scholarly journals Oral Candida Infection in Psoriatic Patients Treated with IL17A Inhibitors: Report of 3 Cases and a Comprehensive Review of the Literature

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 3
Author(s):  
Efstathios Pettas ◽  
Vasiliki Savva ◽  
Vasileios Ionas Theofilou ◽  
Maria Georgaki ◽  
Nikolaos G. Nikitakis
Keyword(s):  
Oral Mucosa ◽  
Case Reports ◽  
Oral Candidiasis ◽  
Clinical Impression ◽  
Oral Lesions ◽  
Close Monitoring ◽  
Immune Mediated ◽  
Satisfactory Clinical Response ◽  
Oral Candida ◽  
Temporally Correlated

An intact and fully functional immune system plays a crucial role in the prevention of several infectious diseases. Interleukin (IL)17 is significantly involved in oral mucosa immunity against several antigens and microorganisms, including Candida albicans (CA). Herein, we present three cases of oral candidiasis (OC) related to the use of an IL17A inhibitor for psoriasis. Three psoriatic individuals presented for evaluation of widespread symptomatic oral lesions temporally correlated with the onset of IL17A inhibitors (secukinumab in two patients and brodalumab in one patient). Clinical examination revealed either partially removable white plaques in an erythematous background (case #1) or diffuse erythematous lesions (cases #2 and 3) involving several areas of the oral mucosa. Cytology smear, accompanied by histopathologic examination in case #1, confirmed the clinical impression of OC in all three cases. All patients received antifungal therapy with satisfactory clinical response. No discontinuation of the antipsoriatic regimen was recommended, but all patients were advised to remain under monitoring for possible OC relapses. During the last few years, new systemic biologic agents targeting IL17 have been used for the management of variable immune-mediated diseases. Few clinical trials and scarce case reports have shown that these medications place individuals at high risk of developing candidiasis. We propose that patients treated with these medications should be at close monitoring for the development of OC and, if it occurs, receive appropriate management.

scholarly journals Hiperplasia Fibrosa Inflamatoria: Reporte de un caso

2021 ◽  
Vol 13 (1) ◽  
pp. 136-140
Author(s):  
Brian Andrés García Orellana ◽  
María de Lourdes León Vintimilla ◽  
Martha Alejandra Cornejo Córdova
Keyword(s):  
Older Adults ◽  
Oral Mucosa ◽  
Histopathological Examination ◽  
Case Reports ◽  
Conventional Technique ◽  
Oral Lesions ◽  
Removable Dental Prosthesis ◽  
Removable Prosthesis ◽  
The Right

BACKGROUND: Inflammatory fibrous hyperplasia associated with the use of removable dental prosthesis (IFH) is an adaptive lesion caused by long-term trauma exerted by a poorly adapted removable prosthesis on the oral mucosa, usually in the vestibular sulcus. Its diagnosis and treatment is imperative, due to its potential to cause discomfort to the patient, altering aesthetics, phonectics and chewing. CASE REPORTS: A 41-year-old denture wearer woman was referred due to discomfort in the right lower vestibular sulcus, the clinical examination showed a bilobed enlargement with an invagination where the edge of the prosthesis fits, the patient has worn the prosthesis for 15 years. EVOLUTION: Resection with scalpel (conventional technique) was performed. The histopathological examination reported inflammatory fibrous hyperplasia and a new total removable bimaxillary prosthesis was made for the patient. CONCLUSIONS: HFI is one of the main oral lesions in older adults denture wearers and it causes aesthetic and functional alterations; it is produced by the constant irritation caused by the settlement of the prosthesis borders on the mucovestibular sulcus as a consequence of alveolar resorption. Treatment is meant to eliminate the injury and its etiology; the absence of lesions on the mucosa and the bottom of the sulcus is completely necessary.

scholarly journals Immune mediated Lesions of the oral cavity: A scrupulously researched review

2021 ◽  
Vol 7 (4) ◽  
pp. 238-244
Author(s):  
Sunita Gupta ◽  
Shriya Khera
Keyword(s):  
Oral Cavity ◽  
Clinical Features ◽  
Oral Mucosa ◽  
Signs And Symptoms ◽  
Review Article ◽  
Oral Lesions ◽  
Immune Mediated ◽  
Salient Features

Oral mucosa may be the first site to manifest protean signs and symptoms in immune mediated diseases. Therefore, it is of paramount importance to have a thorough and vast knowledge about various diseases. It is the role of Oral and Maxillofacial Diagnostician to diagnose the lesions according to their salient features.In this review article, we aim to describe the immune mediated oral lesions, their clinical features, investigations and management.

scholarly journals MULTICENTER STUDY OF CANDIDA SPECIES IN ORAL MUCOSA OF DIFFERENT PATIENTS: ANALYSIS OF 711 STRAINS AND LITERATURE REVIEW

2020 ◽  
Vol 49 (2) ◽  
pp. 105-119
Author(s):  
Rennan Luiz Oliveira dos Santos ◽  
Luciana Da Silva Ruiz ◽  
Marcos Ereno Auler ◽  
Jorge Kleber Chavasco ◽  
Débora Moreira ◽  
...  
Keyword(s):  
Literature Review ◽  
Oral Mucosa ◽  
Candida Species ◽  
Oral Candidiasis ◽  
Molecular Methods ◽  
Future Research ◽  
Correct Identification ◽  
Candida Spp ◽  
Culture Collections ◽  
Oral Candida

This study aimed to identify Candida spp. collected from oral mucosa and maintained in culture collections, correlating the findings with the medical history of patients and comparing with data from the literature over the past five years. Seven hundred and eleven oral Candida spp. isolates, collected between 2013 and 2017,  were selected and identified using traditional and molecular methods. In addition, a literature review was performed with the key words: “Oral”, “Candida” and “Yeast”. Seven species of the genus Candida: were identified C. albicans (73.3%); C. tropicalis (9.3%); C. parapsilosis (8.2%); C. glabrata (3.9%); C. guilliermondii(2.8%); C. krusei (1.7%) and C. lusitaniae (0.3%). The strains identified as C. albicans were submitted to molecular methods using specific primers and of these, 5.8% were identified as C. dubliniensis strains. The greatest diversity of strains was found in patients presenting no systemic diseases or HIV +, while the highest percentage of strains of Candida non-albicans were observed in cancer patients. This study reports a representative distribution of Candida species among individuals exhibiting distinct clinical conditions, in order to contribute to the design of future research on details of aspects involved in the infections caused by thesemicroorganisms. The correct identification of oral Candida strains contributes to a realistic epidemiological approach and future clinical protocols against these pathogens.KEY WORDS: Candida; oral candidiasis; dentistry; yeasts; HIV; co-infection

Case Report: Delayed Alemtuzumab-Induced Concurrent Neutropenia and Thrombocytopenia in Relapsing-Remitting Multiple Sclerosis

2021 ◽  
pp. 089719002110212
Author(s):  
Akaansha Ganju ◽  
James C. Stock ◽  
Kim Jordan
Keyword(s):  
Multiple Sclerosis ◽  
Case Reports ◽  
Severe Neutropenia ◽  
Cell Counts ◽  
Immune Mediated ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Study Participants ◽  
Relapsing Remitting Multiple Sclerosis

Alemtuzumab is an anti-CD52 monoclonal antibody used to treat relapsing-remitting multiple sclerosis following failure of second-line medications. It is administered intravenously in 2 treatment sequences 1 year apart. This drug is frequently associated with mild infusion reactions within days of administration, increased infection risk, and long term adverse events from secondary autoimmunity. Alemtuzumab-induced serious immune-mediated thrombocytopenia (ITP) is well-reported and occurred in 1.0-2.2% of participants in initial phase 2 and 3 trials for multiple sclerosis. Significant neutropenia, however, is rare and was only observed in 0.1% of study participants. Delayed neutropenia and/or ITP is thought to occur from secondary autoimmunity. Few case reports have described severe neutropenia occurring beyond 2 months of last alemtuzumab dose. We present an unusual case of delayed combined neutropenia and thrombocytopenia that occurred 15 months after the second infusion of alemtuzumab. The patient was asymptomatic and presented following discovery of neutropenia and thrombocytopenia during routine laboratory studies. The patient responded to steroids initially and was discharged, although outpatient cell counts subsequently revealed recurrent neutropenia and ITP. The adverse drug reaction probability (Naranjo) scale was completed and showed probable likelihood that the adverse event was alemtuzumab-related. Long term screening for delayed hematologic abnormalities, at least 4 years after initial dose, is necessary when using alemtuzumab. Greater research is needed to understand the mechanism of drug-associated neutropenia.

scholarly journals Candida albicans in patients with oronasal communication and obturator prostheses

2009 ◽  
Vol 20 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Beatriz Silva Câmara Mattos ◽  
Andréa Alves de Sousa ◽  
Marina Helena C. G. de Magalhães ◽  
Marcia André ◽  
Reinaldo Brito e Dias
Keyword(s):  
Candida Albicans ◽  
Oral Mucosa ◽  
Sodium Hypochlorite ◽  
Buccal Mucosa ◽  
Treatment Evaluation ◽  
Antifungal Treatment ◽  
Therapeutic Protocol ◽  
Candidal Infection ◽  
Oral Candida ◽  
Palatal Mucosa

Patients using obturator prostheses often present denture-induced stomatitis. In order to detect the presence of oral Candida albicans in patients with oronasal communications and to evaluate the effectiveness of a topical antifungal treatment, cytological smears obtained from the buccal and palatal mucosa of 10 adult patients, and from the nasal acrylic surface of their obturator prostheses were examined. A therapeutic protocol comprising the use of oral nystatin (Mycostatin®) and prosthesis disinfection with sodium hypochlorite was prescribed for all patients. Seven patients were positive for C. albicans in the mucosa, with 1 negative result for the prosthetic surface in this group of patients. Post-treatment evaluation revealed the absence of C. albicans on prosthesis surface and on the oral mucosa of all patients. The severity of the candidal infection was significantly higher in the palatal mucosa than in the buccal mucosa, but similar in the palatal mucosa and prosthesis surface, indicating that the mucosa underlying the prosthesis is more susceptible to infection. The therapeutic protocol was effective in all cases, which emphasizes the need for denture disinfection in order to avoid reinfection of the mucosa.

scholarly journals Clinical Characteristics and Relevance of Oral Candida Biofilm in Tongue Smears

2021 ◽  
Vol 7 (2) ◽  
pp. 77
Author(s):  
Eunae Cho ◽  
YounJung Park ◽  
Ki-Yeol Kim ◽  
Dawool Han ◽  
Hyun Sil Kim ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Oral Candidiasis ◽  
Salivary Flow ◽  
Nutritional Deficiencies ◽  
Low Grade ◽  
High Grade ◽  
Novel Method ◽  
Oral Candida ◽  
Antifungal Use ◽  
Candida Biofilm

Dimorphic Candida exist as commensal yeast carriages or infiltrate hyphae in the oral cavity. Here, we investigated the clinical relevance of Candida hyphae in non-pseudomembranous oral candidiasis (OC) by smears of tongue biofilms. We conducted a retrospective study of 2829 patients who had had tongue smears regardless of OC suspicion. Clinical characteristics were evaluated using a novel method of assessing hyphae. Clinical factors (moderate/severe stimulated pain, pain aggravated by stimulation, tongue dorsum appearance and initial topical antifungal use) were highly significant in the high-grade hyphae group but were statistically similar in the low-grade hyphae and non-observed hyphae group, suggesting low-grade hyphae infection as a subclinical OC state. In addition to erythematous candidiasis (EC), a new subtype named “morphologically normal symptomatic candidiasis” (MNSC) with specific pain patterns and normal tongue morphology was identified. MNSC had a significantly higher proportion of moderate and severe stimulated pain cases than EC. Low unstimulated salivary flow rate (<0.1 mL/min) was found to be a common risk factor in MNSC and EC. In non-pseudomembranous OC, pain patterns were dependent on Candida hyphae degree regardless of tongue dorsum morphology. Morphologic differences seen in high-grade hyphae infection were not associated with systemic diseases or nutritional deficiencies.

scholarly journals PREVENTION OF CANDIDIASIS IN PATIENTS USING REMOVABLE DENTURES

2022 ◽  
Author(s):  
Andrey SEVBITOV ◽  
◽  
Aleksey DOROFEEV ◽  
Sergey MIRONOV ◽  
Samer AL-KHOURY ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Oral Mucosa ◽  
Oral Candidiasis ◽  
Age Groups ◽  
Local Immunity ◽  
Thermal Insulating ◽  
Removable Plate ◽  
Orthopedic Care ◽  
Oral Tissue ◽  
Receptor Apparatus

Despite innovations in orthopedic dentistry, removable dentures belong to the most popular orthopedic care category. Removable dentures are combined stimuli that affect the mucous membrane and neuro-receptor apparatus. Acrylic plastic prostheses, widely used in prosthetic dentistry, have a negative side mechanical, chemical-toxic, sensitizing, and thermal insulating effect on oral tissue and prosthetic impression area. This is often complicated by a violation of the biocenosis of the oral cavity, the growth of pathogenic microflora that releases toxins, especially an increase in the number of yeast colonies that irritate the oral mucosa and prosthetic stomatitis. It was observed 100 patients with oral candidiasis of various age groups from 45 to 65 years. Of these, 60 patients with removable plate prostheses; 40 patients with partially removable prostheses. Chronic forms of candidiasis were diagnosed in 40 patients and with exacerbation of chronic forms of candidiasis in 60 people. The number of untreated carious cavities and poor hygienic condition of the oral cavity directly affects the severity of candidiasis. Acute forms of candidiasis were observed mainly in patients with high DMF and PMA indices. The severity of candidiasis depends on the degree and duration of wearing dentures and hygienic conditions - the most severe forms of invasive candidiasis were observed in the presence of removable plate prostheses, the complete absence of teeth, and the use of a prosthesis for more than 10-15 years. A combined lesion of the oral mucosa and the red border of the lips was observed mainly in patients older than 60 years. The presence of candidiasis in the oral cavity in patients with removable plate prostheses leads to a statistically significant change in the indicators of local immunity of the oral cavity: an increase in the concentration of serum IgG and IgA and the values of the coefficient of the balance of local immunity factors.

Inductive Effect of a Ritonavir-Containing Hepatitis C Treatment Regimen on Warfarin in a Patient—A Case Report

2018 ◽  
Vol 32 (4) ◽  
pp. 470-473 ◽  
Author(s):  
Audrey C. Rosene ◽  
Jaymee L. Gaspar
Keyword(s):  
Hepatitis C ◽  
Treatment Regimen ◽  
Case Reports ◽  
Warfarin Dose ◽  
International Normalized Ratio ◽  
Close Monitoring ◽  
Anticoagulation Management ◽  
Hepatitis C Treatment ◽  
History Of ◽  
Repeated Use

The warfarin management strategy for a mechanical mitral valve patient initiated on a ritonavir-based hepatitis C treatment regimen is described. A 62-year-old male with a past medical history of hepatitis C genotype 1a and stable warfarin dose history was initiated on a concomitant Viekira Pak® (VP) regimen containing ritonavir. Prior to initiation of the VP for hepatitis C treatment, the patient was stable on a warfarin dose of 40 mg/wk for 5 months. During treatment with VP, the patient experienced a markedly decreased international normalized ratio (INR) and warfarin requirements ultimately increased 125% from baseline (90 mg/wk). Effective anticoagulation management throughout and surrounding the treatment period for hepatitis C involved frequent warfarin dose adjustments, including preemptive changes, close monitoring, and repeated use of enoxaparin to ensure adequate thrombotic prophylaxis. This is believed to be the first reported case describing the management of warfarin in a patient with hepatitis C who received VP and required a drastically increased weekly warfarin dose. The possible mechanisms suggestive of this interaction and similar case reports in the literature are discussed.

DNA Methylome Distinguishes Oropharyngeal and Oral Cancer from Oral Lesions and Healthy Oral Mucosa

2020 ◽  
Author(s):  
Milutin Gašperov Nina ◽  
Ivan Sabol ◽  
Ksenija Božinović ◽  
Emil Dediol ◽  
Marinka Mravak-Stipetić ◽  
...  
Keyword(s):  
Oral Mucosa ◽  
Oral Lesions ◽  
Early Diagnostics ◽  
Gene Methylation ◽  
Dna Methylome ◽  
Transcription Factor Genes ◽  
Or Genes ◽  
New Good ◽  
The Given ◽  
Potential Biomarkers

Abstract Background: There is a strong need to find new, good biomarkers of head and neck squamous cell carcinoma (HNSCC), because of the prognoses and high mortality of patients. The aim of this study was to identify the potential biomarkers in HNSCC that have differences in their DNA methylome and potentially premalignant oral lesions, in comparison to healthy oral mucosa.Methods: In this study 32 oral samples were tested: 9 healthy oral mucosae, 13 HNSCC and 10 potentially premalignant oral lesions for DNA methylation by Infinium MethylationEPIC BeadChip.Results: Our findings showed a panel of genes significantly hypermethylated in their promoters or specific sites in HNSCC samples in comparison to healthy oral samples, which are mainly oncogenes, receptor and transcription factor genes, or genes included in cell cycle, transformation, apoptosis and autophagy. A group of hypomethylated genes in HNSCC, in comparison to healthy oral mucosa, is mainly involved in the host immune response and transcriptional regulation. The results also showed significant differences in gene methylation between HNSCC and potentially premalignant oral lesions, as well as differently methylated genes that discriminate between oral lesions and healthy mucosa.Conclusions: The given methylation panels point to the possibly early diagnostics of HNSCC as well as potentially premalignant oral lesions and its possible implication in clinical practice.

scholarly journals Oral Manifestations in HIV/AIDSInfected Children

2011 ◽  
Vol 05 (03) ◽  
pp. 291-298 ◽  
Author(s):  
Charles Mugisha Rwenyonyi ◽  
Annet Kutesa ◽  
Louis Muwazi ◽  
Isaac Okullo ◽  
Arabat Kasangaki ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Dental Caries ◽  
Highly Active Antiretroviral Therapy ◽  
Dietary Habits ◽  
Oral Candidiasis ◽  
Cervical Lymphadenopathy ◽  
World Health ◽  
Mulago Hospital ◽  
Oral Lesions ◽  
Oral Manifestations

ABSTRACTObjectives: To assess factors influencing the distribution of oral manifestations in HIV/AIDS-infected children attending the Paediatric Infectious Disease Clinic in Mulago Hospital, Kampala. Methods: This was a cross-sectional study comprising 237 children (males/females: 113/124) aged 1 to 12 years. The parents/guardians were interviewed to obtain demographic information, oral hygiene practices, dietary habits and health seeking behaviours as well as any medications taken. The children were clinically examined for oral lesions based on World Health Organization criteria with modifications. Results: About 71.7% of the children cleaned their teeth. About 16.9% of the children had visited a dentist since birth, mainly for emergency care. One or more oral lesions were recorded in 73% of the children of whom 19.0% experienced discomfort during oral functions. Cervical lymphadenopathy, oral candidiasis and gingivitis were the most common soft tissue oral lesions: 60.8%, 28.3% and 19.0%, respectively. Except for dental caries, the overall frequency distribution of soft tissue oral lesions was significantly lower in children on highly active antiretroviral therapy (HAART) as compared to their counterparts not on HAART. The prevalence of dental caries in deciduous and permanent dentitions was 42.2% and 11.0%, respectively. Tooth brushing and previous visits to the dentist were indirectly and significantly associated with dental caries. About 5.9% (n=14) of the children had <200 CD3 + CD4 T-lymphocyte cells per μl of blood. Conclusions: The majority of the children had one or more oral lesions, particularly in the group not on HAART. Some of the lesions were associated with discomfort during oral functions. (Eur J Dent 2011;5:291-298)

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