1/16. Infected lung bulla with elevated cancer antigen 125 both in serum and aspirated fluid.A 78-year-old man was admitted to the hospital for treatment of an infected lung bulla. Cancer antigen 125 (CA125) was elevated in both his serum and fluid aspirated from the bulla. Concomitant resolution of the high serum CA125 level and the bullous fluid was observed after combination treatment of antibiotics and percutaneous fluid drainage, suggesting the appearance of CA125 in response to a localized inflammatory reaction in the bullous cavity.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/16. esophageal stenosis in childhood: dystrophic epidermolysis bullosa without skin blistering due to collagen VII mutations.We report a 9-year-old girl who experienced recurrent dysphagia since infancy. Crohn's disease was suspected because she had aphthous ulcers of the mouth and anal dermatitis with hematochezia. After bougienages of esophageal stenoses and medication for inflammatory bowel disease proved unsuccessful, interdisciplinary re-examination revealed the cause of the symptoms to be an extracutaneous form of dystrophic epidermolysis bullosa, a genetic skin fragility disorder. Dystrophic epidermolysis bullosa is caused by mutations in the COL7A1 gene encoding collagen VII, a protein of the epidermal attachment complex, and typically manifests with trauma-induced skin blistering, scarring, nail dystrophy, and, in some cases, mucosal involvement. The present proband never developed skin blisters but had nail dystrophy and erosions of the oral, esophageal, and genitoanal mucosa, which healed with slight scarring. mutation analysis disclosed compound heterozygosity for recessive mutations in the COL7A1 gene. The paternal mutation 425 A-->G caused abnormal splicing resulting in a premature stop codon. The maternal mutation G2775S led to the substitution of a glycine by a serine in the triple helical domain of collagen VII. This case shows that mucosal disease and esophageal strictures in childhood are not always acquired, but can also represent a genetic defect of dermal-epidermal adhesion, even in the absence of skin blistering.- - - - - - - - - - ranking = 1.6199681650257keywords = mouth (Clic here for more details about this article) |
3/16. Childhood bullous pemphigoid: a clinicopathologic study and review of the literature.Bullous pemphigoid (BP) is an acquired bullous disorder that predominantly affects the elderly. It is rare in children but when it occurs, there is considerable clinical and histologic overlap with other acquired or congenital blistering disorders. A definitive diagnosis of childhood BP requires direct immunofluorescence and, in some cases, characterization of the target antigen. Three cases of childhood BP are presented, with their histologic and immunofluorescence findings. The first was a 5-month-old male infant who presented with erythema and bullae of the palms and soles and was found to have linear deposition of IgG and C3 along the dermoepidermal junction on direct immunofluorescence (DIF). Histopathologic examination revealed a subepidermal blister containing eosinophils. Type IV collagen was demonstrated along the floor of the blister cavity by a direct immunoperoxidase technique. The second case was an 8-month-old female infant who presented with a blistering eruption of her palms and soles that then became widespread. Direct immunofluorescence showed linear IgG and C3 at the dermoepidermal junction, with laminin deposition at the base of the blister. The third case was a 7-year-old female with bullae and erosions on the vulva and vaginal mucosa. A subepidermal blister was seen on microscopic examination whereas immunofluorescence demonstrated linear IgG and C3 deposition at the basement membrane zone (BMZ). A literature review uncovered 50 cases of childhood BP confirmed by direct or indirect immunofluorescence, or both, and often with evidence of autoantibodies against either the 180 kD or the 230 kD human bullous pemphigoid antigens (BP180 or BP230). This review was used to delineate characteristics of childhood BP, including the newly proposed subtypes: infantile BP and childhood localized vulval BP. Infantile BP presents within the first year of life and is characterized by BP-like lesions on erythematous or normal acral skin. Localized vulval BP is a self-limited, nonscarring BP-like process that involves only the vulva. Both subtypes are normally self-limited and respond well to either topical or systemic steroids, if treatment is initiated before the disease becomes widespread.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/16. mucous membrane pemphigoid: nasal and laryngeal manifestations.mucous membrane pemphigoid (MMP) is a sub-epithelial blistering disease that primarily involves mucosal surfaces but may also involve the skin. Clinically, it appears as vesiculobullous lesions of the oral cavity and eyes, but other tissues such as the nasopharyngeal and laryngeal mucosa can also be affected. Ultimately, scarring and airway stenosis may occur. The condition should be managed by a multidisciplinary team led by a dermatologist. Immunosuppressive therapy forms the mainstay of treatment, with surgery having both a diagnostic role and a use in the treatment of complications such as airway obstruction. There must be a low threshold of suspicion for laryngeal involvement in this group of patients, so that prompt action can be taken. Once laryngeal stenosis has occurred repeated endoscopic laser excision of scar tissue can be used to maintain an adequate airway. Adjuvant use of mitomycin-C can be used beneficially in the treatment of laryngeal complications of MMP.- - - - - - - - - - ranking = 23.735407861496keywords = oral cavity, cavity (Clic here for more details about this article) |
5/16. Rapid-growth lung cancer associated with a pulmonary giant bulla: a case report.A giant bulla of the lung is suggested as a risk factor for lung cancer. Here we report a case with lung cancer in a giant bulla, which showed rapid progression. A 57-year-old man, who had a history of heavy smoking, was admitted to our hospital due to hemoptysis. A chest X-ray revealed a giant bulla with a ground glass shadow and a high fluid level in the right upper lung. sputum cytology was negative for malignant cells. A chest X-ray a month later showed increases of the size of the radio-opaque shadow and of the air-fluid retention, suggesting pulmonary hemorrhage from the giant bulla. Limited resection or lobectomy was indicated, but pneumonectomy was performed due to the severe air-leak. Macroscopically, a multiple nodular tumor arose from the bulla wall, which might be related to blood flow and necrotic tissue. The postoperative pathological diagnosis was papillary adenocarcinoma. Unfortunately, the patient developed a recurrence of carcinoma in the pleuroperitoneal cavity and died at 2.5 months after the operation. Based on this report and review of other cases in the literature, we should keep in mind the rapid progression of lung cancer in association with an emphysematous bulla.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
6/16. Angina bullosa haemorrhagica: a case report and a concise review.Various differential diagnoses pertaining to angina bullosa haemorrhagica (ABH) have been reported in the dental literature; these differential diagnoses include mucous membrane pemphigoid, bullous pemphigoid, bullous lichen planus, epidermolysis bullosa, dermatitis herpetiformis, linear IgA disease, and oral amyloidosis. ABH is characterized by a solitary blood blister in the palate and may worsen progressively, leading to multiple lesions in other areas. The bullae usually rupture spontaneously and the sites heal uneventfully. Possible etiological factors include trauma, long-term use of steroids, diabetes, and hereditary predilection. Pathological studies have yielded nonspecific findings and the underlying etiopathology remains ill-defined. This article describes a case of ABH following the use of a 0.12% chlorhexidine gluconate mouthrinse and presents a concise review of the literature pertaining to ABH and differential diagnoses.- - - - - - - - - - ranking = 1.6199681650257keywords = mouth (Clic here for more details about this article) |
7/16. Assessing phytophotodermatitis: boy with erythema and blisters on both hands.Phytophotodermatitis (PPD) is a phototoxic reaction which occurs when the skin comes in contact with a photosensitizer and is subsequently exposed to radiation. PPD is often seen in people handling furocoumarin-containing products, such as agricultural workers, bartenders, florists, and gardeners. It may also be seen in beachgoers, athletes, and children. The pattern of the lesions usually resembles streaks; the hands and mouth are most commonly affected due to eating and handling of the offending furocoumarin-containing agents.- - - - - - - - - - ranking = 1.6199681650257keywords = mouth (Clic here for more details about this article) |
8/16. Bullous amyloidosis of the oral cavity: a rare clinical presentation and review.Bullous amyloidosis (BA) is a rare cutaneous manifestation primarily of systemic amyloidosis, a disease in which abnormal proteinaceous material is formed and deposited in response to inflammatory conditions and plasma cell dyscrasias. Hemorrhagic bullae indicative of BA are usually associated with purpura and may be the initial clinical signs of systemic amyloidosis or monoclonal gammopathies, such as multiple myeloma and Waldenstrom's macroglobulinemia. Bullous amyloidosis of the oral cavity is highly uncommon and can mimic other vesiculobullous lesions of the oral mucosa. This article highlights an unusual case of oral BA and reviews important aspects of the disease.- - - - - - - - - - ranking = 118.67703930748keywords = oral cavity, cavity (Clic here for more details about this article) |
9/16. Angina bullosa haemorrhagica--a possible relation to steroid inhalers.Angina bullosa haemorrhagica (ABH) is a recently recognized condition, characterized by benign subepithelial blood-filled blisters in the mouth. The history is characteristic and distinction from other causes of oral blistering can be made by simple clinical signs or on histological grounds. This condition does not appear in standard dermatology texts, yet patients with ABH usually present to a dermatology clinic. A case with typical history is reported in an asthmatic patient who very regularly used a steroid inhaler. The possible aetiological role of such steroid-based inhalers is discussed.- - - - - - - - - - ranking = 1.6199681650257keywords = mouth (Clic here for more details about this article) |
10/16. Oral non-dystrophic bullous eruption mainly limited to the gingivae: a mechano bullous response. A variant of cicatricial mucous membrane pemphigoid?Fourteen patients with recurrent blistering entirely restricted to the mouth have been observed for up to 7 years. Their average age was 52 years, and there was a predilection for females (ratio 2-5:1). patients presented with thick-roofed blisters and denuded, red, boggy areas of mucosa. The area of maximal involvement with the labial gingiva, and whilst the blisters would arise spontaneously, mechanical trauma was the obvious provocative factor in all patients. Gentle friction on normal looking mucosa would produce a bulla which became blood filled. re-epithelialization usually occurred within 1-3 weeks, with no scarring. Biopsies showed subepithelial bullae, and direct immunofluorescence was positive in the basement membrane zone of 2 of the 5 cases examined. The most striking feature was the extreme fragility of the epithelial attachment to the underlying corium, as shown by a useful clinical test with a probe. In 10 patients, the condition gradually remitted and the probe test became difficult to perform. The term acquired oral non-dystrophic epidermolysis bullosa was considered for the diagnosis, although a forme fruste of cicatricial mucous membrane pemphigoid remained an alternative.- - - - - - - - - - ranking = 1.6199681650257keywords = mouth (Clic here for more details about this article) |
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