Eosinophilic ulcer: the role of stress-induced psychoneuroimmunologic factors.

INTRODUCTION: Eosinophilic ulcer (EU) is a rare pathology and its etiology is still slightly known. It is a benign lesion characterized by fast-growing ulceration with elevated and indurated borders, most commonly affecting the tongue. CASE REPORT: The authors describe a case of EU on a lingual border that was initiated and had its clinical behavior altered by the psychological stress the patient was experiencing. DISCUSSION: This paper discusses the stress effects that alter the individual's immunologic response, thus attracting mast cells and eosinophils towards the mucosal epithelium, which are involved in eosinophilic ulcer. The authors make an association between eosinophilic ulcer and atopic dermatitis, two diseases that appear to have a similar, though not fully defined, etiology. The psychological stress factor was considered a predisponent factor for eosinophilic ulcer etiology and its interference in the etiology and evolution of this disease should be considered.

Tratamento da osteomielite supurativa crônica de mandíbula em criança com curto período de hospitalização / Treatment of chronic suppurative osteomyelitis in the mandible of a child with short period of hospitalization

Este trabalho tem o objetivo de relatar um caso de osteomielite supurativa crônica de mandíbula em uma criança de 4 anos de idade tratada cirurgicamente, e para isso, foi utilizado um tempo curto de hospitalização. Uma criança saudável do gênero masculino foi admitida no hospital, com quadro de infecção facial com evolução de 4 meses, apresentando dor e drenagem de secreção como principais sinais e sintomas. O exame tomográfico evidenciava um espessamento do corpo e ramo mandibulares no lado direito, áreas de reabsorção óssea difusa e presença de sequestros ósseos na mesma região, confirmando o diagnóstico de osteomielite supurativa crônica. O paciente foi submetido a tratamento cirúrgico através de drenagem, remoção de sequestros e corticotomia vestibular da mandíbula, colocação de drenos e fistulectomias, além da remoção dos dentes envolvidos. O paciente respondeu, de forma rápida e satisfatória, ao tratamento cirúrgico empregado. A execução do ato operatório, conforme descrito, é fundamental para a obtenção de resultados satisfatórios, o que possibilitou a grande vantagem de levar a uma rápida resolução do quadro infeccioso com curto período de hospitalização e o mínimo de sequelas.

The purpose of this article was to report a case of chronic suppurative osteomyelitis (CSO) in the mandible of a 4-year-old child surgically treated during a short period of hospitalization. A healthy male child was referred to the hospital with a picture of facial infection that had progressed over four months, his principal symptoms and signs being pain and pus drainage. The CT scan clearly showed a thickening of the mandible body and ramus on the right-hand side, areas of diffuse bone resorption and the presence of bone sequestra in the same region confirming the diagnosis of CSO. The patient underwent surgical treatment by means of drainage, removal of the of the sequestra and vestibular corticotomy of the mandible, placement of drains and fistulectomies, as well as extraction of the involved teeth. The patient responded in a rapid and satisfying manner to the surgical treatment employed. The performance of the surgical procedure as described is essential for achieving satisfactory results and had the great advantage of producing a swift resolution of the infection with a short period of hospitalization and a minimum of sequelae.