| A 14-year-old adolescent girl presented with a 2-year history of an exquisitely tender, vegetating cheilitis. Because of this, she was unable to drink fluids and was repeatedly hospitalized for dehydration and pain management. lip and skin biopsies, as well as multiple laboratory studies did not support a definitive diagnosis. After 2 years, a diagnosis of factitial cheilitis was finally established. ( info) |
2/102. Histopathology and electron and immunofluorescence microscopy of gingivitis granulomatosa associated with glossitis and cheilitis in a case of Anderson-fabry disease. A 17-year-old white boy with signs, symptoms, and family history of angiokeratoma corporis diffusum universale, Anderson-fabry disease (AFD), developed recurrent and then persistent swelling of both lips, erythematous hyperplastic gingivae, and a pebbled tongue. Positive blood findings were raised serum IgE, decreased T-cell level, and increased B-cell level. Histopathology of the gingiva showed noncaseating granulomas with multinucleate giant cells containing Schaumann bodies and large plasma-cell infiltrates in which immunofluorescence demonstrated immune globulins of several classes. Electron microscopy and histochemistry demonstrated ceramide in the vasculature. No glycolipid was found in the macrophages or giant cells of the granulomas which, in contrast, resembled sarcoid reactions. plasma cells with Russell bodies and immune reaction-induced degranulation of mast cells were also identified. The pathogenesis of the oral findings possibly relates to altered immune reactivity associated with damage to the microvasculature analogous to that in melkersson-rosenthal syndrome. ( info) |
| melkersson-rosenthal syndrome is classically described as a triad of orofacial swelling, facial palsy, and fissured tongue. More often this syndrome presents in its oligosymptomatic forms. melkersson-rosenthal syndrome may not be as rare as suspected but rather a syndrome that often goes undiagnosed. Presented is the case of a mentally challenged man who was eventually diagnosed with melkersson-rosenthal syndrome only after being misdiagnosed and incorrectly treated for an odontogenic infection for more than a decade. ( info) |
4/102. Allergic contact cheilitis due to effervescent dental cleanser: combined responsibilities of the allergen persulfate and prosthesis porosity. A 55-year-old man with a dental prosthesis for 3 years had had a chronic relapsing cheilitis for more than 1 year. He was patch tested with the European standard series, his own topicals, and the dental cleanser at 10% pet. A relevant positive reaction was found to the cleansing agent, which contained 20% potassium persulfate. The breakdown of the test confirmed sensitivity to this agent and to ammonium persulfate, both positive ( ) at 2.5% pet. The patient was free of symptoms after he had avoided the cleanser. Subsequent chemical investigations performed with a fragment of a used dental prosthesis revealed strong adsorption of persulfate, both on the resin and on the dental tartar. Cleansing agents, adsorbed on tartar and porous resins of worn dental prostheses, should be considered as potential sensitizers and consequently patch tested on such patients with chronic cheilitis. ( info) |
| An oligosymptomatic manifestation of the melkersson-rosenthal syndrome is described. The importance of serial sections of the tissue specimen is emphasized. Satisfactory postoperative results are obtained. ( info) |
6/102. Complete dentures and the associated soft tissues. Some of the conditions of the soft tissues related to complete dentures encountered during a period of 25 years at a university clinic were presented and discussed from the standpoint of the clinical prosthodontist. During this time, over 1,000 denture patients were treated each year. For some conditions, a method of management was offered with treatment by sound prosthodontic principles rather than unneccessary medication. That denture fabrication involves much more than mere mechanical procedures is an understatement. Complete dentures are foreign objects in the oral cavity that are accepted and tolerated by the tissue to a degree that is surprising. As prosthodontists, we can gain satisfaction from the realization that the incidence of oral cancer due to dentures is less than extremely low. At the same time, we must be ever mindful of the statement by Sheppard and associates. "Complete dentures are not the innocuous devices we often think they are." Every dentist must remember that one of his greatest missions is to serve as a detection agency for cancer. The information discussed indicates (1) the need for careful examination of the mouth, (2) the value of a rest period of 8 hours every day for the supporting tissues, and (3) the importance of regular recall visits for denture patients. Robinson stated that while the dental laboratory technician can be trained to aid the dentist in the fabrication of prosthetic devices, his lack of knowledge of reactions and diseases of the oral tissues limits him to an auxiliary role. Complete prosthodontics is a highly specialized health service that greatly affects the health, welfare, and well-being of the patient. It can be rendered only by the true professional who is educated in the biomedical sciences. ( info) |
| Actinic prurigo is a separate entity from the polymorphous light eruption that affects American Indians. It has been reported mainly from North and south america, with only few reported cases from Britain or asia. We report a case of actinic prurigo in a Thai girl who showed cheilitis and pruritic papules on exposed areas for three years. We were able to induce populovesicular lesions by three consecutive irradiations with 100 J/cm2 UVA and 2 minimal erythematous dose of UVB. However, three weeks after irradiation, a prurigo papule developed at the UVB irradiated site. ( info) |
| In porphyria cutanea tarda, the most common type of porphyria, blisters of the skin occur because of high sensitivity to sunlight. This case report describes porphyria cutanea tarda of the lower lip mimicking an actinic cheilitis in a 62-year-old man with a history of Hodgkin's lymphoma. ( info) |
9/102. Chronic fissural cheilitis: a manifestation of anterior crowding. A 48-year-old man, otherwise in good health, was seen with a chronic painful fissure of the upper lip mucosa. For at least 2 years it had failed to respond to a variety of topical agents. Though not previously reported, the primary etiologic factor was thought to be irritation from contact with his misaligned anterior teeth. Eight months into orthodontic treatment, the lesion healed and did not return. orthodontics included preadusted edgewise mechanics. However, the right maxillary lateral incisor was not bracketed but instead guided into position by direct contact with the archwire. ( info) |
10/102. cheilitis caused by contact urticaria to mint flavoured toothpaste. A 26-year-old woman presented with a 12-month history of persistent dermatitis of the lips. She had failed to respond to cosmetic avoidance and therapeutic measures. Patch testing was negative, including her toothpaste and toothpaste flavours. She defied diagnosis until an acute flare followed immediately after dental treatment with a mint flavoured tooth cleaning powder. This led us to prick test her to mint leaves and this was positive. Her cheilitis settled after changing from her mint-flavoured toothpaste. A diagnosis of contact urticaria should be considered in cases of cheilitis of unknown cause. ( info) |