Cases reported "Oral Ulcer"

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1/4. Oral paracoccidioidomycosis or squamous cell carcinoma?

    paracoccidioidomycosis is a deep, systemic, and progressive mycosis caused by paracoccidioides brasiliensis. Oral lesions normally are multiples with a mulberry-like appearance. This article reviews an unusual case involving a chronic, solitary, and ulcerated lesion whose clinical aspects were similar to squamous cell carcinoma. Viewed microscopically, the lesion showed pseudoepitheliomatous hyperplasia and non-necrotizing granulomas. The patient was treated with systemic ketoconazole. Over the next 11 years, follow-up examinations were performed but no recurrence was observed.
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keywords = necrotizing
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2/4. hiv/TB co-infection: literature review and report of multiple tuberculosis oral ulcers.

    Human immunodeficiency virus/tuberculosis (hiv/TB) co-infected subjects demonstrate enhanced hiv replication and plasma viremia; CD4 T-cell depletion; morbidity and mortality; and susceptibility to secondary bacterial and fungal infections compared to subjects solely infected with hiv. As the incidence of hiv/TB infection has been increasing, one would have expected to encounter oral lesions of tuberculosis more frequently. However, such oral lesions are uncommon. The lesions usually occur as ulcerations of the tongue. We report an additional case in an hiv/TB co-infected 39 year-old black male, who presented with chronic, painless, multiple oral ulcers, occurring simultaneously on the tongue, bilaterally on the palate and mucosa of the alveolar ridge. Microscopic examination confirmed the presence of chronic necrotizing granulomatous inflammation, with the identification of acid fast bacilli in the affected oral mucosal tissue. Anti-retroviral and anti-tuberculous treatment resulted in the resolution of the oral lesions. Confirmatory histopathological diagnosis following a biopsy is essential to determine the exact nature of chronic oral ulceration in an hiv individual and especially to distinguish between oral squamous cell carcimoma, lymphoma, infection (bacterial or fungal) and non-specific or aphthous type ulceration.
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keywords = necrotizing
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3/4. Complex oral manifestations of an hiv-seropositive patient.

    A complex manifestation of characteristic oral lesions occurring simultaneously in an hiv-seropositive patient is presented. Necrotizing ulcerative gingivitis (NUG), necrotizing ulcerative periodontitis (NUP), oral-facial herpes infection, pseudomembranous candidiasis and atypical oral ulceration are discussed. In spite of extremely low CD4 T-cell counts of 3 x 10(6)/L and lack of anti-retroviral therapy, an AIDS patient responded favourably to standard periodontal therapy. In the follow-up period of 3 months, no recurrence of any of the oral lesions initially present occurred and no special prophylactic regimes were needed to maintain oral health. This case illustrates that appropriate management of the oral manifestations contributes significantly to improvement of the quality of life of patients in the terminal stage of hiv-AIDS.
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keywords = necrotizing
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4/4. Oral tuberculosis following autologous bone marrow transplantation for Hodgkin's disease with interleukin-2 and alpha-interferon immunotherapy.

    A patient with Hodgkin's disease (HD) underwent autologous bone marrow transplantation (ABMT). Six months later while receiving interleukin (IL)-2 and alpha-interferon immunotherapy, he developed a painful lesion in his oral cavity with a fistula in the buccal area. Excision biopsy disclosed necrotizing granulomatous inflammation with acid-fast bacillus. The patient received a 9-month course of isoniazide, rifampin and pyrazinamide, and recovered. The possible pathophysiological mechanism is discussed.
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ranking = 1
keywords = necrotizing
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