Actinomycosis of the ventral tongue with successful laser ablation therapy: A case report.

BACKGROUND: We present a first case report of an Actinomycosis lesion of the ventral tongue. Actinomycosis of the tongue is an uncommon finding. CASE DESCRIPTION: The 64-year-old female patient presented with a leukoplakic ventral tongue lesion. The diagnosis Actinomycosis was confirmed by histopathologic evaluation. The lesion was successfully treated with antibiotics and laser ablation therapy. PRACTICAL IMPLICATIONS: Diagnostic and therapeutic concerns are discussed. Clinicians are alerted to considering Actinomycosis within the differential diagnosis of leukoplakic tongue lesions.

A Case of Cheilitis Granulomatosa/Orofacial Granulomatosis.

A case of a 19-year-old female patient is presented to a private practice dental clinician with swelling of the lower lip and inflammation of the anterior dorsal tongue. The patient presented with moderate oral pain as well as abdominal pain. The lesions were biopsied and noted for a granulomatous histopathologic appearance. The patient reported a history of using cinnamon as a flavoring agent. The lesions resolved within two weeks after the biopsy procedures and topical steroid therapy. The lesions were diagnosed as cheilitis granulomatosa/orofacial granulomatosis. The patient has remained lesion free as of the three-year follow-up. Etiologic, diagnostic and therapeutic issues related to this relatively rare condition of cheilitis granulomatosa/orofacial granulomatosis are discussed.

Oral Psoriasis of the Tongue: A Case Report.

Psoriasis is a common dermatological disease, but oral psoriasis is rarely reported in the literature. Its diagnosis has been a contentious issue among physicians. Its presence in the absence of skin lesions is not completely accepted by all physicians, and diagnosis is complicated by the fact that there are no defined criteria. We present a case report of oral psoriasis in a man who did not have skin lesions concurrently but did have a previous history of dermal psoriasis. Additionally, we discuss the history, typical presentation, and current treatments of oral psoriasis.

Erythema multiforme major secondary to a cosmetic facial cream: first case report.

BACKGROUND: Oral erythema multiforme (EM) major is an acute immune-mediated disorder typically involving the oral mucosa, triggered by a hypersensitivity reaction to an antigen. CASE SUMMARY: A 59-year-old woman presented to an oral medicine clinic with a chief complaint of "mystery disease" of 1 year's duration. The condition was described as repeated episodes of severe, painful, asymmetric oral lesions that responded to systemic steroid therapy. A previous oral biopsy described fibrinoid necrosis, mixed inflammation, and granulation tissue. A regimen of descending-dose prednisone was administered, and 3 weeks later the tissues appeared to be partially healed. Direct immunofluorescence staining of a biopsied oral mucosal lesion was negative. To rule out a drug causation, the patient discontinued hydrochlorothiazide and escitalopram oxalate. However, on steroid tapering, episodic lesions recurred. The patient was placed on combination systemic prednisone and azathioprine. The oral lesions resolved again, but new episodes occurred immediately after tapering. The patient's daily facial cosmetics were evaluated, and she was asked to stop using cosmetics with the active ingredient octocrylene. After eliminating the use of facial cosmetics containing octocrylene, the episodes no longer recurred. CONCLUSIONS: We report a case of cosmetic-induced EM major and suggest that the triggering allergen is octocrylene.

A topical imiquimod-induced oral mucosal lichenoid reaction: a case report.

BACKGROUND: Imiquimod (IMI) is a topical immune response modifier used in the treatment of actinic keratosis and cheilitis. Actinic cheilitis is a potentially premalignant condition that requires therapeutic intervention. IMI therapy is noted for producing cutaneous and mucosal adverse effects. The authors report the case of an 88-year-old woman who was treated for actinic cheilitis of the upper lip with IMI and who consequently experienced an oral mucosal lichenoid reaction of the lower lip and right buccal mucosa. RESULTS: The patient was treated successfully with high-dose steroid therapy, and the oral lesions resolved in 17 days. CONCLUSIONS: To our knowledge, this is the first case report regarding an IMI-induced oral mucosal lichenoid reaction. Clinicians should be aware of the potential of IMI to cause lichenoid reactions. PRACTICAL IMPLICATIONS: IMI is an efficacious therapeutic agent when used in the treatment of actinic cheilitis, but it is prone to cause oral mucosal side effects such as lichenoid reactions. Therefore, it is important for dentists to be knowledgeable concerning potential mucosal IMI side effects.

Oral tissue irritants in toothpaste: a case report.

In this case, an adolescent patient presented with multiple, asymptomatic ulcerated lesions- resembling aphthous ulcerations- located in the oral cavity. The etiology of these lesions appeared to be associated with soft tissue irritants found in the patient's toothpaste. This report highlights the need to rule out known oral irritants in dentifrices for patients who present with oral ulcerations.

Oral erythema multiforme major: a triple case report.

This article presents three cases of erythema multiforme (EM) major with predominant oral mucosal lesions. Two males, aged 28 and 10, and a 19-year-old woman came to the clinic with oral vesiculoerosive lesions consistent with a diagnosis of EM major. All three patients reported histories consistent with an initial oral herpetic infection. Management with topical and systemic steroids resolved the lesions successfully in all three cases. The relatively recent literature has documented differences between EM and Stevens-Johnson syndrome. It is important for dentists to understand the etiology of EM and the associated diagnostic and management issues.

Medical consultations for medically complex dental patients.

In order to discuss the issue of the medical consultation letter for medically complex dental patients, information is provided with regard to the specifics of the process. Medical, dental, and legal implications are discussed. Specific scripting and format are provided.

A retrospective evaluation of 56 patients with oral burning and limited clinical findings.

This study retrospectively evaluated the charts of 56 patients who had been referred to an oral medicine clinic between 1995 and 2004 with oral burning and limited clinical findings. Of the 56 patients, 35 had a final diagnosis of essential burning mouth disorder (EBMD). Five patients with EBMD had a family history of diabetes and two had been diagnosed with late-onset diabetes. Other oral burning diagnoses included sialoadenitis (burning lips syndrome), irritation or allergic reactions to triclosan, diabetic neuropathy, subclinical oral candidiasis, nutritional deficiency/neuropathy, and a drug reaction to an ACE inhibitor (scalded mouth syndrome) that resulted in oral burning.