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J Drugs Dermatol ; 18(6): 576, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31251551


Background: DNA repair enzymes have been shown to reduce actinic keratoses and non-melanoma skin cancers, but their use for the treatment of actinic cheilitis has not been studied. Objective: The purpose of this pilot study was to examine the efficacy of a DNA repair enzyme lip balm containing T4 endonuclease in reducing the severity of actinic cheilitis in patients who applied the lip balm twice daily for 3 months. Methods: We performed a prospective study in which 29 patients with a diagnosis of actinic cheilitis underwent a 3-month trial using a topical DNA repair enzyme lip balm containing T4 endonuclease applied to the lips twice daily. The primary, objective outcome was percent of actinic lip involvement, measured using computer software by dividing the calculated affected surface area by the calculated total surface area. Additional outcomes included pre- and post-intervention determination of an actinic cheilitis score on the Actinic Cheilitis Scale, which visually and tactilely quantifies the percentage of lip involvement, amount of roughness, erythema, and tenderness as well as a physician assessment using the Global Aesthetic Improvement Scale. Results: Twenty-five of the 29 enrolled patients completed the trial. The lip balm significantly decreased the percentage of affected lip surface area (P<0.0001). According to the Actinic Cheilitis Scale, data demonstrate that the lip balm significantly decreased the percentage of lip involvement (P=0.002), amount of roughness (P=0.0012)), erythema (P=0.0020), and tenderness (P=0.0175). The total Actinic Cheilitis Scale score also significantly improved after the 3-month treatment period (P<0.0001). According to the Global Aesthetic Improvement Scale, the average score for all 26 patients was 1.04. Conclusion: This study suggests that topical DNA repair enzyme lip balm containing T4 Endonuclease could potentially be a safe and efficacious way to improve and treat actinic cheilitis. J Drugs Dermatol. 2019;18(6):576-579

Queilite/tratamento farmacológico , Enzimas Reparadoras do DNA/administração & dosagem , Desoxirribonuclease (Dímero de Pirimidina)/administração & dosagem , Proteínas Virais/administração & dosagem , Administração Tópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Queilite/diagnóstico , Esquema de Medicação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
Autops. Case Rep ; 9(2): e2018075, Abr.-Jun. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-994662


Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown etiology that affects the lip. It is characterized histologically by a dense infiltrate of plasma cells with a variety of clinical features. The response to different therapeutic modalities is controversial, especially regarding the effectiveness of corticosteroids. We present a case of a 56-year-old Caucasian man with a painful ulcerated and crusted area in the lower lip, resembling a squamous cell carcinoma or actinic cheilitis. Topical corticosteroid was used for one week, which resulted in partial regression and motivated a biopsy. The histological examination provided the diagnosis of PCC. The patient has been disease-free for six months. We also provide a discussion on the criteria of differential diagnosis and management of this rare condition.

Humanos , Masculino , Pessoa de Meia-Idade , Queilite/diagnóstico , Plasmócitos/patologia , Diagnóstico Diferencial , Doenças Labiais/diagnóstico
Rev. clín. med. fam ; 12(1): 21-23, feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182884


La queilitis exfoliativa se caracteriza por una descamación recurrente del borde labial, con eritema y formación de costras. Aunque la etiología es desconocida, además de la posible intervención de los agentes causantes de queilitis agudas, en la queilitis exfoliativa suelen existir alteraciones psicológicas o situaciones de estrés que parecen favorecerla

Exfoliative cheilitis is characterized by recurrent desquamation of the labial border, with erythema and crusting. Although its etiology is unknown, apart from the possible intervention of the agents that cause acute cheilitis, there are usually psychological disorders or stress situations that seem to contribute to its development

Humanos , Feminino , Adulto Jovem , Queilite/diagnóstico , Doenças Labiais/diagnóstico , Dermatite Esfoliativa/diagnóstico , Macrolídeos/uso terapêutico , Queilite/tratamento farmacológico , Atenção Primária à Saúde/estatística & dados numéricos
Acta Clin Croat ; 57(2): 342-351, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30431729


Although cheilitis as a term describing lip inflammation has been identified and recognized for a long time, until now there have been no clear recommendations for its work-up and classification. The disease may appear as an isolated condition or as part of certain systemic diseases/conditions (such as anemia due to vitamin B12 or iron deficiency) or local infections (e.g., herpes and oral candidiasis). Cheilitis can also be a symptom of a contact reaction to an irritant or allergen, or may be provoked by sun exposure (actinic cheilitis) or drug intake, especially retinoids. Generally, the forms most commonly reported in the literature are angular, contact (allergic and irritant), actinic, glandular, granulomatous, exfoliative and plasma cell cheilitis. However, variable nomenclature is used and subtypes are grouped and named differently. According to our experience and clinical practice, we suggest classification based on primary differences in the duration and etiology of individual groups of cheilitis, as follows: 1) mainly reversible (simplex, angular/infective, contact/eczematous, exfoliative, drug-related); 2) mainly irreversible (actinic, granulomatous, glandular, plasma cell); and 3) cheilitis connected to dermatoses and systemic diseases (lupus, lichen planus, pemphi-gus/pemphigoid group, -angioedema, xerostomia, etc.).

Queilite , Dermatopatias , Alérgenos , Queilite/diagnóstico , Diagnóstico Diferencial , Humanos , Dermatopatias/diagnóstico
Dermatol Ther ; 31(4): e12613, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29687567


Actinic cheilitis (AC) can precede the development of squamous cell carcinoma (SCC) of the lip, a location with higher risk of invasiveness and metastasis. Herein, we reported the use of ingenol mebutate (IngMeb) 0.015% gel on three consecutive days to treat three patients suffering from AC. All the three patients achieved complete clearance of AC with rapid clinical effect, favorable safety profile, good patient's compliance related to short time of applications, and few local skin reactions. So IngMeb is an attractive new therapy for AC. Moreover, the present case report adds further evidence to the usefulness of dermoscopy and Reflectance confocal microscopy (RCM) in the assessment and monitoring of treatment outcome.

Queilite/diagnóstico , Queilite/tratamento farmacológico , Dermoscopia , Diterpenos/administração & dosagem , Lábio/efeitos dos fármacos , Lábio/patologia , Microscopia Confocal/métodos , Administração Tópica , Idoso , Idoso de 80 Anos ou mais , Queilite/patologia , Feminino , Géis , Humanos , Masculino , Valor Preditivo dos Testes , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento
Rev. méd. Minas Gerais ; 28: [1-6], jan.-dez. 2018.
Artigo em Português | LILACS | ID: biblio-970568


A Queilite Actínica (QA) é uma condição clínica que acomete o vermelhão do lábio inferior intimamente relacionada com com exposição excessiva à luz solar. Geralmente acomete o sexo masculino acima de 45 anos. O caso apresenta um paciente gênero masculino, leucoderma, 59 anos, com lesão de atrofia da borda do vermelhão do lábio inferior, superfícies lisas, manchas eritroleucoplásicas, limites nítidos e formato irregular. O diagnóstico clínico foi de Queilite Actínica. A biópsia incisional foi conduzida e apresentou microscopicamente um epitélio estratificado pavimentoso hiperqueratinizado com áreas de acantose, a lâmina própria era fibrosa, exibia infiltrado inflamatório crônico e uma faixa basofílica amorfa e acelular consistente com elastose solar proeminente e um quadro de Displasia Moderada. O tratamento proposto foi a vermelhectomia, mas houve recusa do paciente em realizar esse procedimento. Diante das alterações, percebe-se a importância do cirurgião- dentista na precisão do diagnóstico precoce e tratamento, impedindo a transformação maligna da lesão. (AU)

Actinic cheilitis (AC) is a common clinical condiction which affects the lower lip vermilion closely related to excessive exposure to sunlight. Usually affects males above 45 years. The case features a male patient, leucoderma, 59, edge of atrophic lesion of the lower lip vermilion, smooth surfaces, eritroleucoplásicas spots, clear limits and irregular shape. The clinical diagnosis was Actinic cheilitis. The incisional biopsy was conducted and microscopically presented a stratified epithelium hiperqueratinizado with areas of acanthosis, the lamina propria was fibrous, showed chronic inflammatory infiltrate and basophilic amorphous band and acellular consistent with prominent solar elastosis and Dysplasia Moderate frame. The proposed treatment was vermilionectomy but was patient refusal to perform this procedure. Faced with the changes, we see the importance of dental surgeon on the accuracy of early diagnosis and treatment, preventing malignant transformation of the lesion. (AU)

Humanos , Masculino , Pessoa de Meia-Idade , Lábio , Queimadura Solar , Queilite/diagnóstico , Queilite , Lábio/lesões , Atrofia
Dermatol Online J ; 23(3)2017 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-28329526


Chronic granulomatous disease (CGD) is a primaryimmunodeficiency disorder that affects the phagocyticcells of the innate immune system. It is characterizedby recurrent or persistent infections with granulomaformation. Lupus-like lesions have been reported incarriers of CGD and less frequently, in patients withCGD. Immunological study in these patients areusually negative. We describe the case of an 8-yearoldboy with CGD who developed chronic and acutecutaneous lupus erythematous with angular cheilitis,oral ulcers, Raynaud phenomenon, and positiveserologies for antinuclear, anticentromere, and anti-Saccharomyces cerevisiae antibodies.

Dermatoses Faciais/diagnóstico , Dermatoses do Pé/diagnóstico , Doença Granulomatosa Crônica/imunologia , Lúpus Eritematoso Cutâneo/diagnóstico , Anticorpos Antinucleares/imunologia , Anticorpos Antifúngicos/imunologia , Queilite/complicações , Queilite/diagnóstico , Queilite/imunologia , Criança , Dermatoses Faciais/complicações , Dermatoses Faciais/imunologia , Dermatoses Faciais/patologia , Dermatoses do Pé/complicações , Dermatoses do Pé/imunologia , Dermatoses do Pé/patologia , Doença Granulomatosa Crônica/complicações , Humanos , Lúpus Eritematoso Cutâneo/complicações , Lúpus Eritematoso Cutâneo/imunologia , Lúpus Eritematoso Cutâneo/patologia , Masculino , Úlceras Orais/complicações , Úlceras Orais/diagnóstico , Úlceras Orais/imunologia , Doença de Raynaud/complicações , Doença de Raynaud/diagnóstico , Doença de Raynaud/imunologia , Fatores de Risco , Saccharomyces cerevisiae/imunologia
Clin Dermatol ; 35(5): e1-e14, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29289276


Heath care providers should be comfortable with normal as well as pathologic findings in the lips, because the lips are highly visible and may display clinical manifestations of local, as well as systemic inflammatory, allergic, irritant, and neoplastic alterations. Fortunately, the lips are easily accessible. The evaluation should include a careful history and physical examination, including visual inspection, as well as palpation of the lips and an examination of associated cervical, submandibular, and submental nodes. Pathologic and microscopic studies, as well as a review of medications, allergies, and habits, may further highlight possible etiologies. Many lip conditions, including premalignant changes, are relatively easy to treat, when the abnormalities are detected early; however, advanced disease and malignancies are challenging for both the patient and clinician. Treatment should be focused on eliminating potential irritants or allergens and treatment of the primary dermatosis. In this paper we review physiologic variants as well as pathologic conditions of the lips.

Carcinoma de Células Escamosas/diagnóstico , Doenças Labiais/diagnóstico , Doenças Labiais/terapia , Carcinoma de Células Escamosas/terapia , Queilite/diagnóstico , Queilite/etiologia , Queilite/terapia , Herpes Labial/diagnóstico , Herpes Labial/terapia , Humanos , Doenças Labiais/congênito , Doenças Labiais/etiologia , Lúpus Eritematoso Discoide/complicações , Exame Físico , Transtornos da Pigmentação/complicações , Psoríase/complicações , Síndrome de Sjogren/complicações
Pan Afr Med J ; 24: 176, 2016.
Artigo em Francês | MEDLINE | ID: mdl-27795773


Tuberculosis of the oral cavity is rare. It is associated with clinical polymorphism and poses above all a diagnostic problem. We report the case of a 42-year-old male patient with tubercular cheilitis. This study aims to focus attention on tuberculosis that can be detected exceptionally in specific locations, such as the oral lip.

Queilite/diagnóstico , Tuberculose Bucal/diagnóstico , Tuberculose Pulmonar/diagnóstico , Adulto , Queilite/microbiologia , Humanos , Doenças Labiais/diagnóstico , Doenças Labiais/microbiologia , Masculino , Tuberculose Bucal/complicações , Tuberculose Pulmonar/complicações
Dermatol Online J ; 22(6)2016 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-27617610


Mucosal plasmacytoses constitute a group of idiopathic inflammatory disorders, characterized by a dense infiltrate of plasma cells at the mucocutaneous junction without any recognizable dermatosis or neoplasm. We report an unusual clinical presentation of mucosal plasmacytosis presenting with hemorrhagic crusting of the lips, mimicking erythema multiforme.

Queilite/patologia , Eritema Multiforme/diagnóstico , Gengivite/patologia , Plasmócitos/patologia , Estomatite/patologia , Adulto , Queilite/diagnóstico , Diagnóstico Diferencial , Feminino , Gengivite/diagnóstico , Humanos , Estomatite/diagnóstico
Photodiagnosis Photodyn Ther ; 16: 27-34, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27491855


Actinic cheilitis (AC) is considered a potentially malignant disorder of the lip. Biomolecular markers study is important to understand malignant transformation into squamous cell carcinoma. Fourier transform infra red (FT-IR) spectroscopy was used to analyze AC in this study. OBJECTIVES: The aim of the study was to evaluate if FT-IR spectral regions of nucleic acids and collagen can help in early diagnosis of malignant transformation. METHODS: Tissues biopsies of 14 patients diagnosed with AC and 14 normal tissues were obtained. FT-IR spectra were measured at five different points resulting in 70 spectra of each. Analysis of Principal components analysis (PCA) and linear discrimination analysis (LDA) model were also used. In order to verify the statistical difference in the spectra, Mann-Whitney U test was performed in each variable (wavenumber) with p-value <0.05. RESULTS: After the Mann-Whitney U test the vibrational modes of CO (Collagen 1), PO2 (Nucleic Acids) and CO asymmetric (Triglycerides/Lipids) were observed as a possible spectral biomarker. These bands were chosen because they represent the vibrational modes related to collagen and DNA, which are supposed to be changed in AC samples. Based on the PCA-LDA results, the predictive model corresponding to the area under the curve was 0.91 for the fingerprint region and 0.83 for the high wavenumber region, showing the greater accuracy of the test. CONCLUSIONS: FT-IR changes in collagen and nucleic acids could be used as molecular biomarkers for malignant transformation.

Queilite/diagnóstico , Queilite/metabolismo , Colágeno/análise , Diagnóstico por Computador/métodos , Ácidos Nucleicos/análise , Espectrofotometria Infravermelho/métodos , Adulto , Biomarcadores/análise , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
Med. oral patol. oral cir. bucal (Internet) ; 21(1): e53-e58, ene. 2016. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-149425


Background: Actinic prurigo (AP) is an idiopathic photodermatosis, this entity requires exposure to UV-B and -A to develop lesions. Apoptosis is a physiological death program that can be initiated by a permanently active mechanism (extrinsic pathway) or irreparable damage (intrinsic pathway). Material and methods: Descriptive study, the sample size comprised 64 paraffin blocks of tissue with a diagnosis of AP. In H&E-stained slides, the diagnosis of AP was corroborated, and 1-µm-thick sections were processed for immunohistochemistry (IHC). A database was constructed with SPSS version 20, Inc., Chicago, IL, USA, and descriptive statistics were analyzed by X2 test and comparison of means. Results: A total of 64 cases were processed, of which 40 (62.5%) were cheilitis AP and 24 (37.5%) were AP in the skin. Of the 40 cheilitis samples, 27 were positive for Bcl-2 and caspase 3 (67.5%), p53 was expressed in 30 (75%). Of the skin lesions, p53 and caspase 3 were expressed in 18 of 24 cases (75%), and 13 were positive for Bcl-2 (54%). Conclusions: We propose that apoptosis is the last step in the type IV subtype a-b hypersensitivity responseactivation of the intrinsic pathway indicates that external factors, such as UV-A and -B are the trigger (AU)

No disponible

Humanos , Apoptose/fisiologia , Prurigo/etiologia , Ceratose Actínica/diagnóstico , Queilite/diagnóstico , Diagnóstico Diferencial , Raios Ultravioleta/efeitos adversos
Int J Dermatol ; 55(1): 11-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26452783


A caliber-persistent labial artery (CPLA) is an incipient arterial branch that penetrates near the submucosal tissue of the lip without dividing or reducing in diameter and often appears as a palpable lesion on the lip. It occurs at an incidence of approximately 3%. This study investigated the causes of swelling of the lips, focusing on CPLA, and reviewed the literature for past cases in order to inform the treatment of a 32-year-old man presenting with an asymptomatic, solitary, elevated lesion on the vermilion of the upper lip of seven months duration. Biopsy resulted in abundant bleeding. Histopathology showed fragments of connective tissue composed of spindle-shaped cells, fibroblasts, collagen fibers and sections of small blood vessels with lymphocytic infiltration of chronic inflammatory cells around the small vessels. A thick-walled section reminiscent of a major artery was apparent. In view of the size of the lesion and concern over the functional and esthetic impairment that might result from surgery, the patient was treated with triamcinolone (40 mg/ml) injected at low pressure into the lesion, which caused the formation of deposits of colloidal particles within the lesion. The procedure was repeated twice at 2-week intervals. Subsequently, the lesion was found to have completely regressed. The favorable therapeutic results achieved, and the findings of the present review, support the intralesional injection of triamcinolone as a first-line conservative treatment in CPLA rather than a surgical approach that can result in inordinate hemorrhaging.

Artérias/anormalidades , Queilite/diagnóstico , Lábio/irrigação sanguínea , Triancinolona/administração & dosagem , Malformações Vasculares/patologia , Adulto , Biópsia por Agulha , Queilite/etiologia , Seguimentos , Glucocorticoides/administração & dosagem , Humanos , Imuno-Histoquímica , Injeções Intralesionais , Lábio/efeitos dos fármacos , Masculino , Índice de Gravidade de Doença , Resultado do Tratamento , Malformações Vasculares/complicações
Presse Med ; 45(2): 240-50, 2016 Feb.
Artigo em Francês | MEDLINE | ID: mdl-26681528


The whole examination of oral cavity, other mucosae and skin is required when managing a cheilitis. Irritants (climatic, mechanical, caustic agents...) constitute the main aetiological factors of cheilitis. Allergic contact cheilitis should be investigated with a detailed anamnesis in order to search any causative agent in contact with the oral mucosae. Patch testing is required to confirm the diagnosis of delayed hypersensivity. Chronic actinic cheilitis occurs mostly in middle-aged, fair-skinned men. It is a potentially malignant condition that requires biopsies to exclude severe dysplasia or carcinoma. Angular cheilitis can occur spontaneously but is frequently related with several precipitating factors, such as systemic immune suppression, local irritation and moisture, fungal and/or bacterial infection. Cheilitis can also be seen in various systemic conditions such as lichen planus, lupus, atopic dermatitis and nutritional deficiencies. Erosive and crusty cheilitis and bullous erosive stomatitis are the main oral features of erythema multiforme and Stevens-Johnson syndrome. Granulomatous macrocheilitis (cheilitis granulomatosa) presents with intermittent or permanent lip swelling. It should be confirmed by a biopsy. It can be either isolated (Miescher macrocheilitis) or associated with various systemic conditions.

Queilite/diagnóstico , Queilite/terapia , Queilite/etiologia , Humanos
An. sist. sanit. Navar ; 38(3): 409-416, sept.-dic. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-147334


Fundamento: El eccema labial es un problema poco frecuente en las Unidades de Eccema de Contacto (UEC). Hasta el momento han sido publicadas escasas series que muestren el perfil de estos pacientes y las causas de su eccema, ninguna de ellas española. El objetivo de este estudio fue el de analizar el perfil epidemiológico de los pacientes que acuden a la UEC en nuestro entorno, los diagnósticos principales y los alérgenos relevantes. Material y métodos: Se realizó una revisión retrospectiva de los pacientes remitidos a la UEC en el periodo 2005-2014. Se realizaron pruebas epicutáneas con la serie estándar ampliada del Grupo Español de Investigación en Dermatitis Alérgica de contacto (GEIDAC), productos propios y otras baterías complementarias. Resultados: En los 78 pacientes estudiados, los diagnósticos más frecuentes fueron la dermatitis de contacto alérgica y la dermatitis atópica. Los alérgenos relevantes más frecuentes fueron los cosméticos y los fármacos tópicos. Conclusiones: Es fundamental estudiar a los pacientes con eccema labial con pruebas epicutáneas para poder filiar correctamente su etiología y según esto, realizar un tratamiento más adecuado (AU)

Background: Lip eczema is an infrequent problem in Contact Dermatitis Units (CDU). Very few series have been published to date that show the profiles of such patients and the causes of their eczemas, and none are Spanish. The goal of this study was to analyze the epidemiological profile of the patients who attend a CDU in our setting, the main diagnoses and the relevant allergens. Methods: A retrospective review was made of the patients referred to the CDU in the 2005-2014 period. Patch tests were carried out with the extended standard series of the Spanish Research Group on Allergic Contact Dermatitis (Grupo Español de Investigación en Dermatitis Alérgica de contacto - GEIDAC), our own products and other complementary sets. Results: The most frequent diagnoses in the 78 patients studied were allergic contact dermatitis and atopic dermatitis. The most frequent relevant allergens were cosmetics and topical medications. Conclusions: It is essential to study the patients with lip eczema with patch tests to be able to correctly determine their etiology and accordingly to carry out the most suitable treatment (AU)

Humanos , Masculino , Feminino , Dermatite Atópica/complicações , Dermatite Atópica/patologia , Testes do Emplastro/enfermagem , Dermatite Alérgica de Contato/genética , Hipersensibilidade/sangue , Cosméticos/toxicidade , Queilite/patologia , Dermatite Atópica/genética , Testes do Emplastro/métodos , Testes do Emplastro/normas , Dermatite Alérgica de Contato/classificação , Dermatite Alérgica de Contato/complicações , Hipersensibilidade/metabolismo , Cosméticos/síntese química , Preparações Farmacêuticas/metabolismo , Queilite/complicações , Queilite/diagnóstico