scholarly journals Oral ulcers in children- a clinical narrative overview

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Corinne Légeret ◽  
Raoul Furlano
Keyword(s):  
Treatment Options ◽  
Correct Diagnosis ◽  
Pemphigus Vulgaris ◽  
Nutritional Deficiencies ◽  
Stevens Johnson Syndrome ◽  
Mucous Membrane Pemphigoid ◽  
Duration Of Symptoms ◽  
Family Doctors ◽  
Oral Ulcers ◽  
Clinical Narrative

AbstractThe prevalence of oral ulcers in children is reported to be 9%, however diagnosis of oral lesions can be challenging, being an unspecific symptom of several diseases. Differential diagnosis can range from classic infectious disease of childhood (e.g. herpangina, hand-foot-and-mouth-disease) over nutritional deficiencies, gastrointestinal disorders, inflammations (e.g. pemphigus vulgaris, lichen planus, mucous membrane pemphigoid) to side effects of medications (Stevens-Johnson Syndrome) or chronic dieseases (e.g. sarcoidosis, systemic Lupus erythematodes, familial Mediterrenean fever). Therefore, children with oral ulcers are treated by many different specialists such as dentists, family doctors, paediatricians, rheumatologists, haematologists, gastroenterologists and otorhinolaryngologists.A systematic literature search and a narrative literature review about the potential 48 diseases connected to oral ulcers were performed. According to the duration of symptoms and size of the lesions, a tabular overview was created to support the clinician in making a correct diagnosis, additionally different treatment options are presented.

Differential Diagnosis of Superficial Ulcerations of the Oral Mucosa

1979 ◽  
Vol 87 (6) ◽  
pp. 734-740 ◽  
Author(s):  
Richard A. Chole ◽  
George H. Domb
Keyword(s):  
Differential Diagnosis ◽  
Oral Mucosa ◽  
Verrucous Carcinoma ◽  
Pemphigus Vulgaris ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Mucous Membrane Pemphigoid ◽  
Diagnostic Challenge ◽  
Johnson Syndrome ◽  
Herpetic Gingivostomatitis

Superficial ulcerations of the oral mucosa often present a diagnostic challenge to the physician because of the similarity of one ulcer to another. A diagnosis is made by the analysis of multiple factors, including the lesion's location, size, grouping, onset, patient's age, involvement of other systems of the body, and course of the disease. The histopathology of the lesion may be specific, especially in certain potentially fatal diseases. This paper presents the means for the differential diagnosis of a variety of superficial ulcers of the oral mucosa: varicella, herpangina, recurrent aphthous stomatitis, Behcet's disease, Stevens-Johnson syndrome, traumatic ulcer, verrucous carcinoma, primary herpetic gingivostomatitis, recurrent herpetic stomatitis, pemphigus vulgaris, and benign mucous membrane pemphigoid.

Rash and Mucositis Associated With Mycoplasma pneumoniae and Chlamydophila pneumoniae: A Recurrence of MIRM?

2020 ◽  
Author(s):  
Danielle Brazel ◽  
Brooke Kulp ◽  
Geoanna Bautista ◽  
Andrew Bonwit
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Treatment Options ◽  
Specific Treatment ◽  
Corticosteroid Treatment ◽  
Stevens Johnson Syndrome ◽  
First Case ◽  
Johnson Syndrome ◽  
Vesicular Rash ◽  
Recurrent Aphthous Ulcers ◽  
Definition Of

Abstract Introduction A new concept has come to light recently, that is, Mycoplasma-induced rash and mucositis (MIRM). Here, we report the first case of recurrent rash, mucositis, and conjunctivitis involving Mycoplasma pneumoniae and C. pneumoniae that fits under the criteria of what is currently defined as MIRM. Case Presentation A patient aged 12 years with a history of recurrent aphthous ulcers presented in 2013 with worsening oral lesions, conjunctivitis, and vesicular rash. Her respiratory polymerase chain reaction (PCR) panel was positive for M. pneumoniae. She was diagnosed with Stevens-Johnson syndrome (SJS) secondary to M. pneumoniae and treated with a macrolide, acyclovir, and intravenous immunoglobulin (IVIG). The same patient returned 3 years later with an identical constellation of symptoms, at which time her PCR was positive for C. pneumoniae. In addition to IVIG and a macrolide, a corticosteroid treatment was administered. Discussion Here, we present the case of a pediatric patient with a recurrence of mucocutaneous disease that is more consistent with MIRM than the proposed SJS or erythema multiforme (EM) documented via histology. Our patient’s symptoms were controlled with azithromycin and IVIG and, in the second episode, with corticosteroids as well. This case adds to that of Mayor-Ibarguren et al, providing further evidence that C. pneumonia may also be a trigger for MIRM. Patients will benefit from expanding the definition of MIRM, as the pathogenesis differs from SJS and EM and could result in more specific treatment options.

Stressful Life Events as a Trigger for Autoimmune Disease? A Case Report on Mucous Membrane Pemphigoid

Dental Update ◽  
2021 ◽  
Vol 48 (5) ◽  
pp. 379-382
Author(s):  
Robert Devine ◽  
Melanie Simms
Keyword(s):  
Mucous Membrane ◽  
Patient Outcomes ◽  
Stressful Life Events ◽  
Treatment Options ◽  
Rare Condition ◽  
Corticosteroid Treatment ◽  
Diagnostic Tools ◽  
Mucous Membrane Pemphigoid ◽  
Acute Presentation

This case discusses the acute presentation of a patient with mucous membrane pemphigoid to an emergency dental department. Mucous membrane pemphigoid is a rare condition, but its presentation can be severe and concerning for both the patient and clinician. The case presents the manifestations of florid desquamative gingivitis and extensive mucosal erosions due to burst bullae. We discuss the possible causes of the condition in this patient, likely to be the stress of recent cardiac surgery, as well as exploring the efficacy of diagnostic tools, treatment options and adverse effects of corticosteroid treatment. CPD/Clinical Relevance: Correct and timely diagnosis of vesiculobullous disorders has notable impacts on patient outcomes and quality of life.

scholarly journals CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment

2018 ◽  
Vol 41 (4) ◽  
pp. 381-389 ◽  
Author(s):  
Annelore De Grauwe ◽  
Irem Ayaz ◽  
Sohaib Shujaat ◽  
Simon Dimitrov ◽  
Logan Gbadegbegnon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Conventional Radiography ◽  
Paediatric Population ◽  
Treatment Optimization ◽  
Diagnostic Efficacy

Summary Background Taking into account radiation doses, safety, and protection, we highlighted the features in which cone-beam computed tomography (CBCT) can offer an advantage compared to the conventional two-dimensional imaging in paediatric dentistry before orthodontic treatment. Objective The aim of this article was to conduct a systematic review to assess the diagnostic efficacy of CBCT in the paediatric population at a pre-orthodontic phase. Search methods MEDLINE via PubMed was searched to identify all peer-reviewed articles potentially relevant to the review until 1 July 2018. Relevant publications were selected by two reviewers independently. Selection criteria The literature selection for this systematic review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was based on predetermined inclusion criteria. Data collection and analysis Data were collected on overall study characteristics and examination characteristics of the selected studies. Methodological quality of the selected studies was evaluated. Original studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Thereafter, levels of evidence were obtained according to Grading of Recommendations Assessment, Development and Evaluation criteria. Results As a result of the QUADAS assessment, a total of 37 articles were included in the protocol. Following a proper protocol, CBCT was regarded as a reliable tool for assessment and management of impacted canine and root fracture. It provided a better evaluation of normal and pathological condylar shape and volume. CBCT was a superior choice for pre-surgical diagnostic applications in cleft lip and/or palate over a medical computed tomography based on its lower radiation exposure, shorter investigation time, and low purchase costs. Conclusions CBCT is justified only in those cases where conventional radiography fails to provide a correct diagnosis of pathology. Therefore, it cannot be regarded as a standard method of diagnosis. CBCT imaging may also be justified when it positively affects treatment options or provides treatment optimization. Registration None. Conflict of interest None to declare.

scholarly journals Clinical profile of cardiac myxoma: 11 years’ experience of 90 cases

2016 ◽  
Vol 31 (1) ◽  
pp. 18-22
Author(s):  
Md Toufiqur Rahman ◽  
Md Zulfikar Ali ◽  
Md Humayun Kabir ◽  
STM Abu Azam ◽  
AAS Majumder ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Primary Tumour ◽  
Correct Diagnosis ◽  
Cardiac Myxoma ◽  
Benign Neoplasm ◽  
Clinical Feature ◽  
Duration Of Symptoms ◽  
Pedal Oedema ◽  
Mechanical Interference ◽  
The Mean

Introduction: Cardiac myxoma is a benign neoplasm that represents the most common primary tumour of the heart. Because of nonspecific symptoms, early diagnosis may be a challenge. Although the left atrium is the most commonly involved site of origin in 75% of cases, it can arise from any of the cardiac chambers. Symptoms from a cardiac myxoma are more pronounced when the myxomas are left-sided, racemosus, and over 5 cm in diameter. Symptoms are produced by mechanical interference with cardiac function or embolization. Being intravascular and friable, myxomas account for most cases of tumor embolism. The site of embolism is dependent upon the location (left or right atrium) and the presence of an intracardiac shunt. Most atrial myxomas are benign and can be removed by surgical resection.Objectives: To see clinical presentation and echocardiographic profile of cardiac myoxomas.Methods: 90 cardiac myxoma patients who admitted both in cardiology and cardiac surgery departments of National Institute of Cardiovascular Diseases (NICVD), Dhaka from August 2003 to July, 2014 were studied clinically and by echocardiogram. Clinical histories were reviewed, noting age, gender, and clinical presentation.Results: There were 30 males and 60 females, ages ranged from 17 to 76 years. The commonest clinical feature was dyspnoea (94.44%), followed by palpitation (76.67%), chest discomfort (74.44%), constitutional symptoms (50%), pedal oedema (20%), syncope (14.44%), and embolization (7.7%). The mean duration of symptoms was 09.7 months.Conclusion: The clinical presentation of cardiac myxoma is often nonspecific, so high index of clinical suspicion is important for its early and correct diagnosis. The size and appearance of the myxomas correlated with the presenting symptoms.Bangladesh Heart Journal 2016; 31(1) : 18-22

scholarly journals Clinical guidelines frailty. Part 2

2020 ◽  
pp. 115-130 ◽  
Author(s):  
O. N. Tkacheva ◽  
Yu. V. Kotovskaya ◽  
N. K. Runikhina ◽  
E. V. Frolova ◽  
A. V. Naumov ◽  
...  
Keyword(s):  
Internal Medicine ◽  
General Practitioners ◽  
Clinical Guidelines ◽  
Treatment Options ◽  
Adult Patients ◽  
Family Doctors ◽  
Russian Association

The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. This publication includes treatment options for patients with frailty.

Anogenital dermatoses

2019 ◽  
pp. 345-356
Keyword(s):  
Lichen Sclerosus ◽  
Intraepithelial Neoplasia ◽  
Pemphigus Vulgaris ◽  
Stevens Johnson Syndrome ◽  
Seborrheic Keratosis ◽  
Fixed Drug Eruption ◽  
Inflammatory Conditions ◽  
Squamous Intraepithelial Neoplasia ◽  
Fixed Drug ◽  
Skin Conditions

Ano-genital dermatoses provides information on the following anogenital skin conditions: common benign lesions/anomalies (angiokeratomas, Fordyce spots, epidermoid cysts, epidermal naevi, haemangioma, idiopathic calcinosis of the scrotum, melanocytic naevi, nabothian follicles, pearly penile papules, pigmentary changes, prominent hair follicles, seborrheic keratosis, skin tags, vulval papillae); degenerative condition (ovarian failure); infective conditions (tinea cruris, erythrasma); inflammatory conditions (irritant and contact dermatitis, seborrhoeic dermatitis, fixed drug eruption, psoriasis, lichen planus, plasma cell balanitis, lichen sclerosus, hidradenitis suppuritiva); ulcerative conditions (aphthous ulcers, Lipschutz ulcers, Behçet’s disease, erythema multiforme/Stevens–Johnson syndrome, pyoderma gangrenosum, pemphigus vulgaris); premalignant conditions and malignant conditions (extramammary Paget’s disease, squamous intraepithelial neoplasia). The chapter ends with a table of options for steroids of differing strengths.

scholarly journals Characteristics and treatment effectiveness of the nummular headache: a systematic review and analysis of 110 cases

2020 ◽  
Vol 2 (1) ◽  
pp. e000049
Author(s):  
Urvish K Patel ◽  
Sidra Saleem ◽  
Arsalan Anwar ◽  
Preeti Malik ◽  
Bindi Chauhan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Complete Resolution ◽  
Rating Scale ◽  
Botulinum Toxin Type A ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Primary Headache ◽  
Tricyclic Antidepressant ◽  
Nummular Headache ◽  
Pubmed Database

Background/objectiveNummular headache (NH) is a primary headache disorder characterised by intermittent or continuous scalp pain, affecting a small circumscribed area of the scalp. As there are limited data in the literature on NH, we conducted this review to evaluate demographic characteristics and factors associated with complete resolution of the headache, and effectiveness of treatment options.MethodsWe performed a systematic review of cases reported through PubMed database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and ‘nummular headache’, ‘coin-shaped headache’ and ‘coin-shaped cephalalgia’ keywords. Analysis was performed by using χ2 test and Wilcoxon rank-sum test. For individual interventions, the response rate (RR%) of the treatment was calculated.ResultsWe analysed a total of 110 NH cases, with median age 47 years and age of pain onset 42 years. Median duration to make correct diagnosis was 18 months after first attack. The median intensity of each attack was 5/10 on verbal rating scale over 4 cm diameter with duration of attack <30 min. Patients with NH had median three attacks per day with frequency of 9.5 days per month. 40 (57.97%) patients had complete resolution of the headache after treatment. Patients with complete resolution were younger, more likely to be female, and were more likely to have diagnosis within year. Patients with complete resolution more likely to have received treatment with onabotulinum toxin A (botulinum toxin type A (BoNT-A)), and gabapentin compared with patients without complete resolution. Most effective interventions were gabapentin (n=34; RR=67.7%), non-steroidal anti-inflammatory drugs (NSAIDs) (n=32; RR=65.6%), BoNT-A (n=12; RR=100%) and tricyclic antidepressant (n=9; RR=44.4%).ConclusionYounger patients, female sex and early diagnosis were associated with complete resolution. NSAIDs, gabapentin and BoNT-A were most commonly used medications, with significant RRs.

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