1/311. Oral crohn disease: clinical characteristics and long-term follow-up of 9 cases.BACKGROUND: Oral localization of crohn disease is uncommon and must be differentiated from nonspecific lesions. Its natural course and its long-term prognosis are unknown. OBSERVATIONS: We studied 9 patients (8 male, 1 female; age range, 7-52 years; median age, 16 years) with crohn disease and specific oral lesions, including deep linear ulcers, pseudopolyps, and/or labial or buccal swelling and induration. The prevalence of such lesions was 0.5%. The median follow-up was 11 years. Oral localization developed before (n = 2), at the same time as (n = 2), or after (n = 5) the onset of the digestive disease. Noticeable associated localizations were observed in the anoperineum (n = 8) and the esophagus (n = 3). The median duration of the oral lesions was 4 years (range, 1-13 years), without necessary parallelism with the digestive localization. Five patients had complete healing after a median delay of 2 years. CONCLUSIONS: Oral localization of crohn disease is characterized by a marked male predominance, a young age at onset of crohn disease, and a very protracted course. The high prevalence of associated anal and esophageal involvement suggests that Crohn lesions have a particular trophicity for squamous cell epithelium.- - - - - - - - - - ranking = 1keywords = disease (Clic here for more details about this article) |
2/311. The dentist's role in end-of-life care.dentists and dental specialists have much to offer in ensuring proper pain management in end-of-life care for terminally ill patients. As the population of the united states ages and devastating disease processes continue to affect many, the need for oral comfort care measures will further increase. In an ideal situation, the dentist will be among those consulted in advance of beginning therapeutic regimens that have significant oral side-effects or for cases in which oral care after treatment has begun is accompanied by greatly increased risk. The objectives for dentists caring for terminally ill patients include ensuring comfort, eliminating sites of infection or potential infection, understanding the patient's preferences enhancing oral function, and, when desired, protecting self-esteem through esthetic maintenance. The provision of adequate pain management and comfort care is an unequivocal ethical obligation for the benefit of these patients. dentists have a further ethical obligation to share their knowledge with physicians and patients to set a higher standard for comfort care for the terminally ill.- - - - - - - - - - ranking = 0.11111111111111keywords = disease (Clic here for more details about this article) |
3/311. Recurrent Kawasaki disease.Kawasaki disease (mucocutaneous lymph node syndrome) is a disease of unknown aetiology characterised by vasculitis which may affect the coronary arteries. Young children are most commonly affected although the disease has been described in adults. We report a case of recurrent Kawasaki disease which presented to an oral medicine clinic, where early recognition prompted appropriate management.- - - - - - - - - - ranking = 0.88888888888889keywords = disease (Clic here for more details about this article) |
4/311. Acral keratotic graft versus host disease simulating warts.A 55-year-old man experienced persistent oral graft versus host disease after receiving an HLA-matched allogeneic stem cell peripheral blood transplant for chronic myeloid leukaemia. Twelve months post-transplant, multiple keratotic lesions resembling warts developed on his fingers, on his palms and on the soles of his feet. skin biopsy showed a lichenoid reaction under a hyperplastic and hyperkeratotic epidermis lacking signs of papillomavirus infection. The lesions partially regressed when the patient's oral prednisone was increased. This instance of acral keratotic lesions may represent an unusual expression of chronic graft versus host disease; however, the the hydroxychloroquine which had been used for 8 months to control the patient's oral graft versus host disease cannot be excluded as a cofactor.- - - - - - - - - - ranking = 0.77777777777778keywords = disease (Clic here for more details about this article) |
5/311. Recurrent buccal space abscesses: a complication of Crohn's disease.Oral features of Crohn's disease include ulcerations, lip fissuring, cobblestone plaques, and mucosal tags. We report the case of a 16-year old male patient with a 3-month history of abdominal pain, diarrhea, and oral ulceration. Clinical examinations revealed established intestinal lesions, a marked cobblestone appearance in the oral cavity, and an unusual pattern of presentation not previously reported in the literature: persistent, recurrent buccal space abscesses.- - - - - - - - - - ranking = 0.55555555555556keywords = disease (Clic here for more details about this article) |
6/311. Linear IgA disease histopathologically and clinically masquerading as lichen planus.In each of 2 cases reported, the patient presented with features of erosive lichen planus or lichenoid drug eruptions and an incisional biopsy taken from the patient was diagnosed histologically as lichen planus. Subsequent recurrences or exacerbations were associated with vesiculobullous lesions. Simultaneous or subsequent direct immunofluorescence studies--from the same tissue sample in one case and from a similar site in the other case--demonstrated classic features of linear IgA disease. Both patients were originally treated for lichen planus with systemic and/or topical corticosteroids with limited success. One patient was treated with sulfapyridine with minimal improvement. Both patients were subsequently treated with dapsone and demonstrated significant clinical improvement. We propose that linear IgA disease may be more common than reported in the oral cavity, inasmuch as many cases of recalcitrant lichen planus, erosive lichen planus, and lichenoid drug eruptions, especially those with a vesiculobullous component, may in reality represent linear IgA disease. We recommend that direct immunofluorescence be done in any case in which bullous lichen planus is suspected.- - - - - - - - - - ranking = 0.77777777777778keywords = disease (Clic here for more details about this article) |
7/311. Ultraviolet B irradiation: a new therapeutic concept for the management of oral manifestations of graft-versus-host disease.Ultraviolet irradiation inhibits the proliferative responses of lymphoid cells to mitogens and alloantigens by inactivation of T lymphocytes and antigen-presenting cells. Its immunosuppressive capacity led to the introduction of UV irradiation into clinical practice for the treatment of dermatologic manifestations of chronic graft-versus-host disease. The cumulative experience with psoralen-UV-A rays in the treatment of cutaneous and oral graft-versus-host disease was the incentive for the application of oral UV-B rays in 2 patients with oral graft-versus-host disease signs and symptoms after allogeneic marrow transplantation. Intraoral UV-B irradiation (0.02 mJ/cm(2)) was administered 2 or 3 times per week on an ambulatory basis; the dose was increased by 0. 02 mJ/cm(2) every fourth session. Both patients responded early and satisfactorily, displaying only minimal side effects at a relatively low cumulative dose. Intraoral UV-B proved a valuable modality in the treatment of resistant chronic oral graft-versus-host disease.- - - - - - - - - - ranking = 0.88888888888889keywords = disease (Clic here for more details about this article) |
8/311. Successful treatment of recalcitrant cicatricial pemphigoid with a combination of plasma exchange and cyclophosphamide.We describe two patients with severe oral cicatricial pemphigoid, one of whom also had severe pharyngeal involvement. Both patients were resistant to treatment with corticosteroids and other standard immunosuppressive therapies. plasma exchange alone proved to be only temporarily effective, but the combination of plasma exchange with subsequent cyclophosphamide resulted in a remission in both patients. Both patients experienced mild side-effects during the plasma exchange treatment (urticaria and mild hypotension). At present, at follow-up of 6 and 9 years, respectively, the patients have no symptoms of active disease and have not required any further immunosuppressive treatment.- - - - - - - - - - ranking = 0.11111111111111keywords = disease (Clic here for more details about this article) |
9/311. Felty's syndrome.The clinical and pathologic findings of Felty's syndrome are discussed. A case is presented which demonstrates the nonspecific inflammatory oral lesions commonly seen with this syndrome. The role of the dentist in relating these nonspecific lesions to the basic disease process is emphasized.- - - - - - - - - - ranking = 0.11111111111111keywords = disease (Clic here for more details about this article) |
10/311. Management of orofacial infection in patients with chronic renal disease.Chronic renal failure with resulting imbalance of electrolytes complicated the treatment of a patient with acute facial cellulitis that resulted from a carious molar. The patient's condition improved significantly after three days of hospitalization with meticulous medical and surgical care. He was able to return home after five days.- - - - - - - - - - ranking = 0.44444444444444keywords = disease (Clic here for more details about this article) |
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