RESUMO
Background and Objectives: Lichen planus of the lip (LPL) is a chronic inflammatory condition that resembles actinic cheilitis, discoid lupus erythematosus, graft-versus-host disease, and lichenoid reaction to dental materials or drugs. The purpose of this study was to conduct a literature review on lichen planus lip involvement and to report a retrospective observational study that characterises and explores the clinical, histopathological, and evolution of the lesions in a group of patients with unique involvement of LPL. Materials and Methods: Clinical data of patients diagnosed with LPL was retrieved from the medical charts of the patients referred to the Oral Pathology Department of the "Carol Davila" University of Medicine and Pharmacy. A concurrent electronic literature research was carried out using PubMed and Web of Science from 2003 to 2023. Results: Eleven patients diagnosed with unique LPL were analysed (male/female ratio was 1.75, mean age 63.64 years ± 12.52). All patients presented lesions of the lower lip; the clinical forms were atrophic (six cases) and erosive (five cases), and the histopathological exam confirmed the diagnosis. After topical treatment with corticosteroids, most of the patients had complete remission. The literature review revealed 24 studies (sixteen case reports and eight case series) which comprised 84 patients. Isolated lip involvement was reported in 17 studies, and five articles with concomitant oral lichen planus, while two articles did not mention this criterion. Conclusions: Our study brings new data on isolated lichen planus of the lip that primarily affects the lower lip with predominance in male patients. It was reported worldwide in patients between 22 and 75 years old. Topical corticosteroids were the main treatment prescribed and they usually brought remission of the lesions. Lichen planus of the lip is a challenging diagnosis for oral health practitioner providers as well as for dermatologists.
Assuntos
Líquen Plano Bucal , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Estudos Retrospectivos , Líquen Plano Bucal/tratamento farmacológico , Líquen Plano Bucal/diagnóstico , Lábio/patologia , Líquen Plano/tratamento farmacológico , Líquen Plano/diagnóstico , Adulto , Doenças Labiais/diagnóstico , Doenças Labiais/tratamento farmacológico , Idoso de 80 Anos ou maisAssuntos
Antibacterianos/uso terapêutico , Doenças Labiais/microbiologia , Embolia Pulmonar/microbiologia , Sepse/complicações , Infecções Estafilocócicas/complicações , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Adulto , Infecções Comunitárias Adquiridas/complicações , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Quimioterapia Combinada , Feminino , Humanos , Doenças Labiais/tratamento farmacológico , Staphylococcus aureus Resistente à Meticilina , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/tratamento farmacológico , Sepse/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Tomografia Computadorizada por Raios XAssuntos
COVID-19/diagnóstico , Doenças Labiais/diagnóstico , SARS-CoV-2/isolamento & purificação , Dermatopatias Vesiculobolhosas/diagnóstico , Trombose/diagnóstico , Biópsia , COVID-19/complicações , COVID-19/imunologia , COVID-19/virologia , Teste para COVID-19 , Dexametasona/uso terapêutico , Feminino , Humanos , Lábio/irrigação sanguínea , Lábio/imunologia , Lábio/patologia , Doenças Labiais/tratamento farmacológico , Doenças Labiais/imunologia , Doenças Labiais/patologia , Microvasos/patologia , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/imunologia , Dermatopatias Vesiculobolhosas/patologia , Glicoproteína da Espícula de Coronavírus/isolamento & purificação , Trombose/tratamento farmacológico , Trombose/imunologia , Trombose/patologia , Adulto JovemAssuntos
COVID-19/complicações , Doenças dos Genitais Femininos/virologia , Doenças Labiais/virologia , Úlcera/virologia , Adulto , Teste para COVID-19 , Diagnóstico Diferencial , Feminino , Doenças dos Genitais Femininos/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Doenças Labiais/tratamento farmacológico , Prednisona/uso terapêutico , SARS-CoV-2 , Úlcera/tratamento farmacológicoRESUMO
BACKGROUND: Keratoacanthoma (KA) is a cutaneous neoplasm, which is similar to squamous cell carcinoma (SCC) clinically, cytologically, and histopathologically. Surgical resection is the first choice for treating KA, but it may be impractical when a KA is located in a cosmetically sensitive area. OBSERVATION: We describe a patient with a nodule on the right upper lip. We performed a surgical biopsy to obtain a histopathological diagnosis. Specimen analysis revealed a diagnosis of KA. As the tumor was located in the upper lip, a direct resection may require a flap to reconstruct the lip shape; instead, a noninvasive field approach using photodynamic therapy (PDT) was initiated. After five sessions of treatment, the lesion disappeared, and there was no scar. CONCLUSIONS: Although there is no consensus on using PDT to treat KA, we provide a case report on the effective use of PDT in the treatment of KAs. PDT can be an alternative treatment option when KA is located in a particular anatomic site.
Assuntos
Ácido Aminolevulínico/uso terapêutico , Ceratoacantoma/tratamento farmacológico , Doenças Labiais/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Doenças Labiais/diagnóstico , Hepatopatias/diagnóstico , Linfadenopatia/diagnóstico por imagem , Sarcoidose/diagnóstico , Abdome , Adolescente , Fosfatase Alcalina/sangue , Anti-Inflamatórios/uso terapêutico , Anticorpos Antinucleares/sangue , Antirreumáticos/uso terapêutico , Edema/etiologia , Feminino , Humanos , Lábio/patologia , Doenças Labiais/tratamento farmacológico , Doenças Labiais/patologia , Fígado/diagnóstico por imagem , Hepatopatias/sangue , Hepatopatias/tratamento farmacológico , Testes de Função Hepática , Linfonodos/diagnóstico por imagem , Linfadenopatia/tratamento farmacológico , Mediastino , Metotrexato/uso terapêutico , Prednisolona/uso terapêutico , Sarcoidose/complicações , Sarcoidose/tratamento farmacológico , Sarcoidose/patologia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
BACKGROUND: Cutaneous leishmaniasis is endemic in Morocco. Mucosal involvement is rare. We report a case in Morocco of cutaneous leishmaniasis of the vermilion border of the upper lip extending to the oral mucosa due to Leishmania tropica. PATIENTS AND METHODS: A 15-year-old girl was seen with 2 ulcerated lesions, present for 4 months, situated on the left cheek and vermilion border and extending to the oral mucosa. The diagnosis of leishmaniasis was confirmed by direct examination revealing high numbers of Leishmania amastigotes. Culture of the offending organism in NNN medium and isoenzymatic characterization resulted in identification of L. tropica. Treatment with meglumine antimoniate (Glucantime) was ineffective. The outcome was good after treatment with fluconazole. CONCLUSION: In Morocco, cutaneous leishmaniasis with mucosal involvement is rare, and usually develops as a complication of cutaneous leishmaniasis via direct extension.
Assuntos
Dermatoses Faciais/patologia , Leishmaniose Cutânea/patologia , Doenças Labiais/patologia , Adolescente , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/parasitologia , Feminino , Fluconazol/uso terapêutico , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/parasitologia , Lábio , Doenças Labiais/tratamento farmacológico , Doenças Labiais/parasitologia , Antimoniato de Meglumina/uso terapêutico , Marrocos , Mucosa Bucal/patologiaRESUMO
To the Editor: An otherwise-healthy 27-year-old male patient presented with a 3-month history of an asymptomatic, non-bleeding, rapidly growing nodule, on his left upper vermilion lip.
Assuntos
Antagonistas Adrenérgicos beta/administração & dosagem , Granuloma Piogênico/tratamento farmacológico , Doenças Labiais/tratamento farmacológico , Propranolol/administração & dosagem , Administração Tópica , Adulto , Biópsia , Granuloma Piogênico/diagnóstico , Humanos , Lábio/patologia , Doenças Labiais/patologia , Masculino , Resultado do TratamentoRESUMO
Cheilitis is a group of chronic diseases of the vermilion border that are diverse in etiology, pathogenesis and clinical picture. The development of various forms of cheilitis is facilitated by defects of the architectonics of the lips, unhealthy lifestyle, anatomical features of the lip structure, adverse meteorological effects, decrease in specific and non-specific factors for protecting the oral cavity, the patient's psycho-emotional state, immuno-allergic factors and accompanying general somatic and dental pathologies. The issues of prevention and comprehensive treatment of lip diseases are especially relevant in dental practice. The article presents data on the prevalence of cheilitis and dentoalveolar anomalies and the need for their treatment in young people. Furthermore, the authors provide a composition justification and develop an ointment for the treatment of cheilitis in this category of patients.
Assuntos
Humanos , Adolescente , Pomadas/uso terapêutico , Queilite/prevenção & controle , Queilite/terapia , Doenças Labiais/tratamento farmacológicoAssuntos
Exantema/diagnóstico , Doenças Labiais/diagnóstico , Estomatite Herpética/diagnóstico , Aciclovir/uso terapêutico , Adolescente , Antivirais/uso terapêutico , Exantema/tratamento farmacológico , Exantema/imunologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Doenças Labiais/tratamento farmacológico , Doenças Labiais/imunologia , Estomatite Herpética/tratamento farmacológico , Estomatite Herpética/imunologiaAssuntos
Aciclovir/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Antivirais/uso terapêutico , Ácido Fusídico/uso terapêutico , Herpes Simples/diagnóstico , Doenças Labiais/diagnóstico , Feminino , Herpes Simples/tratamento farmacológico , Herpes Simples/patologia , Herpes Simples/virologia , Humanos , Doenças Labiais/tratamento farmacológico , Doenças Labiais/patologia , Doenças Labiais/virologia , Pessoa de Meia-Idade , Creme para a Pele/uso terapêuticoAssuntos
Compostos Azo/efeitos adversos , Dermatite Alérgica de Contato/tratamento farmacológico , Inibidores Enzimáticos/uso terapêutico , Hidroxicloroquina/uso terapêutico , Doenças Labiais/tratamento farmacológico , Tatuagem/efeitos adversos , Idoso , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Feminino , Humanos , Doenças Labiais/induzido quimicamente , Doenças Labiais/patologiaRESUMO
BACKGROUND: Ace inhibitor-induced angioedema, characterized by sudden-onset swelling of the mucous membrane, skin, or both, is a rare occurrence in the Kingdom of Saudi Arabia. Because of its safety and efficacy, perindopril is a commonly prescribed angiotensin-converting enzyme inhibitor. Here we describe the clinical manifestations, management, and outcome of perindopril-induced angioedema of the lips and tongue in a 65-year-old Saudi man. CASE PRESENTATION: A 65-year-old Saudi Arab man presented to an emergency department with lip and tongue swelling and dysphagia. There were no systemic symptoms and no past history of a similar event. He had been consuming perindopril 5 mg and amlodipine 5 mg for the last 3 weeks: brand name, Coveram, from the company Servier (Ireland) Industries Ltd.; one tablet of Coveram contains 3.395 mg perindopril corresponding to 5 mg perindopril arginine and 6.935 mg amlodipine besilate corresponding to 5 mg amlodipine. A physical examination revealed considerable swelling of his lips and tongue. Examinations of other systems, including his cardiovascular and respiratory systems, revealed unremarkable findings. All laboratory parameters were also normal. Electrocardiography demonstrated sinus rhythm, a normal P axis, and V-rate of 50-99. A clinical diagnosis of perindopril-induced angioedema was made, and perindopril was discontinued. The angioedema resolved completely after the administration of antihistamines and corticosteroids. CONCLUSIONS: Angioedema caused by angiotensin-converting enzyme inhibitors is an uncommon occurrence in Saudi Arabia. The findings from this case are expected to raise awareness about this condition among clinicians in this country.
Assuntos
Angioedema/induzido quimicamente , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Doenças Labiais/induzido quimicamente , Perindopril/efeitos adversos , Doenças da Língua/induzido quimicamente , Corticosteroides/uso terapêutico , Idoso , Angioedema/tratamento farmacológico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Doenças Labiais/tratamento farmacológico , Masculino , Arábia Saudita , Doenças da Língua/tratamento farmacológicoRESUMO
Herpes Labialis results from reactivation of latent herpes simplex virus (HSV-1 or HSV-2) harbored in the trigeminal ganglion during times of psychological stress, cutaneous injury or photo exposure. Following reactivation, the virus is anterogradely transported through axonal termini to the skin where the virus is released and replicates causing a clinical outbreak. Botulinum neurotoxin A (BoNTA) is known to inhibit presynaptic neuropeptide and neurotransmitter release. Whether it has the capacity to interfere with viral shedding and delivery into the skin remains unclear. We were interested in determining whether BoNTA could serve as a potential therapeutic or prophylactic treatment approach for frequent and severe HSV recurrences. We describe a clinical case report in which a patient successfully maintained a sustained absence of HSV outbreaks in regions where BoNTA was intradermally administered. BoNTA may offer a novel therapeutic approach for preventing recurrent HSV disease. J Drugs Dermatol. 2018;17(10):1127-1129.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Herpes Labial/tratamento farmacológico , Herpesvirus Humano 1 , Doenças Labiais/tratamento farmacológico , Neurotoxinas/uso terapêutico , Adulto , Toxinas Botulínicas Tipo A/administração & dosagem , Feminino , Herpes Labial/patologia , Herpes Labial/virologia , Humanos , Injeções Intradérmicas , Doenças Labiais/patologia , Doenças Labiais/virologia , Neurotoxinas/administração & dosagem , Recidiva , Resultado do TratamentoRESUMO
INTRODUCTION: Remarkable advances have occurred in the management of acute ischemic stroke, especially in regards to reperfusion treatments. With advances in reperfusion treatments come the risk of complications associated with these treatments. Areas covered: The article focuses on three acute complications that can occur in the setting of acute ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema following administration of alteplase, a recombinant tissue plasminogen activator. Predictors of the development of these complications are reviewed. The management of cerebral edema and hemorrhagic transformation is also reviewed in depth including potential new treatments targeting the blood-brain barrier. The article also reviews the management of the rare but potentially fatal complication of orolingual angioedema secondary to alteplase. Expert commentary: An understanding of the pathophysiology leading to the development of malignant cerebral edema and hemorrhagic transformation allows the clinician to anticipate and properly manage these acute complications. Regardless of a patient's age or comorbidities, the decision to pursue decompressive hemicraniectomy in patients with malignant cerebral edema should be based on an honest assessment of expected outcome and guided by the patient's prior wishes regarding an acceptable quality of life.
Assuntos
Angioedema/induzido quimicamente , Edema Encefálico/etiologia , Isquemia Encefálica/complicações , Hemorragia Cerebral/etiologia , Fibrinolíticos/efeitos adversos , Doenças Labiais/induzido quimicamente , Doenças da Boca/induzido quimicamente , Acidente Vascular Cerebral/complicações , Ativador de Plasminogênio Tecidual/efeitos adversos , Administração Intravenosa , Angioedema/tratamento farmacológico , Edema Encefálico/terapia , Isquemia Encefálica/tratamento farmacológico , Humanos , Doenças Labiais/tratamento farmacológico , Doenças da Boca/tratamento farmacológico , Qualidade de Vida , Reperfusão , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
This clinical case presents a patient with a raised and ulcerative lesion with erythematous edges in the mouth, on the lower lip that was unsuccessfully treated as herpes labialis. Clinical data and laboratory tests (Montenegro skin test, indirect immunofluorescence, direct parasite search and polymerase chain reaction) led to the diagnosis of American tegumentary leishmaniasis caused by Leishmania (Viannia) sp. Treatment with pentavalent antimonial (Glucantime®) for 120 days was not effective and administration of amphotericin B for 30 days resulted in wound healing. Glucantime® treatment protocol was longer than the recommended by the Brazilian Ministry of Health in the handbook of mucosal leishmaniasis. This suggests that amphotericin B should have been administered earlier, preventing the psychological and social problems faced by the patient. This study reports a rare clinical case of primary mucosal leishmaniasis on the lip that had a delayed diagnosis, highlighting the precariousness in the management of disease and showing that, despite the importance of leishmaniasis in Brazil, it is still neglected by health professionals.
Assuntos
Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Leishmaniose Mucocutânea/diagnóstico , Doenças Labiais/diagnóstico , Adulto , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Leishmania/imunologia , Leishmaniose Mucocutânea/tratamento farmacológico , Doenças Labiais/tratamento farmacológico , Doenças Labiais/parasitologia , MasculinoAssuntos
Edema/parasitologia , Leishmaniose Mucocutânea/diagnóstico , Doenças Labiais/parasitologia , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Doença Crônica , Edema/patologia , Humanos , Leishmaniose Mucocutânea/tratamento farmacológico , Leishmaniose Mucocutânea/patologia , Doenças Labiais/tratamento farmacológico , Doenças Labiais/patologia , Masculino , Pessoa de Meia-IdadeAssuntos
Dermatoses do Pé/patologia , Dermatoses da Mão/patologia , Doenças Labiais/patologia , Lúpus Eritematoso Cutâneo/patologia , Pele/patologia , Corticosteroides/uso terapêutico , Biópsia , Fármacos Dermatológicos/uso terapêutico , Dermatoses do Pé/tratamento farmacológico , Dermatoses da Mão/tratamento farmacológico , Humanos , Doenças Labiais/tratamento farmacológico , Lúpus Eritematoso Cutâneo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pele/efeitos dos fármacos , Resultado do TratamentoRESUMO
Eosinophilic pustular folliculitis (EPF) is a recurrent inflammatory dermatosis primarily involving hair follicles. Several subtypes of EPF have been described: Classic EPF, infantile EPF, and immunosuppression-associated EPF. Although classic EPF has a predilection for face, involvement of hairless areas such as palms and soles has been reported frequently. There are rare case reports of mucosal EPF. Herein, we report a woman who presented with classic EPF involving the lip and oral mucosa.
Assuntos
Eosinofilia/patologia , Dermatoses Faciais/patologia , Foliculite/patologia , Doenças Labiais/patologia , Dermatopatias Vesiculobolhosas/patologia , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Queixo , Eosinofilia/diagnóstico , Eosinofilia/tratamento farmacológico , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/tratamento farmacológico , Feminino , Foliculite/diagnóstico , Foliculite/tratamento farmacológico , Humanos , Indometacina/uso terapêutico , Doenças Labiais/diagnóstico , Doenças Labiais/tratamento farmacológico , Doenças da Boca/diagnóstico , Doenças da Boca/tratamento farmacológico , Doenças da Boca/patologia , Mucosa Bucal/patologia , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/tratamento farmacológicoRESUMO
Tinea barbae represents a very rare dermatophytosis. We report on a tinea barbae profunda following a journey to Southeast Asia. After travel to Thailand, a businessman was affected by a foudroyant proceeding abscessing infection of the upper lip and beard area. The initial therapy with oral acyclovir and oral ciprofloxacin, which later was changed to ampicillin plus sulbactam, intravenously, was unsuccessful. In a biopsy sample, histologically, with Grocott-Gomori's methenamine silver stain, fungal mycelium was apparent in the tissue. Thereupon, terbinafine 250 mg was given for 4 weeks, topically, a 1% ciclopiroxolamine-containing cream. In fungal culture, T. mentagrophytes were found to grow. Meanwhile, the patient's German wife suffered from a tinea faciei. From skin scrapings from the cheek, T. mentagrophytes was also cultivated. This zoophilic dermatophyte was identical with other zoophilic strains of T. mentagrophytes currently found in Germany, which were also acquired in Thailand. The patient had contact with Thai female sex workers who must be considered as a source of infection of the dermatophytosis. There was no animal contact, neither in Thailand, nor in Germany. The infection chain of the dermatophytosis from Thailand probably reached from a female sex worker via the here described patient to his wife in Germany. This pathway of infection has been known for 1 or 2 years, but until now, in Germany, Switzerland, and Austria exclusively via pubogenital infections (tinea genitalis profunda) due to T. mentagrophytes after journeys to Southeast Asia. For treatment, oral antifungal agents should be used, first of all terbinafine, alternatively fluconazole or itraconazole.