Cases reported "Facial Dermatoses"

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1/11. Recalcitrant acne vulgaris secondary to a dental abscess.

    This case report describes a middle-aged man with acne that was recalcitrant to numerous medications, including three courses of isotretinoin. His condition cleared after an infected tooth was removed and recurred when another tooth became carious. acne vulgaris is associated with several immunologic responses including the production of antibodies against propionibacterium acnes, the gram-positive bacteria found in acne lesions. We believe that the presence of our patient's dental infections provoked a follicular inflammatory response resulting in his recalcitrant acne.
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2/11. A cautionary tale. Case report.

    A healthy 26 year old female underwent unsuccessful surgery for an incorrectly diagnosed sebaceous cyst in the cheek. Eventually the problem was traced to a non-vital tooth 24. When the tooth was treated endodontically, the situation resolved in one week.
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3/11. Hypohydrotic ectodermal dysplasia: an unusual presentation and management in an 11-year-old Xhosa boy.

    ectodermal dysplasia (ED) is an inherited disorder in which two or more ectodermally derived structures fail to develop, or are abnormal in development. Hypohydrotic ectodermal dysplasia (HED) or Christ-Siemens-Touraine syndrome, is an X-linked recessive syndrome with an incidence of 1/10,000 to 1/100,000 births. Because of its X-linked inheritance pattern, it is more common in males. HED is characterised by hypohydrosis (diminished perspiration), hypotrichosis (decreased amount of hair) and microdontia (small teeth), hypodontia (lack of development of one or more teeth) or adontia (total lack of tooth development). These patients present diagnostic and treatment challenges because of variable oral manifestations. This report describes an 11-year-old Xhosa boy, who was referred to the University Dental faculty by his general medical practitioner because of hypodontia. General facial features included: frontal bossing, a depressed nasal bridge, 'butterfly' pattern of eczema over the nasal bridge to the malar process of each cheek, thinned out hair, loss of vertical dimension of face and dry skin. Intra-oral examination revealed hypodontia with peg-shaped anterior teeth and diastemas. Radiological examination revealed no developing permanent teeth or tooth buds. diagnosis was confirmed by doing a sweat gland count. Management included oral hygiene instruction, fluoride treatments, construction of a partial lower denture and counselling about his condition with particular reference to the danger of hyperthermia and control of allergies.
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4/11. Oral factitious injuries.

    The subject of oral factitious injuries is reviewed and four cases are reported. It is noted that self-inflicted oral injuries are not limited to the soft tissue but may result in destruction of bone and tooth structure. While children are more often the subjects of self-injurious behavior about the oral cavity, adults may also exhibit similar conduct. Emotional problems are often co-existent with self-inflicted oral injuries, however, in some cases there does not seem to be a readily descernible emotional disturbance. Since factitious injuries often pose diagnostic problems for the dentist, some diagnostic suggestions are included.
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5/11. Facial cellulitis arising from dens evaginatus: a case report.

    Dens evaginatus is a developmental anomaly that produces a tubercle on the occlusal surface of a tooth. It is found most frequently in the mandibular premolars. The occlusal tubercle easily causes occlusal interferences. Attrition or fracture of the tubercle can lead to pulpitis, pulp necrosis, periapical pathosis, and periapical infection. This case report illustrates the treatment of facial cellulitis arising from dens evaginatus with open apex. calcium hydroxide was used for the apexification procedure. One year after canal obturation, radiography revealed no apical pathosis and the apical seal was evident.
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6/11. Spontaneous tooth exfoliation, maxillary osteomyelitis and facial scarring following trigeminal herpes zoster infection.

    A case of trigeminal herpes zoster (HZ) infection affecting the left maxillary and ophthalmic divisions of the fifth cranial nerve in an immuno-competent patient is presented. Extremely rare complications such as osteonecrosis, spontaneous tooth exfoliation, secondary osteomyelitis and facial scarring were observed. Sequestrectomy, aciclovir and erythromycin stearate were effectively used in managing the case.
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7/11. herpes zoster in hiv infection with osteonecrosis of the jaw and tooth exfoliation.

    BACKGROUND: herpes zoster (HZ) infection of the trigeminal nerve is associated with complications such as postherpetic neuralgia, facial scarring, loss of hearing ability and conjunctivitis. Until 2005, postherpetic alveolar necrosis and spontaneous tooth exfoliation have been described in 20 cases unrelated to hiv infection. OBJECTIVE: The aim of this study was to describe hiv infection in patients (two women, two men, average age 30 years) who suffered from HZ attacks to their trigeminal nerves. MAIN OUTCOME MEASURES: None of the patients had received antiherpetic medications or antiretroviral therapy. hiv infection was only diagnosed after the development of HZ. Facial scarring with depigmentation and hyperesthesia (postherpetic neuralgia) was diagnosed in all four patients. Oral findings consisted of spontaneous loss of both maxillary or mandibular teeth. osteonecrosis of varying extent was also found. Treatment consisted of extractions of teeth and administration of antibiotics and analgesics. Healing of alveolar wounds was unremarkable. CONCLUSION: Complications affecting the alveolar bone and teeth seem to be rare in hiv-infected patients.
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8/11. Painful, ulcerated lesions of the palate and facial skin.

    herpes zoster is an acute viral infection that principally affects the skin. It occasionally may involve the oral region with patients sometimes initially complaining of toothache. Generalized skin involvement by the disease should alert the clinician to the possibility of an underlying malignancy. dentists should also be aware that the disease is infectious and can be transmitted, especially to susceptible individuals.
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9/11. Contact urticaria from synthetic cassia oil and sorbic acid limited to the face.

    A patient with contact urticaria with skin and respiratory symptoms was found to be sensitive to both sorbic acid and synthetic oil of cassia. The contact urticaria was only elicitable on intact skin of the face by open testing. The source of the patient's contactants was her shampoo and toothpaste.
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10/11. Perioral leukoderma simulating vitiligo from use of a toothpaste containing cinnamic aldehyde.

    Perioral leukoderma simulating vitiligo developed in a 25-year-old woman. A patch test to cinnamic aldehyde was positive; depigmentation was observed at the patch test site three months after initial application. No changes in pigmentation occurred from a concomitant allergic patch test reaction to neomycin sulfate; only hyperpigmentation occurred at the site of an irritant patch test reaction to nonanoic acid. A toothpaste containing cinnamic aldehyde was implicated; perioral hypopigmentation resolved when a toothpaste without cinnamic aldehyde was substituted. A repeated patch test to cinnamic aldehyde again showed depigmentation at the patch test site three months after application.
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