Autoimmune progesterone dermatitis and stomatitis.

Autoimmune progesterone dermatitis is a rare clinical condition associated with variable cutaneous and mucosal eruptions such as urticaria, erythema multiforme, and eczema. Exacerbation is influenced by hormonal changes of the menstrual cycle. The patient described in this report had recurrent cyclic lesions on the skin, oral mucosa, and lips that appeared just before regular menstruation and persisted until a few days after. During each cycle, the eruptions appeared at the previously affected sites, mimicking the clinical feature of a fixed drug eruption. This rare phenomenon is attributed to an autoimmune reaction to female sex hormones. The condition failed to respond to therapy with prednisone, but improved with the use of an antiestrogen drug, tamoxifen. This medication suppresses ovulation and the post-ovulation rise in endogenous progesterone levels.

Common and less common gingival overgrowth conditions.

Gingival enlargement is caused by some local and systemic pathologic conditions. Clinical manifestations vary and depend on the underlying defects. Diagnosis of these abnormalities and their relationship to underlying systemic conditions is essential prior to establishment of any treatment. Several gingival overgrowth conditions resulting from various causes are included in this review. Some conditions are rare and appear with clinical features interesting to both dentists and dermatologists. A brief review of causes, pathogenesis, and differential diagnosis is presented.

Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash.

This case report describes severe mucosal injuries following misuse of an undiluted over-the-counter mouthwash with a high alcohol content (70%), oil of peppermint and arnica. The mouthwash was to be diluted 5:1 with water. The patient used undiluted solution to better treat her self-diagnosed "contagious gum infection." She experienced burning sensation with each rinse and developed severe mucosal injuries subsequently. Her oral condition improved within 48 hours following discontinuation of use of the mouthwash and application of a mixture of Benadryl Elixir, Maalox Plain, and 2% viscous Lidocaine. A detailed history and review of a patient's medical condition will help to differentiate self-induced mucosal injuries from those caused by an allergic reaction or skin diseases.

Desquamative stomatitis associated with routine use of oral health care products.

Oral mucosal desquamation is a common manifestation of a number of pathologic conditions. The differential diagnoses may range from chemical and electrical burns to conditions such as allergic reactions, hormonal disorders, and mucocutaneous conditions. This article reports two cases of oral mucosal reactions that became a diagnostic challenge at the time of examination. Both subjects had chronic extensive desquamative stomatitis and gingival ulcerations. Following a careful review of their medical and dental history, the use of oral health care products was projected as a possible cause of their mucosal condition.

Provisional restoration for abutment of an existing removable partial denture.

The abutment of an existing removable partial denture may require a crown restoration. Fabrication of a provisional restoration to fit the existing clasp assembly requires special consideration. This article presents a simple technique for fabrication of such provisional restorations. An alginate impression is made of the arch with the removable partial denture in place. The abutment tooth is then prepared, providing adequate clearance between the clasp assembly and the tooth preparation. Cold curing acrylic resin of proper shade is mixed and poured in the impression of the abutment tooth. The impression is then seated in the mouth and removed before the acrylic resin is completely polymerized. The provisional restoration is then separated from the partial denture, finished and polished.

Preliminary impression in patients with microstomia.

This article describes a preliminary impression technique for edentulous patients with microstomia. Stock impression trays are modified to make sectional impressions of the left and right sides of the maxillary arch. The cast poured into the first impression is positioned in the second impression, which is then poured to make the diagnostic cast.

In-office fabrication of a claspless interim partial denture.

This article describes a technique for making a claspless interim removable partial denture that can quickly and easily be made in the dental office. The unnecessary undercuts are eliminated by use of a block-out putty without the need for duplication of the cast. The prosthesis can be inserted with minimum adjustments.

Melanin pigmentation disorders of the skin and oral mucosa.

Pigmented lesions in brown, blue-black, or variations of these colors are relatively rare in the oral cavity but very common in the skin and can range from absolutely benign to highly malignant. The differential diagnosis of brown and blue-black lesions of the oral cavity includes normal racial pigmentation, melanosis, nevi, melanoma, amalgam tattoos, and disorders related to the blood or blood vessels.

Magnetic retention for overdentures.

The use of implanted and opposing magnets has been reviewed. A technique for the use of implanted magnets in the roots of endodontically treated teeth to aid the retention of overdentures has been described.

Epidermolysis bullosa: oral management and case reports.

The prominent clinical characteristic of this uncommon group of skin disorders, which are acquired or are genetically transmitted, is the development of bullae or vesicles in response to minor mechanical trauma. They can either be skin or mucosal lesions. This paper reports on three cases of epidermolysis bullosa dystrophica. The significance of oral management in treating these subjects is discussed.

Chlorhexidine mouthwash-induced fixed drug eruption. Case report and review of the literature.

Various adverse reactions including anaphylactic shock have already been reported after the topical application of chlorhexidine. This article reports for the first time a hypersensitivity reaction in the form of fixed drug eruption after the use of a mouthwash containing chlorhexidine. This report should bring an increased awareness of the possibility of systemic hypersensitivity reaction to chlorhexidine in a previously sensitized person. The report also will add fixed drug eruption to the list of skin hypersensitivity reactions caused by chlorhexidine.

Ataxia-telangiectasia. Review of the literature and a case report.

Cutaneous vascular abnormalities are frequently detected on initial examination of newborns. Many of these lesions are common variations of normal lesions such as nevus simplex and strawberry hemangiomas. Some of the vascular abnormalities, however, are a feature of a number of syndromes with multisystemic involvement. These syndromes have been described under the heading of neurocutaneous diseases. Ataxia-telangiectasia is a neurocutaneous syndrome that appears with progressive cerebellar ataxia, oculocutaneous telangiectasias, and abnormalities of many other organs. Oral mucosa is also affected. Current concepts on the pathogenesis of ataxia-telangiectasia and one case of the disease are presented in this article.