative granuloma with stromal eosinophilia of the oral mucosa: histological and immunohistochemical analysis of three cases.

Minerva Stomatol. 2007 Jan-Feb;56(1-2):73-9

Authors: Pilolli GP, Lucchese A, Scivetti M, Maiorano E, Favia G

Traumatic ulcerative granuloma with stromal eosinophilia is an ulcerated oral lesion which pathogenesis is still unclear. Clinically, this disease is characterized by the presence of chronic ulcerative lesions with elevated and indurated borders in the oral mucosa. It usually develops rapidly and persists for several weeks or months, it presents mainly on the tongue but other areas such as gingival, cheek and vestibular mucosa may also be involved. We report three cases showing their clinical, histological and immunohistochemical analysis. In this study the authors underline the importance of a correct differential diagnosis and monitoring of these patients in order to prevent the development of possible serious complications.

PMID: 17287709 [PubMed - indexed for MEDLINE]

Oral ulcer as an unusual feature of visceral leishmaniasis in an AIDS patient.

Indian J Med Sci. 2007 Feb;61(2):97-101

Authors: Kumar P, Sharma PK, Jain RK, Gautam RK, Bhardwaj M, Kar HK

Leishmaniasis, a globally prevalent parasitic disease, occurs in three forms, viz, visceral, cutaneous and mucocutaneous. It is transmitted by female Phlebotomus sandflies. Human immunodeficiency virus (HIV) infection is increasing worldwide and several reports indicate a rising trend of VL / HIV co-infection, modifying the traditional anthroponotic pattern of VL transmission. India is one of the countries having the largest burden of leishmaniasis; nevertheless, there are very few HIV / leishmania co-infection cases reported so far. We report a 35-year-old homemaker infected with the human immunodeficiency virus; she presented with an oral ulcer. The investigations carried out on her revealed that she was afflicted by visceral leishmaniasis and the oral ulceration was a part of the same. This is only the second such case from the Indian subcontinent and more significantly from a non-endemic area.

PMID: 17259689 [PubMed - indexed for MEDLINE]

Thalidomide. Treat with caution!

Neth J Med. 2006 Dec;64(11):391-2

Authors: Powell RJ

PMID: 17179567 [PubMed - indexed for MEDLINE]

Tuberculous ulcer of tongue with oral complications of oral antituberculosis therapy.

Indian J Dent Res. 2006 Apr-Jun;17(2):87-90

Authors: Ajay GN, Laxmikanth C, Prashanth SK

Tuberculosis (TB) is an infectious disease affecting humans of all ages in all parts of the world. The dentist plays an important role in the identification and control of this condition by early recognition of oral lesions that may precede the detection of the pulmonary form. Occurrence of increased incidence of mycobacterial infections as a part of the spectrum of AIDS only emphasizes the importance of early diagnosis. A case of a tuberculous ulcer on the tongue along with oral ulcerations, which occurred as a consequence of oral antituberculosis therapy (ATT), is presented. Such complications have rarely been reported in the literature and the management of these is described herein. The tuberculous ulcer healed uneventfully in five weeks after institution of ATT and the other ATT-induced ulcers healed after a week of topical anesthetic application. The clinical presentations, differential diagnoses to be considered, and management of such oral manifestations is discussed. The occupational risk posed by TB to the dentist and appropriate precautions to be observed have been highlighted.

PMID: 17051875 [PubMed - indexed for MEDLINE]

Traumatic ulcerative granuloma with stromal eosinophilia: a reactive lesion of the oral mucosa.

Am J Clin Pathol. 2006 Oct;126(4):522-9

Authors: Hirshberg A, Amariglio N, Akrish S, Yahalom R, Rosenbaum H, Okon E, Kaplan I

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a benign lesion of the oral mucosa of an unclear pathogenesis. We analyzed the profile of the inflammatory infiltrate in 12 cases of TUGSE by using immunohistochemical analysis and polymerase chain reaction-based repertoire analysis to detect T- and B-cell receptor gene rearrangements. The inflammatory infiltrate consisted in most cases of B and T lymphocytes, macrophages, abundant eosinophils, and large atypical cells. In 5 cases, CD30+ cells were found. Spectratyping analysis displayed a polyclonal rearrangement of the T-cell receptor g gene in 6 cases and oligoclonality in 5 cases. Monoclonality was observed in 1 case that also fulfilled histologic criteria for lymphoma. Healing was uneventful in all cases, including the one suspected of being lymphoma, with no recurrences in more than 2 years'follow-up. TUGSE can be regarded reactive. Some cases, however, may harbor a dominant clonal T-cell population; in these cases, long-term follow-up is mandatory.

PMID: 16938660 [PubMed - indexed for MEDLINE]

Primary oral tuberculosis: report of two cases.

Indian J Dent Res. 2006 Jan-Mar;17(1):41-4

Authors: Ebenezer J, Samuel R, Mathew GC, Koshy S, Chacko RK, Jesudason MV

Oral lesions of tuberculosis though uncommon, are seen in both the primary and secondary stages of the disease. In secondary tuberculosis, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Primary oral tuberculosis may present as a diagnostic challenge for the clinician. Here we report two patients with primary tuberculosis in the oral cavity who presented to the dental department, were diagnosed and referred for medical management.

PMID: 16900894 [PubMed - indexed for MEDLINE]

Bisphosphonates and oral pathology I. General and preventive aspects.

Med Oral Patol Oral Cir Bucal. 2006 Aug;11(5):E396-400

Authors: Ponte Fernández N, Estefania Fresco R, Aguirre Urizar JM

Bisphosphonates constitute a group of drugs capable of modulating bone turnover, and reduce its remodelling when an excessive resorption occurs. This is why they are indicated in a large group of bone diseases like postmenopausal osteoporosis or osteolysis associated with breast cancer or multiple myeloma. Over the last years and due to their extensive use, many cases of complications associated with their use have been published. Among the most important possible adverse effects are the oral ones, with the appearance of ulcerations and, especially, osteonecrosis of the jaws associated with this therapy. In this paper, we have analyzed the general characteristics of these drugs and their mechanisms of action as well as the described adverse effects, especially oral and maxillofacial has been made special reference regarding the prevention of osteonecrosis of the jaws, heightened by cases described in medical and odontological literature. The preventive protocol backs up the fundamental role of the odontologist in the effective prevention of this process before, during and after the treatment.

PMID: 16878067 [PubMed - indexed for MEDLINE]

HIV seroconversion illness - latest HIV assays may still be negative.

Aust Fam Physician. 2006 Jul;35(7):523-5

Authors: Shields M

Human immunodeficiency virus (HIV) seroconversion illness occurs in up to 80% of patients who newly acquire the virus. It is hoped that the new fourth generation HIV assay will have improved sensitivity for diagnosis. This article describes the case of a patient who presented with typical symptoms of HIV seroconversion illness but who had a negative initial test with the new assay. Current management of HIV seroconversion illness is also outlined.

PMID: 16820828 [PubMed - indexed for MEDLINE]

Oral ulceration and bleeding associated with pancreatic enzyme supplementation in a German shepherd with pancreatic acinar atrophy.

Can Vet J. 2006 Jun;47(6):579-82

Authors: Snead E

A 20-month-old German shepherd with primary pancreatic acinar atrophy and exocrine pancreatic insufficiency that was treated with pancreatic enzyme supplementation, vitamin B12, and cimetidine developed oral bleeding. Following discontinuation of the cimetidine, increased preincubation of the enzymes with the food, and symptomatic therapy for the ulceration, the dog's condition improved.

PMID: 16808232 [PubMed - indexed for MEDLINE]

Nasal extranodal NK/T-cell lymphoma presenting as a perforating palatal ulcer: a diagnostic challenge.

Indian J Dermatol Venereol Leprol. 2006 May-Jun;72(3):218-21

Authors: Patel V, Mahajan S, Kharkar V, Khopkar U

A 40-year-old man presented with chronic nasal stuffiness and bloodstained discharge of 3 years' duration, along with a non-healing palatal ulcer since 2 months. Examination revealed a perforation in the midline on the hard palate and a superficial ulcer on the soft palate. Histopathology and immunohistochemistry suggested a diagnosis of extranodal nasal/nasal-type T-cell lymphoma. The patient was started on multiagent chemotherapy in the form of cyclophosphamide, doxorubicin, vincristine and prednisolone but succumbed after two cycles. Only one case of nasal T cell lymphoma presenting as nasal septal perforation, oronasal fistula and a concomitant palatal ulcer has been described. We report this case of a perforating palatal ulcer as a rare presentation of nasal lymphoma.

PMID: 16766838 [PubMed - indexed for MEDLINE]

A patient with painful oral ulcers.

J Am Dent Assoc. 2006 May;137(5):626-9

Authors: Chi AC, Ravenel MC, Neville BW, Bass EB

PMID: 16739542 [PubMed - indexed for MEDLINE]

[Crohn's disease associated with IgA nephropathy]

Korean J Gastroenterol. 2006 Apr;47(4):324-8

Authors: Youm JY, Lee OY, Park MH, Yang SY, Han SH, Baek YH, Park SR, Lee HL, Yoon BC, Choi HS, Hahm JS, Lee MH, Lee DH, Kee CS

Crohn's disease is a condition of chronic inflammation potentially involving any location of the alimentary tract from mouth to anus. Numerous extraintestinal manifestations can also be present. Urologic complications of inflammatory bowel disease are seen in up to 25% of patients, but renal parenchymal disease has been rarely reported. IgA nephropathy is recognized worldwide as a most common form of primary glomerulonephritis. Clinical manifestations vary, ranging from microscopic hematuria to nephrotic syndrome. Recently, IgA nephropathy associated with systemic diseases has been reported. We describe a case of a 22 year-old man with Crohn's disease associated with IgA nephropathy. At the age of 8 years, microscopic hematuria appeared. After fourteen years, he presented with melena, mild fever, recurrent oral ulcer, microscopic hematuria and proteinuria. Colonoscopic examination revealed characteristic features of Crohn's disease such as multiple ulcers. Microscopic findings showed superficial ulceration with small noncaseating granulomas. Renal biopsy revealed IgA nephropathy. The patient was treated with oral prednisolone, olsalazine, and metronidazole followed by maintenance therapy with sulfasalazine and azathioprine resulting in clinical improvement of Crohn's disease and IgA nephropathy.

PMID: 16632987 [PubMed - indexed for MEDLINE]

Crohn's disease presenting as palatal ulcer.

Indian J Pediatr. 2006 Mar;73(3):229-31

Authors: Ganesh R, Suresh N, Ezhilarasi S, Rajajee S, Sathiyasekaran M

Crohn's disease (CD) in children younger than 5 years of age is termed as early onset inflammatory bowel disease (EO-IBD). We report a 4 yr 6 mo-old child with EO-IBD, who presented with palatal ulcer, an extra intestinal manifestation of Crohn's disease as the dominant feature.

PMID: 16567919 [PubMed - indexed for MEDLINE]

Unusual cyst-like lesions in the parapharyngeal space associated with recurrence of tongue carcinoma.

J Oral Sci. 2005 Dec;47(4):219-22

Authors: Ohki H, Matsumoto M, Hasegawa M, Shimizu O, Mukae S, Amano Y, Komiyama K

A 54-year-old male presented with the complaint of a painful sore on the left side of his tongue. Our examination found an ulcer 15 x 20 mm in size on the left edge of the tongue, with peripheral indurations. The lesion was diagnosed histopathologically as squamous cell carcinoma (T2N0M0). Consequently, the lesion was surgical removed and radical neck dissection was performed. Four months after the operation, two unusual cyst-like lesions were identified in the parapharyngeal space by CT and MRI. A biopsy specimen revealed recurrent carcinoma with a cyst-like structure. The route of the tumor metastasis into the parapharyngeal space was obscured, but it was speculated that the excessive lymph accumulation was due to a lymphatic occlusion caused by the surgical procedure, proliferation of the metastatic carcinoma, or stagnation and accumulation of tissue fluid caused by parapharyngeal invasion by the recurrent lesion.

PMID: 16415566 [PubMed - indexed for MEDLINE]

Role of endothelin-1-dependent up-regulation of leptin in oral mucosal repair.

J Physiol Pharmacol. 2005 Dec;56(4):531-41

Authors: Slomiany BL, Slomiany A

Leptin, a multifunctional hormone that regulates food intake and energy expenditure, has emerged recently as an important modulator of inflammatory cascades associated with wound healing. In this study, we applied the animal model of buccal mucosal ulcer to investigate the role of endothelin-1 (ET-1) and leptin in soft oral tissue repair. Using groups of rats with experimentally induced buccal mucosal ulcers we show that ulcer onset was characterized by a marked increase in the mucosal level of ET-1 and leptin. However, while the ET-1 level gradually declined with healing, the mucosal level of leptin increased reaching maximum expression on the 4th day of healing. Therapeutic administration of phosphoramidon, an inhibitor of ECE-1 activity, not only led to a 53.2% drop in the ET-1, but also produced a dose-dependent reduction (up to 50.9%) in the mucosal level of leptin and up to 42.3% decline in the rate of ulcer healing. A marked drop (54.2%) in the mucosal level of leptin and the reduction (46.8%) in the rate of ulcer healing was also attained in the presence of ETA receptor antagonist BQ610 administration, but not the ETB receptor antagonist BQ788. Moreover, administration of ERK inhibitor, PD98059 in the presence of ETB receptor antagonist, but not the ETA receptor antagonist, caused the reduction the mucosal leptin level as well as a decline in the rate of ulcer healing. Our findings are the first to implicate the requirement for both ET-1 and leptin in orderly progression of the events of soft oral tissue repair. We also show that ET-1 is a key factor in up-regulation of leptin production associated with oral mucosal ulcer healing , and that the effect of ET-1 on leptin production is a consequence of ETA receptor activation and subsequent signaling through MAPK/ERK.

PMID: 16391412 [PubMed - indexed for MEDLINE]

Role of Geotrichum candidum in canine oral ulcers.

Rev Iberoam Micol. 2005 Sep;22(3):183

Authors: Pal M

PMID: 16309361 [PubMed - indexed for MEDLINE]

Epidemiology of the most common oral mucosal diseases in children.

Med Oral Patol Oral Cir Bucal. 2005 Nov-Dec;10(5):376-87

Authors: Rioboo-Crespo Mdel R, Planells-del Pozo P, Rioboo-García R

Dentists who treat children must be alert to the possibility of finding diseases of the oral mucosa, especially in younger children. The present study aimed to review the most updated information and the experience of our group in order to yield epidemiological data that assist diagnosis of the most common diseases of the oral mucosa in children. Recent epidemiologic studies have shown a wide variability in the prevalence of oral mucosal lesions in different regions of the world and have led researchers to draw disparate conclusions. Moreover, studies have not been designed using standard criteria, further explaining the wide variability in the percentage of different groups of children with oral lesions, which ranges from 4.1 to 52.6%. The lesions most frequently considered by authors and that most often appear in the different studies are: recurrent aphthous stomatitis (0.9-10.8%), labial herpes (0.78-5.2%), fissured tongue (1.49-23%), geographic tongue (0.60-9.8%), oral candidiasis (0.01-37%) and traumatic injury (0.09%-22.15%). Dentists must be able to detect any of the numerous possible disorders and perform the correct differential diagnosis, key to the treatment plan. The aim of this paper, based on a review of the different national and international studies, is to contribute data on the most important oral mucosal diseases in the paediatric population in terms of prevalence and differential diagnosis.

PMID: 16264385 [PubMed - indexed for MEDLINE]

Behçet's disease combined with various types of fistula.

Yonsei Med J. 2005 Oct 31;46(5):625-8

Authors: Chung HJ, Goo BC, Lee JH, Bang D, Lee KH, Lee ES, Lee S

Behçet's disease (BD) is a chronic, relapsing, multisystem disorder, characterized by recurrent oral ulcer, genital ulcers, eye lesion, and skin lesion. The underlying pathology is nonspecific vasculitis of all vessel sizes, and severe vasculitis can result in fistula formation of neighboring tissues due to a necrotic process. Herein, eleven cases of BD combined with fistula are presented. In the present study, various types of fistula were associated; enterocutaneous fistula in six patients, and rectovaginal fistula in two. The other three patients showed aortoduodenal fistula, urethrovaginal fistula and urethrocutaneous fistula. They were treated with a corrective operation, but the prognoses were poor due to frequent relapses.

PMID: 16259058 [PubMed - indexed for MEDLINE]

Ocular manifestations of Behcet's disease.

Indian Pediatr. 2005 Sep;42(9):942-5

Authors: A SE, Moses PD, George R

Behcets disease is a systemic inflammatory vascular disorder characterized by recurrent oral and genital ulcers, eye lesion, arthritis and skin lesions. We report a case of Behcets disease with ocular manifestation in an 8 year old boy.

PMID: 16208057 [PubMed - indexed for MEDLINE]

Oral ulcer as an exclusive sign of gastric cancer: report of a rare case.

BMC Cancer. 2005;5:117

Authors: Colombo P, Tondulli L, Masci G, Muzza A, Rimassa L, Petrella D, Santoro A

BACKGROUND: The oral cavity is a rare but occasional target for metastases, which may masquerade as various benign and inflammatory lesions, and sometimes also be asymptomatic. Oral metastatic lesions have been described in various cancers, particularly lung, breast and kidney carcinoma. CASE PRESENTATION: We here describe an uncommon case of a hard palate mucosa and gingival metastasis from gastric carcinoma that was originally diagnosed as a periodontal disease. Histopathological examination of a biopsy of the lesion revealed a signet-ring cell carcinoma, and a subsequent biopsy of an ulcerated stomach lesion showed a poorly differentiated gastric carcinoma. The patient underwent gastric resection but died of heart failure on the tenth postoperative day; a post-mortem examination revealed a residual bilateral ovarian infiltration by gastric carcinoma (Krukenberg's tumor). CONCLUSION: An occult carcinoma of the stomach may rarely metastasise to the oral cavity even as a first and exclusive manifestation; it is important to bear this possibility in mind because such conditions may mimic a benign disease.

PMID: 16171522 [PubMed - indexed for MEDLINE]

AAOMP case challenge: painful oral ulcers.

J Contemp Dent Pract. 2005 Aug 15;6(3):167

Authors: Chi AC, Neville BW

This 33-year old Caucasian female presents complaining of a history of recurrent oral ulcers since childhood. In the past these ulcers typically lasted approximately 7-10 days and recurred every few months. However, more recently she has developed more persistent areas of irritation and ulceration, which tend to come and go. The patient reports the most severe areas of involvement to be the buccal mucosa bilaterally and the lateral tongue. Although in the past her braces seemed to exacerbate her condition, she has not noted significant improvement despite recent removal of her braces by her orthodontist.

PMID: 16127486 [PubMed - indexed for MEDLINE]

Asymptomatic inflammatory bowel disease presenting with mucocutaneous findings.

Pediatrics. 2005 Sep;116(3):e439-44

Authors: Galbraith SS, Drolet BA, Kugathasan S, Paller AS, Esterly NB

Although inflammatory bowel disease (IBD) typically presents with gastrointestinal complaints, mucocutaneous lesions are commonly associated and can precede gastrointestinal symptoms, thereby alerting the clinician to the diagnosis of IBD before the onset of gastrointestinal symptoms. Nine children are reported who had no gastrointestinal symptoms suggestive of IBD but presented with mucocutaneous findings of IBD and were subsequently diagnosed with Crohn's disease or ulcerative colitis based on characteristic features on gastrointestinal endoscopy and/or biopsies. The majority of the patients had oral and perianal lesions. We believe that IBD is a common etiology for persistent oral lesions in the pediatric population. In addition to a good history, children with unexplained oral mucous membrane lesions should have an examination of the rectal and genital mucosa as well as tests for complete blood count, iron levels, sedimentation rate, albumin, and occult blood in the stool with endoscopy and biopsies to rule out IBD if indicated.

PMID: 16099852 [PubMed - indexed for MEDLINE]

Cancer therapy-related oral mucositis.

J Dent Educ. 2005 Aug;69(8):919-29

Authors: Redding SW

Oral mucositis is a common side effect of cancer therapies, particularly radiation therapy for head and neck cancer and various forms of chemotherapy. It commonly results in severe oral pain that can compromise the duration and success of cancer management. Hospitalizations are common because patients lose the ability to take anything by mouth due to severe pain and must have alimentation supported during this period. Pain management usually requires potent narcotic analgesia. Cancer therapy-related oral mucositis is commonly described as the most significant and debilitating acute complication associated with radiation therapy and chemotherapy. Until recently, cancer therapy-induced oral mucositis was thought to be a process involving the epithelium only. Evidence is building that the process of oral mucositis involves far more than just the epithelium, but includes multiple cellular processes of the submucosa as well. Many strategies have been evaluated to prevent oral mucositis, but the data is confusing since it is often conflicting. Therapy with the growth factor, KGF1, appears promising, as it is the only medication currently approved by the FDA. A multifaceted approach that targets the entire mucositis process will probably be needed to optimize overall prevention.

PMID: 16081575 [PubMed - indexed for MEDLINE]

Pemphigus vulgaris. A presentation of 14 cases and review of the literature.

Med Oral Patol Oral Cir Bucal. 2005 Aug-Oct;10(4):282-8

Authors: Camacho-Alonso F, López-Jornet P, Bermejo-Fenoll A

Pemphigus vulgaris (PV) is a chronic vesicular-ampullar mucocutaneous disease that almost always produces oral manifestations. The fact that blisters on the oral mucosa are sometimes the first manifestation of the disease implies that dental professionals must be sufficiently familiarized with the clinical manifestations of PV to ensure early diagnosis and treatment. We present a series of 14 patients with clinically and histologically diagnosed PV seen in the Teaching Unit of Oral Medicine of the University of Murcia (Spain) between 1981 and 2001. A thorough evaluation was made, recording patient age and sex, the location and extent of the lesions, and the signs and symptoms of the disease. Complementary studies were also carried out, with the evaluation of hematological parameters (including blood chemistry), the histology and immunohistochemical characteristics (direct immunofluorescence in 2 cases). Treatment comprised topical corticoids, in 12 cases combined with systemic corticoids, and associated to intralesional corticotherapy in one patient. A good response to treatment was observed in all cases.

PMID: 16056181 [PubMed - indexed for MEDLINE]

[A fatal case of mucocutaneous leishmaniasis after pentavalent antimonial use]

Rev Soc Bras Med Trop. 2005 May-Jun;38(3):258-60

Authors: Oliveira MC, Amorim RF, Freitas Rde A, Costa Ade L

The authors report a case of mucocutaneous leishmaniasis in a 45-year-old patient who was unsuccessfully treated with pentavalent antimonial for 30 days. After 10 days from the initial treatment and before starting a new therapeutic regimen with the same drug the patient died due to sudden cardiac arrest.

PMID: 15895180 [PubMed - indexed for MEDLINE]

[Oral pain and loss of teeth in a 36-year-old woman]

Enferm Infecc Microbiol Clin. 2005 Apr;23(4):241-2

Authors: Vallalta M, Sahuquillo-Arce E, Salavert M, Lacruz J

PMID: 15826550 [PubMed - indexed for MEDLINE]

Oral ulcers in children under chemotherapy: clinical characteristics and their relation with Herpes Simplex Virus type 1 and Candida albicans.

Med Oral Patol Oral Cir Bucal. 2005;10 Suppl 1:E1-8

Authors: Sepúlveda E, Brethauer U, Rojas J, Fernández E, Le Fort P

OBJECTIVE: The objective of this study was to determine the clinical characteristics of oral ulcers in pediatric oncology patients undergoing chemotherapy and their relation with the presence of Herpes Simplex Virus (HSV) type 1 and Candida albicans. STUDY DESIGN: The sample consisted of 20 ulcerative lesions from 15 children treated with chemotherapy in the Pediatric Service of the Regional Hospital of Concepción, Chile. Two calibrated clinicians performed clinical diagnosis of the ulcers and registered general data from the patients (age, general diagnosis, absolute neutrophil count, and number of days after chemotherapy) and clinical characteristic of the ulcers: number, size, location, presence or absence of pain and inflammatory halo, edge characteristics, and exudate type. Additional to clinical diagnosis, culture for Candida albicans (C) and polymerase chain reaction (PCR) for Herpes Simplex Virus type 1 was performed. RESULTS: Ten ulcers occurred in patients with acute lymphoblastic leukemia, five in patients with acute myeloblastic leukemia and five in patients with other neoplastic diseases. Eight ulcers were HSV (+) / C (-), 6 HSV (-) / C (-), 4 HSV (+) / C (+) and 2 HSV (-) / C (+). Preferential location was the hard palate. Most lesions were multiple, painful, with inflammatory halo, irregular edges and fibrinous exudate. The average size was 6,5 millimeters, and the mean number of days after chemotherapy was 7.5 days. CONCLUSIONS: Oral ulcers in children with oncological diseases did not present a specific clinical pattern. They were strongly associated with HSV.

PMID: 15800462 [PubMed - indexed for MEDLINE]

The chewing of betel quid and oral submucous fibrosis and anesthesia.

Anesth Analg. 2005 Apr;100(4):1210-3

Authors: Eipe N

Oral submucous fibrosis (OSMF) is a premalignant lesion of the buccal mucosa caused by chewing betel quid. It results in progressive inability to open the mouth. OSMF causes difficulty in laryngoscopy and intubation of the trachea. Patients with OSMF require anesthesia for trismus correction, resection, and reconstructive (oncoplastic) surgery for coexisting oral malignancies or other unrelated surgeries. Our review of the anesthetics of 44 patients with oral malignancies suggested that 8 had OSMF. The preoperative airway assessment, including the Mallampati score and the clinical Tumor Node Metastasis stage, were useful in predicting the need for fiberoptic intubation. Patients with oral malignancies and OSMF had increased requirement for fiberoptic endotracheal intubations (62.5%) compared with those without OSMF (44.4%). Three different techniques of airway management (tracheal intubation after direct laryngoscopy, fiberoptic tracheal intubation, and tracheostomy) in four patients with OSMF are described. OSMF contributes to the development of the malignancy, delays the diagnoses, and complicates the anesthetic management.

PMID: 15781548 [PubMed - indexed for MEDLINE]

Langerhans's cell histiocytosis.

Med Oral Patol Oral Cir Bucal. 2005 Mar-Apr;10(2):185

Authors: Milian MA

A 42 year-old male, smoker, was referred for evaluation of an ulcer located in the gingiva, during one month, that produced disturbances. On the intraoral examination we appreciated an ulceration of 0.5 cm, on a mandibular torus, in the lingual gingiva of the left first molar (Fig. 1-2). A panoramic x-Ray (Fig. 3), a CT scan (Fig. 4) and a biopsy were taken (Fig. 5-6, Fig. 6 is a S-100 stain).

PMID: 15735553 [PubMed - indexed for MEDLINE]

Lingual ulcer as the only sign of recurrent mycobacterial infection in an HIV/AIDS-infected patient.

Med Oral Patol Oral Cir Bucal. 2005 Mar-Apr;10(2):109-14

Authors: Ramírez-Amador V, Anaya-Saavedra G, González-Ramírez I, Mosqueda-Gómez JL, Esquivel-Pedraza L, Reyes-Gutiérrez E, Sierra-Madero J

The report describes an HIV/AIDS patient seen at a referral center in Mexico City, in whom a mycobacterial infection in the oral mucosa, probably tuberculosis (TB) was identified. The purpose is to describe the clinical and histological findings in an HIV-infected patient, who after being treated successfully for tuberculous lymphangitis 4 years ago, presented with a lingual ulcer as the only suggestive sign of recurrence of mycobacterial infection, probably M. tuberculosis. A 39-year-old man seen in the HIV clinic of the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" in Mexico City since 1991 for HIV infection. In 1999 the patient developed tuberculous lymphangitis; he was managed with a 4-drug regimen for 12 months, with improvement of local and systemic symptoms. In May of 2003, the patient presented a painful superficial lingual ulcer, 0.7 cm in diameter, well circumscribed, crateriform with slightly elevated, irregular and indurated borders, of 4 months duration. The histopathological examination showed chronic granulomatous inflammation with giant multinucleated cells, suggestive of mycobacterial infection, and recurrence of TB was considered. Rifampin, isoniazide, pyrazinamide, ethambutol and streptomycin were administered. The lingual lesion improved with partial healing at the first week and total remission at 45 days after the beginning of the antituberculous treatment. In June, 2003, the patient began highly active antiretroviral therapy (HAART) that included two NRTIs and one NNRTI. At 7 months of follow-up, the patient remains free of lingual lesions. The particularity of the present case is that the lingual ulcer was the only sign of infection by mycobacteria, suggestive of TB, in an HIV/AIDS patient that probably represented a recurrence of a previous episode.

PMID: 15735542 [PubMed - indexed for MEDLINE]

The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994.

J Am Dent Assoc. 2004 Sep;135(9):1279-86

Authors: Shulman JD, Beach MM, Rivera-Hidalgo F

BACKGROUND: Most reports of oral lesion prevalence are based on studies of atypical populations. There are no published studies on oral mucosal lesion prevalence in U.S. adults that are based on a national probability sample. METHODS: The Third National Health and Nutrition Examination Survey, or NHANES III, employed a complex, multistage sample of 33,994 civilian, noninstitutionalized people from 19,528 households. Dentist examiners were trained to recognize, classify and record in a standardized manner the clinical characteristics of each of the 48 conditions of interest to include diagnosis, size, location, surface morphology, color consistency, pain, duration and history using procedures based on the World Health Organization's Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. RESULTS: Examinations were performed on 17,235 people aged 17 years and older, of whom 4,801 (27.9 percent) had a total of 6,003 lesions. Denture-related lesions (stomatitis, hyperplasia, ulcers, inflammation and angular cheilitis) composed 8.4 percent and tobacco-related lesions (smokeless tobacco-related and nicotinic stomatitis) composed 4.7 percent of all lesions. Discounting denture-related lesions, amalgam tattoos were the most prevalent lesions (3.30 percent), followed closely by cheek/lip bites (3.05 percent) and frictional white lesions (2.67 percent). Smokeless-tobacco users (odds ratio, or OR, = 3.90) and removable denture wearers (OR = 3.57) had the highest odds of having a lesion. CONCLUSION: Lesion prevalences differed significantly by age, sex, race/ethnicity, denture wearing and tobacco use. When lesion-specific prevalences are cited in the literature, they should be stratified by covariates known to be associated with them.

PMID: 15493392 [PubMed - indexed for MEDLINE]

The prevalence and severity of oral impacts on daily performances in Thai primary school children.

Health Qual Life Outcomes. 2004;2:57

Authors: Gherunpong S, Tsakos G, Sheiham A

BACKGROUND: Traditional methods of measuring oral health mainly use clinical dental indices and have been complemented by oral health related quality of life (OHRQoL) measures. Most OHRQoL studies have been on adults and elderly populations. There are no systematic OHRQoL studies of a population-based sample of children. The objective of this study was to assess the prevalence, characteristics and severity of oral impacts in primary school children. METHODS: Cross-sectional study of all 1126 children aged 11-12 years in a municipal area of Suphanburi province, Thailand. An OHRQoL measure, Child-Oral Impacts on Daily Performances index (Child-OIDP) was used to assess oral impacts. Children were also clinically examined and completed a self-administered questionnaire about demographic information and oral behaviours. RESULTS: 89.8% of children had one or more oral impacts. The median impact score was 7.6 and mean score was 8.8. Nearly half (47.0%) of the children with impacts had impacts at very little or little levels of intensity. Most (84.8%) of those with impacts had 1-4 daily performances affected (out of 8 performances). Eating was the most common performance affected (72.9%). The severity of impacts was high for eating and smiling and low for study and social contact performances. The main clinical causes of impacts were sensitive tooth (27.9%), oral ulcers (25.8%), toothache (25.1%) and an exfoliating primary tooth (23.4%). CONCLUSIONS: The study reveals that oral health impacts on quality of life in Thai primary school children. Oral impacts were prevalent, but not severe. The impacts mainly related to difficulty eating and smiling. Toothache, oral ulcers and natural processes contributed largely to the incidence of oral impacts.

PMID: 15476561 [PubMed - indexed for MEDLINE]

Involvement of chemokines and Th1 cytokines in the pathogenesis of mucocutaneous lesions of Behçet's disease.

Arthritis Rheum. 2004 Jul;50(7):2291-5

Authors: Ben Ahmed M, Houman H, Miled M, Dellagi K, Louzir H

OBJECTIVE: To investigate a possible pathogenic role of cytokines in Behçet's disease (BD) by focusing on the analysis of cytokine gene expression within mucocutaneous BD lesions. METHODS: The study group comprised 20 patients with active BD. In this group, a set of chemokines as well as Th1 and Th2 cytokines in biopsy specimens obtained from oral and genital ulcers, pseudofolliculitis lesions, and lesions at the site of pathergy testing were studied using real-time quantitative reverse transcriptase-polymerase chain reaction. RESULTS: We observed important increases in the expression of interleukin-8 (IL-8) ( approximately 700-fold), monocyte chemoattractant protein 1 ( approximately 65-fold), interferon-gamma ( approximately 71-fold), and IL-12 ( approximately 69-fold) messenger RNA in BD lesions compared with normal skin. Except for IL-10 ( approximately 75-fold increase), Th2 cytokines (i.e., IL-4 and IL-13) were absent. CONCLUSION: Our data suggest a direct role of Th1 lymphocytes in the pathogenesis of mucocutaneous BD lesions.

PMID: 15248229 [PubMed - indexed for MEDLINE]

Persistent nicorandil induced oral ulceration.

Heart. 2004 Jul;90(7):e38

Authors: Healy CM, Smyth Y, Flint SR

Four patients with nicorandil induced ulceration are described, and the literature on the subject is reviewed. Nicorandil induced ulcers are very painful and distressing for patients. Clinically they appear as large, deep, persistent ulcers that have punched out edges. They are poorly responsive to topical steroids and usually require alteration of nicorandil treatment. The ulceration tends to occur at high doses of nicorandil and all four cases reported here were on doses of 40 mg per day or greater. In these situations reduction of nicorandil dose may be sufficient to promote ulcer healing and prevent further recurrence. However, nicorandil induced ulcers have been reported at doses as low as 10 mg daily and complete cessation of nicorandil may be required.

PMID: 15201264 [PubMed - indexed for MEDLINE]

Epidemiology of gastroesophageal reflux disease: a general population-based study in Xi'an of Northwest China.

World J Gastroenterol. 2004 Jun 1;10(11):1647-51

Authors: Wang JH, Luo JY, Dong L, Gong J, Tong M

AIM: Gastroesophageal reflux disease (GERD) is a common disorder in the Western population, but detailed population-based data in China are limited. The aim of this study was to understand the epidemiology of symptomatic gastroesophageal reflux (SGER) in adults of Xi'an, a northwestern city of China, and to explore the potential risk factors of GERD. METHODS: Symptoms suggestive of GERD, functional dyspepsia (FD), irritable bowel syndrome (IBS), upper respiratory diseases and some potential risk factors were investigated in a face-to-face manner in a region-stratified random samples of 2789 residents aged 18-70 years in Xi'an by using a standardized questionnaire. METHODS: With a response rate of 91.8%, the prevalence of SGER was 16.98% (95% CI, 14.2-18.92) in Xi'an adults, and no gender-related difference was observed (P<0.05). SGER was more common among subjects aged 30-70 years than in those aged 18-29 years (P<0.01). The prevalence of SGER in rural, urban and suburban subjects was 21.07%, 17.44% and 12.12%, respectively, and there was a significant difference between rural, urban and suburban regions (P<0.05). Compared with subjects without SGER, the prevalence of symptoms suggestive of FD and IBS, pneumonia, asthma, bronchitis, laryngitis, pharyngitis, chronic cough, wheeze, globus sensation, oral ulcer and snore was significantly increased in subjects with SGER (P<0.01). Heavy smoking (OR=5.76; CI, 3.70-6.67), heavy alcohol use (OR=2.85; CI, 1.67-4.49), peptic ulcer (OR=5.76; CI, 3.99-8.32), cerebral palsy (OR=3.97; CI, 1.97-8.00), abdominal operation (OR=2.69; CI, 1.75-4.13), obesity (OR=2.16; CI, 1.47-3.16), excessive food intake (OR=1.43; CI, 1.17-1.15), sweet food (OR=1.23; CI, 0.89-1.54), and consumption of coffee (OR=1.23; CI, 0.17-2.00) were independently associated with SGER. The episodes of GERD were commonly precipitated by dietary factors (66.05%), followed by body posture (26.54%), ill temper (23.72%), fatigue (22.32%) and stress (10.93%). CONCLUSION: GERD is common in Xi'an's adult population with a mild or moderate degree. The etiology and pathogenesis of GERD are probably associated with FD, IBS, and some respiratory, laryngopharyngeal and odontostological diseases or symptoms. Some lifestyles, diseases and dietary factors are the risk factors of GERD.

PMID: 15162542 [PubMed - indexed for MEDLINE]

Oral health is impaired in Behçet's disease and is associated with disease severity.

Rheumatology (Oxford). 2004 Aug;43(8):1028-33

Authors: Mumcu G, Ergun T, Inanc N, Fresko I, Atalay T, Hayran O, Direskeneli H

OBJECTIVES: This study aimed to investigate the oral health of Turkish patients with Behçet's disease (BD) and whether it is associated with the disease course. METHODS: One hundred and twenty patients with BD, 35 patients with recurrent aphthous stomatitis (RAS) and 65 healthy Turkish controls (HC) were included in the study. Oral health was investigated by indices applied in a BD out-patient clinic. RESULTS: The mean scores of plaque, sulcus bleeding and gingival indices, probing depth and the number of extracted teeth were observed to be higher in patients with BD and RAS compared to HC (P<0.05). In the linear regression analysis, plaque index score was associated with the presence of oral ulcers and male gender. An elevated plaque index score was observed to be a significant risk factor for increased severity score in patients with BD in the logistic regression analysis (P = 0.034). CONCLUSIONS: Oral health is impaired in BD and associated with disease severity. Improvement of the oral health of BD patients may affect their disease course, leading to a better prognosis.

PMID: 15161982 [PubMed - indexed for MEDLINE]

Severe recurrent neurological disease in the MAGIC syndrome.

J Rheumatol. 2004 May;31(5):1018-9

Authors: Gertner E

PMID: 15124284 [PubMed - indexed for MEDLINE]

Spectrum of oral manifestations of HIV/AIDS in the Perm region (Russia) and identification of self-induced ulceronecrotic lingual lesions.

Med Oral. 2004 May-Jul;9(3):212-5

Authors: Gileva OS, Sazhina MV, Gileva ES, Efimov AV, Scully C

OBJECTIVE: To study the frequency and spectrum of oral manifestations of HIV-infected drug-users in the Perm region. SUBJECTS: 104 seropositive HIV-infected drug-users (69 male, 35 female; ages 15 to 32 years; 13 co-infected with hepatitis viruses) and 13 AIDS-infected drug-users (7 male, 6 female; ages 16 to 37 years; 12 co-infected with hepatitis viruses). RESULTS: The most frequent forms of oral mucosal lesions in the HIV-infected group -- candidiasis (32.7%), herpetic lesions (15.4%), cheilitis glandularis (3.9%), recurrent aphthous stomatitis (2%). Regional lymphadenopathy was observed in 31% cases. The ulceronecrotic oral mucosal lesions were seen in the sublingual region and tongue in 11.5% patients and manifested with pain, dysarthria, dysphagia, and dysgeusia. These lesions were found in drug-users who injected the opioids sublingually. AIDS patients had oral candidiasis (84.6%), herpetic lesions (53.8%), recurrent aphthous stomatitis (15.4%) and cheilitis glandularis (7%). All AIDS-patients had severe xerostomia, and 15.4% had unilateral or bilateral swelling of the parotid glands. Generalized ulceronecrotic gingivostomatitis was found in 50% of the patients but the sublingual ulceronecrotic lesions were not identified. CONCLUSIONS: 1. The spectrum of oral cavity lesions of HIV/AIDS patients in Perm region is widespread enough. 2. Dissemination of oral cavity lesions is increasing in proportion of disease progression. 3. Dental care of HIV/AIDS patients should include periodic oral examinations to monitor their disease progression and to alleviate symptoms of oral opportunic and neoplastic diseases, to improve the life-style of the patients infected with HIV.

PMID: 15122122 [PubMed - indexed for MEDLINE]

Oral mucosal ulceration: a manifestation of previously undiagnosed pulmonary tuberculosis.

J Am Dent Assoc. 2004 Mar;135(3):336-40

Authors: Sezer B, Zeytinoglu M, Tuncay U, Unal T

BACKGROUND: Tuberculosis, or TB, is a chronic infectious disease that can affect any part of the body, including the mouth. Oral lesions may be the only finding of primary pulmonary TB, in which case proper diagnosis by dentists is vital. CASE DESCRIPTION: The authors present a case in which the patient sought treatment for a painful oral lesion. A histopathologic examination revealed characteristics of TB. Subsequently, pulmonary lesions were detected, and a diagnosis of pulmonary TB was confirmed. The patient underwent antituberculosis therapy, and his oral and systemic conditions improved rapidly. CLINICAL IMPLICATIONS: Although oral manifestations of TB are rare, clinicians should be aware of their possible occurrence in their patient populations. Such awareness can help diagnose TB at an early stage, thereby preventing complications and potential contaminations.

PMID: 15058623 [PubMed - indexed for MEDLINE]

Mucous membrane plasmacytosis: a case report and review of the literature.

Dermatol Online J. 2003 Dec;9(5):15

Authors: Bharti R, Smith DR

Mucous membrane plasmacytosis is a rare, idiopathic condition consisting of a dense plasma-cell infiltrate of the mucous membranes. Zoon first described a plasma-cell infiltrate occurring on the glans penis and plasmacytosis involving other body orifices have been reported under a variety of different terms. White et al. simplified the terminology by suggesting all plasma-cell infiltrates of the mucous membranes of body orifices be termed plasma-cell orificial mucositis. The differential diagnoses and treatment for mucous membrane plasmacytosis are summarized. A middle-aged female with an unusual plasma-cell proliferation disorder of the upper aerodigestive tract is reported for its rarity.

PMID: 14996388 [PubMed - indexed for MEDLINE]

The spectrum of cutaneous reactions associated with calcium antagonists: a review of the literature and the possible etiopathogenic mechanisms.

Dermatol Online J. 2003 Dec;9(5):6

Authors: Ioulios P, Charalampos M, Efrossini T

Calcium antagonists (CAs) or calcium-channel blockers, are a common group of antihypertensive medications. These drugs have the property of blocking the calcium channels of the vascular and cardiac smooth-muscle fibers. They have been associated with cutaneous reactions ranging from exanthems to severe adverse events. The frequency of these reactions may be as high as 48 percent. The most common are ankle or pedal edema (up to 30 %), gingival hyperplasia (up to 21 %), and flushing (up to 10 %). Less common are facial or truncal telangiectasia, photosensitivity reactions, new-onset psoriasis (as well as exacerbation of it), purpuric exanthems, pemphigoid manifestations, subacute cutaneous lupus erythematosus, gynecomastia, erythromelalgia, and oral ulcers. Particular adverse manifestations relate to drug potency, degree of vasodilatation, patient age, coexistence of other diseases, co-administration of other cytochrome P450 CYP3A-metabolized medications, fibroblast stimulation, and blood cell effects. Calcium antagonists are associated with a wide range of skin reactions, and the dermatologist should include these in the differential diagnosis of cutaneous diseases.

PMID: 14996379 [PubMed - indexed for MEDLINE]

Chronic lingual ulceration caused by lipoma of the oral cavity. Case report.

Med Oral. 2004 Mar-Apr;9(2):166-7, 163-6

Authors: Del Castillo Pardo de Vera JL, Cebri&#xE1;n Carretero JL, Gómez García E

Although lipomas are among the most frequent tumors in the human body, their presentation in the oral cavity is not common. Oral cavity lipomas usually show a slow painless and assymptomatic growing. When these tumors reach big sizes, they can cause compressive symptons and deformities. In this paper we present the case of a patient in whom oral lipoma was the final finding in the differential diagnosis of a chronic mucosal ulcer. CT scan and MRI images and microscopical examination after fine-needle aspiration were the clue for the final diagnosis. The surgical excision of the tumor was the basis for the healing of the ulcer. We also review the most relevant and recent literature about clinic, diagnosis and treatment for these tumors.

PMID: 14990884 [PubMed - indexed for MEDLINE]