Asunto(s)
Emolientes/efectos adversos , Enfermedades de los Labios/etiología , Enfermedades de los Labios/patología , Vaselina/efectos adversos , Acné Vulgar/tratamiento farmacológico , Adolescente , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/uso terapéutico , Femenino , Humanos , Isotretinoína/efectos adversos , Isotretinoína/uso terapéuticoRESUMEN
Rehabilitant Malayan sun bears often remain in captivity for long periods of time and may experience significant welfare challenges including disability and persistent lip lesions. This study aimed to investigate whether short-term observations of behavior such as oral stereotypies are useful as noninvasive indicators of lip lesion pain, and whether behavior differs between able-bodied and disabled bears. Observations were collected from 21 captive, rehabilitant Malayan sun bears, of both sexes, a range of ages, and with lip lesions ranging in severity. Some also had disabilities.Oral stereotypy frequency was unrelated to lip lesion severity (p > 0.05), and no relationships with other behaviors were found; however, visual disabilities had significant effects on behavior. For example, visually disabled bears walked more than able-bodied bears (p = 0.003) or those with physical disabilities (p = 0.01). Further research on the feeding behavior of bears suffering from lip lesions may elucidate other potential behavioral indicators of pain. Researching effects of visual disabilities in bears with a larger sample size is also recommended to determine generalizable impacts in affected individuals and resulting welfare implications.
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Conducta Animal , Enfermedades de los Labios/veterinaria , Ursidae/lesiones , Ursidae/fisiología , Bienestar del Animal , Animales , Cambodia , Femenino , Enfermedades de los Labios/etiología , Masculino , Conducta Estereotipada , Grabación en Video , Trastornos de la Visión/veterinariaRESUMEN
Lip edema with non-caseating granulomas or lymphangiectasia pose a clinical and pathological challenge. These findings can be attributed to cheilitis granulomatosa (CG), Melkersson-Rosenthal syndrome (MRS), or Crohn disease (CD) depending on the appropriate clinical context. Lymphangiectasis, in particular, is a common pathological finding in CD due to lymphatic obstruction by granulomas and intralymphatic granulomas. Because oral symptoms can precede gastrointestinal symptoms of CD or be seen in patients with asymptomatic gastrointestinal disease, the identification of lymphangiectasia should raise the possibility of underlying CD. We present a case of a young woman with several years of lip swelling, with notable lymphangiectasia and subtle granulomas on pathological evaluation. The patient was diagnosed with MRS at an outside institution and treated with systemic steroids, without further systemic evaluation. We believe that early recognition of lymphangiectasia and consideration of CD early in the work-up are critical for early diagnosis and appropriate management. Neither clinical nor histopathological findings should be used in isolation to diagnose GC, MRS, or CD as there is significant debate as to the etiology and overlapping findings of these conditions. We highlight the importance of lymphangiectasia in diagnosing underlying CD in the appropriate clinical context.
Asunto(s)
Enfermedad de Crohn/complicaciones , Enfermedades de los Labios/etiología , Linfangiectasia/etiología , Adulto , Femenino , Humanos , Síndrome de Melkersson-Rosenthal/etiologíaRESUMEN
Autoimmune progesterone dermatitis is a rare condition with varying clinical presentations. We present a case of autoimmune progesterone dermatitis presenting as recurrent, marked angioedema-like lip swelling without any other skin changes.
Asunto(s)
Angioedema/etiología , Enfermedades Autoinmunes/complicaciones , Enfermedades Autoinmunes/diagnóstico , Dermatitis/complicaciones , Dermatitis/diagnóstico , Enfermedades de los Labios/etiología , Progesterona/efectos adversos , Adolescente , Enfermedades Autoinmunes/tratamiento farmacológico , Dermatitis/tratamiento farmacológico , Femenino , Humanos , Pruebas Intradérmicas , RecurrenciaRESUMEN
Background: Surgical approaches to thyroidectomies have undergone a rapid evolution over the past three decades. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is currently the latest remote access procedure for the treatment of benign and malignant thyroid disease. The purpose of this article is to present the results of TOETVA from five different international institutions. Materials and Methods: From 2016 to 2019, 152 TOETVA procedures were performed on 149 patients at five separate international institutions. Outcomes were analyzed from a prospectively maintained database. There were 12 (8%) men and 137 (92%) women with mean ages of 41.5 ± 10.3 (27-69) and 46.9 ± 1.8 (17-78), respectively. Results: There were 3 (2%) cases that required conversion from the endoscopic approach to an open procedure. A thyroid lobectomy was performed in 111 (73.0%) cases, total thyroidectomy in 38 (25.0%) cases whereas a completion thyroidectomy in 3 (2.0%) cases. Mean operative times were 161.8 ± 42.4 (83-304) minutes for the lobectomy, 213.4 ± 71.7 (120-430) minutes for the total thyroidectomy, and 136.7 ± 109.8 (64-263) minutes for the completion thyroidectomy. The final pathology report revealed 107 (70.4%) benign nodules, 44 (28.9%) nodules with underlying papillary thyroid carcinoma, and 1 (0.7%) case with Hurthle cell carcinoma. Of the 152 cases, 7 (4.7%) patients developed temporary hypoparathyroidism. There were 5 (3.3%) patients who developed transient recurrent laryngeal nerve (RLN) injury and 3 (2.0%) with persistent injury of the RLN. Temporary lower lip numbness was noted in 51 (33.6%) patients whereas 1 (0.7%) patient was noted to have persistent numbness. We reported 57 (38.5%) patients with temporary chin numbness, 9 (5.9%) patients with skin injuries, and 2 (1.3%) with tracheal perforation. Conclusion: To date, the literature and the outcomes from these 5 international institutions have determined that, in select patients, TOETVA can be as safe and efficacious as the traditional trans-cervical technique for the treatment of specific thyroid pathologies.
Asunto(s)
Cirugía Endoscópica por Orificios Naturales/métodos , Cáncer Papilar Tiroideo/cirugía , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Adolescente , Adulto , Anciano , Mentón , Conversión a Cirugía Abierta , Femenino , Humanos , Hipoestesia/etiología , Hipoparatiroidismo/etiología , Enfermedades de los Labios/etiología , Masculino , Persona de Mediana Edad , Cirugía Endoscópica por Orificios Naturales/efectos adversos , Tempo Operativo , Traumatismos del Nervio Laríngeo Recurrente/etiología , Estudios Retrospectivos , España , Suiza , Taiwán , Cáncer Papilar Tiroideo/patología , Enfermedades de la Tiroides/cirugía , Neoplasias de la Tiroides/patología , Tiroidectomía/efectos adversos , Tráquea/lesiones , Estados Unidos , Adulto JovenRESUMEN
Crohn's disease (CD) is a multifactorial, chronic immune-mediated disorder. The oral cavity is involved in 0.5% to 20% of the patients with CD. Oral manifestations of CD are sometimes nonspecific and can be overlooked by the clinicians. These manifestations may precede intestinal symptoms and can serve as indicators for early diagnosis. To increase awareness and to contribute to the standard intervention, here we report a paediatric case with persistent idiopathic swelling of the lower lip and perianal fistula. Microscopic examinations revealed multiple non-necrotising granulomas with chronic inflammation, oedema and lymphangiectasia. The patient was treated with metronidazole 500 mg and ciprofloxacin 500 mg twice a day for one month. The perioral lesions were managed with topical 0.03% tacrolimus and oral prednisone 10 mgtwice a day for one month, followed by a tapered regimen of 10 mg/day for another month. The patient's symptoms improved without full remission at the 6-month follow-up.
Asunto(s)
Enfermedad de Crohn/complicaciones , Enfermedades de los Labios/etiología , Niño , Enfermedad de Crohn/diagnóstico , Humanos , Masculino , Fístula Rectal/complicacionesRESUMEN
BACKGROUND: Sialolithiasis is the most common disease of the salivary glands. Sialolithiasis usually develops in the major salivary glands, and rarely in the minor salivary glands, with only 2% of all cases of sialolithiasis occurring in the minor salivary glands and sublingual glands. Sialoliths in the minor salivary glands result in few or no clinical symptoms and are seldom identified on imaging. CASE PRESENTATION: We report herein our experience with a case of minor salivary gland sialolithiasis in a 67-year-old woman. On examination, an elastic soft, mobile, and well-circumscribed mass was palpable within the left upper lip. Ultrasound examination revealed a hypoechoic mass with heterogeneous internal echoes. The mass was excised under local anesthesia. Based on histopathological findings, a diagnosis of minor salivary gland sialolithiasis was established. CONCLUSIONS: Diagnosis of minor salivary gland sialolithiasis is challenging due to the difficulty of detecting sialoliths on imaging. A well-circumscribed mass was detected in the upper lip, and ultrasound examination revealed a round lesion, raising the suspicion of a benign tumor. Other diseases that can develop at the upper lip are calcified lymph node, phlebolith, fibroma, pleomorphic adenoma, myxoma, vascular malformation, salivary gland tumor, non-specific sialadenitis, and malignant tumor. Surgical excision is the favored approach for confirming a diagnosis of intramucosal nodular lesions.
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Enfermedades de los Labios/diagnóstico , Cálculos de las Glándulas Salivales/diagnóstico , Anciano , Femenino , Humanos , Labio/diagnóstico por imagen , Labio/patología , Labio/cirugía , Enfermedades de los Labios/etiología , Enfermedades de los Labios/patología , Enfermedades de los Labios/cirugía , Cálculos de las Glándulas Salivales/complicaciones , Cálculos de las Glándulas Salivales/diagnóstico por imagen , Cálculos de las Glándulas Salivales/cirugía , Glándulas Salivales Menores/diagnóstico por imagen , Glándulas Salivales Menores/patología , Glándulas Salivales Menores/cirugía , UltrasonografíaAsunto(s)
Enfermedades de los Labios/patología , Labio/lesiones , Complicaciones del Embarazo/patología , Seudolinfoma/patología , Adulto , Relación CD4-CD8 , Femenino , Humanos , Enfermedades de los Labios/etiología , Embarazo , Complicaciones del Embarazo/etiología , Seudolinfoma/etiología , Linfocitos T/patologíaAsunto(s)
Antibacterianos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Fármacos Dermatológicos/efectos adversos , Dermatosis Facial/etiología , Enfermedades de los Labios/etiología , Mupirocina/efectos adversos , Tacrolimus/análogos & derivados , Adulto , Femenino , Humanos , Pruebas del Parche , Tacrolimus/efectos adversosRESUMEN
Various techniques for correcting whistling deformities that occurred after primary surgery for cleft lip have been reported. These techniques are mainly intended to correct the lack of volume of the red lip. However, irregularity of the dry-wet lip junction (mucocutaneous junction) in the red lip has rarely been mentioned. If the wet lip is located in an exposed area, not only is the aesthetic appearance poor but also uncomfortable complications such as a crusted or bleeding lip repeatedly occur under a dry condition. A new technique for correcting the irregular line of the dry-wet lip junction is described in this report. The technique is simple. After removal of the exposed wet lip, flaps are designed on both dry lip sides of the defect as M-W-M plasty and are transposed toward the defect. The dog-ears are small; the scar is inconspicuous because it is incorporated with the wrinkle line, and scar contracture is prevented. In addition, more soft tissues may be included to correct a mild whistling deformity.
Asunto(s)
Labio Leporino/cirugía , Labio/cirugía , Adolescente , Preescolar , Fisura del Paladar/cirugía , Femenino , Humanos , Enfermedades de los Labios/etiología , Enfermedades de los Labios/cirugía , Masculino , Trastornos de la Pigmentación/etiología , Trastornos de la Pigmentación/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugíaAsunto(s)
Carcinoma Neuroendocrino/diagnóstico , Edema/etiología , Enfermedades de los Labios/etiología , Neoplasia Endocrina Múltiple Tipo 2b/diagnóstico , Neuroma/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Lengua/diagnóstico , Carcinoma Neuroendocrino/complicaciones , Niño , Femenino , Humanos , Neoplasia Endocrina Múltiple Tipo 2b/complicaciones , Neuroma/complicaciones , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Lengua/complicacionesRESUMEN
Although head and neck squamous cell carcinoma represents one of the most common cancers among adults, it is rare in pediatric patients. The purpose of this report is to discuss the case of a 15-year-old male patient referred by his dentist due to a three-month old ulcer in his lower lip. The patient denied tobacco smoking and drinking alcohol, and confirmed that he performed manual labor in a brick yard, being exposed daily to the sun without protection. Clinical examination revealed an exophytic rounded ulcer in the right lower lip, measuring 1.5 cm, with a flaky bed. An incisional biopsy was performed, and histopathologic analysis confirmed the diagnosis of squamous cell carcinoma. The treatment of choice was surgical excision. Malignancy should be included in the differential diagnosis of chronic oral ulcers in children and adolescents. Moreover, chronic sun exposure might be associated with occurrence of lip squamous cell carcinoma.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de los Labios/diagnóstico , Adolescente , Biopsia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Diagnóstico Diferencial , Humanos , Enfermedades de los Labios/etiología , Neoplasias de los Labios/patología , Neoplasias de los Labios/cirugía , Masculino , Luz Solar/efectos adversos , Úlcera/etiologíaRESUMEN
BACKGROUND: Systemic sclerosis (SSc) is an autoimmune disease with multisystem involvement, dominated by a general fibrosis. The early stage of the disease is associated with progressive damage to microcirculation, particularly in the respiratory tract, the gastrointestinal tract and skin. The face assumes a typical appearance characterized by microstomia (reduction of mouth opening) and microcheilia (thinning of the lips). These conditions cause a considerable reduction in performance status of patients. We treated them by fat grafting, rich in adipose stem cells, and we evaluated through time clinical, functional and aesthetic evaluation of oral pathology associated with SSc. MATERIALS AND METHOD: From September 2014 to May 2016, we enrolled and treated seven patients in the plastic, reconstructive and aesthetic surgery clinic. Through time, we evaluated the following parameters: evaluation of mouth opening (maximum opening in superior-inferior and lateral directions) and lip thicknesses, both measured by doctors of the aforementioned operating unit; variation in the quality of life as perceived by patients according to the MHISS scale (Mouth Handicap Systemic Sclerosis); variation in severity of labial fibrosis assessed by microscopic analysis of pre- and post-fat transfer samples in the pathology clinic; safety of the protocol, according to the management of side effects resulting from the procedure; aesthetic evaluation, made by external observers and non-experts in the field, on pre- and post-operative photographs. RESULTS AND CONCLUSIONS: We reported satisfying results, both functionally and aesthetically, for all parameters except one, for which the sample size might have proven critical. These data should be a starting point for further experimental research and clinical trials. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Asunto(s)
Tejido Adiposo/trasplante , Enfermedades de los Labios/cirugía , Microstomía/cirugía , Esclerodermia Sistémica/complicaciones , Trasplante de Células Madre/métodos , Adulto , Anciano , Estudios de Cohortes , Estética , Femenino , Supervivencia de Injerto , Humanos , Italia , Enfermedades de los Labios/etiología , Masculino , Microstomía/etiología , Microstomía/fisiopatología , Persona de Mediana Edad , Estudios Retrospectivos , Medición de Riesgo , Esclerodermia Sistémica/diagnóstico , Cirugía Plástica/métodos , Trasplante de Tejidos/métodos , Trasplante Autólogo , Resultado del TratamientoRESUMEN
Hepatitis C virus (HCV) infection remains the main cause of liver disease and can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. HCV may also develop extrahepatic manifestations in the skin, eyes, joints, kidneys, nervous system, and immune system. In fact, several studies reported that up to 70% of HCV patients experienced extrahepatic manifestations. Lichen planus (LP), which is an immune system disorder that is triggered by viral infections, allergens, and stress, can affect the skin, mouth, nails, and scalp. The association of LP with HCV has been reported, but the effect of HCV treatment on LP remission is controversial. We encountered a 53-year-old man with HCV genotype 2a and LP that were successfully treated with sofosbuvir and ribavirin for 12 weeks. After treatment, he achieved sustained virological response against HCV and remission of erosive LP lesions on the lip. In the era of interferon (IFN)-based treatment for HCV, exacerbation of autoimmune diseases is a common adverse event. Therefore, use of an IFN-free regimen of direct-acting antivirals for HCV might prevent the extrahepatic manifestation of an immune disorder.
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Antivirales/uso terapéutico , Hepacivirus/genética , Hepatitis C/tratamiento farmacológico , Liquen Plano/etiología , Enfermedades de los Labios/etiología , Ribavirina/uso terapéutico , Sofosbuvir/uso terapéutico , Antivirales/administración & dosificación , Quimioterapia Combinada , Genotipo , Hepacivirus/efectos de los fármacos , Hepatitis C/complicaciones , Hepatitis C/virología , Humanos , Liquen Plano/patología , Labio/patología , Enfermedades de los Labios/patología , Masculino , Persona de Mediana Edad , Ribavirina/administración & dosificación , Sofosbuvir/administración & dosificaciónAsunto(s)
Anestesia General/métodos , Intubación Intratraqueal/métodos , Laringoscopía/métodos , Enfermedades de los Labios/prevención & control , Labio/lesiones , Anciano , Anestesia General/efectos adversos , Anestesia General/instrumentación , Estudios Cruzados , Humanos , Intubación Intratraqueal/efectos adversos , Intubación Intratraqueal/instrumentación , Laringoscopios/efectos adversos , Laringoscopía/efectos adversos , Laringoscopía/instrumentación , Enfermedades de los Labios/etiología , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Resultado del TratamientoAsunto(s)
Anestesia General/efectos adversos , Fracturas de Cadera/cirugía , Máscaras Laríngeas/efectos adversos , Enfermedades de los Labios/etiología , Labio/lesiones , Complicaciones Posoperatorias/etiología , Anciano de 80 o más Años , Anestesia General/instrumentación , Anestesia General/métodos , Femenino , Humanos , Boca Edéntula/complicacionesRESUMEN
Cutaneous pathomimia is a self-induced disease characterized by conscious self-injury to mucocutaneous boundary or its phaneres. We report the case of a 22-year old woman, with no notable medical history, presenting with sudden onset ulceration on her lower lip evolving for 3 months in a context of preservation of patient's clinical status. The patient had previously consulted several dermatologists and had undergone two skin biopsies with non-specific histological diagnosis. Clinical examination showed painful, well-defined ulceration with clean surface and non-indurated basis, measuring 1 × 3 cm in diameter and involving the left half of the lower lip (A). Given the clinical appearance of the lesion, its chronic nature and the lack of response to local care, several diagnosis were suspected: squamous cell carcinoma, cutaneous leishmaniasis, pyoderma gangrenosum Deep biopsy was performed showing a loss of substance revealing the chorion, without histological characters of malignancy. Syphilis and HIV tests were negative. Fifteen days after, patient's evolution was marked by the appearance of an identical lesion on the right side of the lower lip, with complete healing of the former lesion by occlusive dressing (B). The follow-up interview showed, again, manipulation with the hand as well as family conflicts. Examination by a psychiatrist compared with clinical and evolutionary data showed cutaneous pathomimia.