Topic tacrolimus, alternative treatment for oral erosive lichen planus resistant to steroids: a case report.

The lichen planus is a mucocutaneous disease with unknown etiology and auto-immune pathogenia. There have been three variants of lichen planus: the reticular, the plaque-like and the atrophic-erosive lesions. It s a chronic disease with acute relapses that generally affects more frequently to women from the fourties. The diagnostic is based on the clinic identification of the lesions joined with the histopathologic study (basal cells hidropic degeneration, linfoplasmocitic infiltration and absence of displasy signs). The great number of therapeutic options are explained for its high prevalency (0.5-2%), its recurrence and its risk for malignant transformation. We present a case of oral erosive lichen planus, refractory to numerous treatments, mainly corticosteroids. During 15 days the lesion responded to the administration of a 0.1% tacrolimus in topic application. This article tries to show the new indication of tacrolimus, a calcineurin inhibitor immunosuppressor, that it is effective in the erosive lesions treatment.

Topic tacrolimus, alternative treatment for oral erosive lichen planus resistant to steroids: a case report

El liquen plano es una enfermedad mucocutánea de etiología desconocida y patogenia autoinmune. Existen tres variantes de liquen plano: la forma reticular, la forma en placas y la forma atrófico-erosiva. El curso es crónico con frecuentes reactivaciones. Afecta con más frecuencia a mujeres en la 4ª década de la vida y superiores. El diagnóstico se basa en la identificación clínica de las lesiones junto a el estudio histopatológico (degeneración hidrópica de la capa basal, infiltradode linfo-plasmocitario y ausencia de signos de displasia). Su alta prevalencia (0,5-2%), su carácter recurrente y el potencial riesgo de transformación maligna explican el gran número de opciones terapéuticas disponibles.Presentamos un caso de liquen plano erosivo, de mucosa oral, resistente a múltiples tratamientos, fundamentalmente corticoideos. En el plazo de 15 días respondió a la administración de tacrolimus al 0,1% en aplicación tópica. El artículo pretende señalar la indicación novedosa del principio activo tacrolimus, un inmunosupresor inhibidor de la calcineurina, que se ha demostrado eficaz en la solución de las lesiones erosivas

The lichen planus is a mucocutaneous disease with unknown etiology and auto-immune pathogenia. There have been three variants of lichen planus: the reticular, the plaque-like and the atrophic-erosive lesions. It’s a chronic disease with acute relapses that generally affects more frecuently to women from the fourties. The diagnostic is based on the clinic identification of the lesions joined with the histopathologic study (basal cells hidropic degeneration, linfoplasmocitic infiltration and absence of displasy signs). The great number of therapeutic options are explained for its high prevalency (0.5-2%), its recurrence and its risk for malignant transformation.We present a case of oral erosive lichen planus, refractory to numerous treatments, mainly corticosteroids. During 15 days the lesion responded to the administration of a 0.1% tacrolimus in topic application. This article tries to show the new indication of tacrolimus, a calcineurin inhibitor immunosuppressor, that it is effective in the erosive lesions treatment

Osteonecrosis of the jaws and bisphosphonates. Report of three cases.

Bisphosphonates are recently acquiring increasing relevance in the treatment of several diseases. In line with the increased use of these compounds, cases of mandibular osteonecrosis, and to a lesser extent, maxillary osteonecrosis, are being reported. This necrosis is difficult to treat in patients who usually have a previously limited quality of life. A surgical performance carried out by oral and maxillofacial surgeons, stomatologists and odontologists might lead to bone exposure. A treatment based on conservation and as harmless as possible seems to be the most advisable way of acting with these patients in order to minimize the incidence and treat the complications, once the lesions have been ascertained. We report three cases treated in our service of osteonecrosis of the jaws after exodontics. This side effect should be remembered before starting any surgical treatment in these patients.

Osteonecrosis maxilar y bisfosfonatos. Presentación de tres nuevos casos / Osteonecrosis of the jaws and bisphosphonates. Report of three cases

Los bisfosfonatos están adquiriendo una relevancia terapéutica cada vez mayor, dada su utilidad en el manejo de diversas patologías.Con el incremento de su uso, se están documentando casos de necrosis ósea mandibular, y en menor medida maxilar, de difícil solución y con una importante afectación de la calidad de vida de los pacientes en tratamiento con estos fármacos.El factor que con mayor frecuencia desencadena el proceso es la actuación de los profesionales: odontólogos, estomatólogos y cirujanos orales y maxilofaciales. La previsión, las intervenciones atraumáticas y el tratamiento conservador, parecen ser los medios más adecuados para minimizarla incidencia o resolver las complicaciones.Este artículo presenta tres casos, seguidos por nuestro servicio, de pacientes con necrosis ósea maxilar tras procedimientos dentales, fundamentalmente exodoncias.El conocimiento de este posible efecto secundario de los bisfosfonatos debería ser tenido en cuenta antes de cualquier intervenciónen este tipo de pacientes

Bisphosphonates are recently acquiring increasing relevance in the treatment of several diseases.In line with the increased use of these compounds, cases of mandibular osteonecrosis, and to a lesser extent, maxillary osteonecrosis,are being reported. This necrosis is difficult to treat in patients who usually have a previously limited quality of life.A surgical performance carried out by oral and maxillofacial surgeons, stomatologists and odontologists might lead to bone exposure.A treatment based on conservation and as harmless as possible seems to be the most advisable way of acting with these patients in order to minimize the incidence and treat the complications, once the lesions have been ascertained.We report three cases treated in our service of osteonecrosis of the jaws after exodontics.This side effect should be remembered before starting any surgical treatment in these patients

Angioma cavernoso cervicofacial gigante. A propósito de un caso / Giant cavernous angioma of the head and neck. A case report

El angioma cavernoso es un tumor vascular benigno y una de las lesiones congenitas mas comunes. Presenta una alta incidencia en cabeza y cuello, y es más frecuente en las mujeres. Tiene un buen pronóstico, siendo recomendable su extirpación en los casos de tumores grandes y con riesgo de hemorragia importante. El tratamiento quirúrgico parece el más efectivo, aunque existen diversas posibilidades terapéuticas que frecuentemente se asocian a la resección de la tumoración. Presentamos el caso clínico de un paciente varón de 55 años con una tumoración cervicofacial de predominio lingual y de grandes dimensiones, analizando los diversas diagnósticos diferenciales y los aspectos clínicos, patológicos y terapéuticos de este tipo de lesiones (AU)