-
The Journal of International Medical... Dec 2023The aetiology of oral mucosal diseases, such as recurrent aphthous ulcer (RAU), oral lichen planus (OLP) and burning mouth syndrome (BMS), involves many factors, and it... (Review)
Review
The aetiology of oral mucosal diseases, such as recurrent aphthous ulcer (RAU), oral lichen planus (OLP) and burning mouth syndrome (BMS), involves many factors, and it remains difficult for clinicians to effectively relieve disease symptoms and formulate coping strategies. With the rapid development of psychology, the role of mental and psychological factors in RAU, OLP and BMS has gradually attracted researchers attention, but the specific mechanism has not been completely determined. This narrative review describes the potential neurobiological mechanism of oral mucosal diseases and detailed psychological factors after introducing relevant research into psychological factors and oral mucosal diseases. Future research strategies and innovations needed to understand and treat oral mucosal diseases and psychological factors, as well as how to prevent oral mucosal diseases by regulation of the neuroendocrine system, are also discussed.
Topics: Humans; Mouth Diseases; Stomatitis, Aphthous; Lichen Planus, Oral; Burning Mouth Syndrome
PubMed: 38150546
DOI: 10.1177/03000605231218619 -
Therapie 2024Cutaneous adverse drug reactions (ADRs) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality....
Cutaneous adverse drug reactions (ADRs) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Maculopapular exanthema and urticaria are the most common types of cutaneous ADR. Serious cutaneous ADRs, which may cause permanent sequelae or have fatal outcome, may represent 2% of all cutaneous ADR and must be quickly identified to guide their management. These serious reactions include bullous manifestations (epidermal necrolysis i.e. Stevens-Johnson syndrome and toxic epidermal necrolysis), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP). Some risk factors for developing cutaneous ADRs have been identified, including immunosuppression, autoimmunity or genetic variants. All drugs can cause cutaneous ADRs, the most commonly implicated being antibiotics (especially aminopenicillins and sulfonamides), anticonvulsants, allopurinol, antineoplastic drugs, non-steroidal anti-inflammatory drugs and iodinated contrast media. Pathophysiology is related to immediate or delayed "idiosyncratic" immunologic mechanisms, i.e., usually not related to dose, and pharmacologic/toxic mechanisms, commonly dose-dependent and/or time-dependent. If an immuno-allergic mechanism is suspected, allergological explorations (including epicutaneous patch testing and/or intradermal test) are often possible to clarify drug causality, however these have a variable sensitivity according to the drug and to the ADR type. No in vivo or in vitro test can consistently confirm the drug causality. To determine the origin of a rash, a logical approach based on clinical characteristics, chronologic factors and elimination of differential diagnosis (especially infectious etiologies) is required, completed with a literature search. Reporting to pharmacovigilance system is therefore essential both to analyze drug causality at individual level, and to contribute to knowledge of the drug at population level, especially for serious cutaneous ADRs or in cases involving newly marketed drugs.
Topics: Humans; Skin; Stevens-Johnson Syndrome; Anti-Bacterial Agents; Acute Generalized Exanthematous Pustulosis; Anti-Inflammatory Agents, Non-Steroidal
PubMed: 37980248
DOI: 10.1016/j.therap.2023.09.011 -
Clinical Oral Investigations Nov 2023This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS).
MATERIALS AND METHODS
We included and evaluated studies on H. pylori infection and RAS from PubMed, EMBASE, Cochrane Library, and Web of Science databases published up to January 31, 2023. The characteristics of these studies were collected, and the quality was evaluated by Newcastle-Ottawa Scale (NOS). The random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). To further explore the sources of heterogeneity, meta-regression analysis and subgroup analyses were performed. Funnel plot, Egger's test, and Begg's test were used to assess publication bias.
RESULTS
In total, fifteen case-control studies with 1137 individuals (601 cases and 536 controls) were included. The H. pylori was found to be significantly associated with RAS (OR: 1.83 95% CI: 1.41-2.37, P = 0.001). In the subgroup analyses, studies that used PCR (OR: 2.03 95% CI: 1.31-3.15) or UBT (OR: 1.83 95% CI: 1.13-2.96) yielded a significant positive association, while a non-significant association (OR: 1.12 95% CI: 0.61-2.08) was found from studies that used ELISA method. Sensitivity analyses showed that the results were robust. No significant publication bias was found.
CONCLUSIONS
The current evidence does not rule out an association between H. pylori and RAS. The effect of H. pylori on RAS varies in detection methods and sources of sample. Large samples, multiple clinical studies, and improved methods are still needed to determine the exact effect of H. pylori on RAS.
CLINICAL SIGNIFICANCE
H. pylori infection may be a risk factor for the pathogenesis of RAS.
Topics: Humans; Stomatitis, Aphthous; Helicobacter pylori; Helicobacter Infections; Risk Factors
PubMed: 37798535
DOI: 10.1007/s00784-023-05273-y -
Deutsche Medizinische Wochenschrift... Sep 2023Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself...
Behçet's syndrome (BS, synonym: Behçet's disease, or Adamantiades-Behçet's disease, ABD) is classified as a vasculitis of variable vessel size and can manifest itself in both arterial and venous vessels. Its extensive and at the same time interindividually very different clinical picture is not uncommon a challenge, both with regard to the diagnosis of this rheumatic systemic disease, which is rather rare in our latitudes, and its therapeutic options. In addition to the four cardinal symptoms of recurrent oral aphthae, genital aphthae, skin and eye lesions, the clinical picture offers numerous other manifestations which often require interdisciplinary cooperation. In addition to the above mentioned ocular involvement, which can still lead to blindness if inadequately treated, this is especially true for intestinal and cerebral manifestations as well as for large vessel vasculitis.A final revision of the European League Against Rheumatism recommendations for the management of Behcet's syndrome (EULAR) was made in 2018, and the recommendations are now established internationally as an important treatment guide. Therapy is based on the leading organ involvement. After adalimumab received approval for the treatment of posterior ocular involvement in 2016, another agent, apremilast, became available in 2020. The drug is recommended for the treatment of recurrent oral aphthae in adult Behçet's patients requiring systemic therapy. Nevertheless, there is a further need for new drugs.This article aims to highlight recent findings in the areas of epidemiology, immunopathogenesis & genetics, clinical findings, and therapy, with an emphasis on clinical relevance.
Topics: Adult; Humans; Behcet Syndrome; Stomatitis, Aphthous; Vasculitis; Arteries; Blindness; Rheumatic Diseases
PubMed: 37611579
DOI: 10.1055/a-1958-2338 -
Cells Aug 2023Melatonin exerts various physiological effects through melatonin receptors and their ability to scavenge free radicals. Radiotherapy is a common treatment for head and...
Melatonin exerts various physiological effects through melatonin receptors and their ability to scavenge free radicals. Radiotherapy is a common treatment for head and neck tumors, but stomatitis, a side effect affecting irradiated oral mucosa, can impact treatment outcomes. This study investigated the preventive effect of melatonin, a potent free radical scavenger, on radiation-induced oral mucositis. Mice were irradiated with 15 Gy of X-ray radiation to the head and neck, and the oral mucosa was histologically compared between a melatonin-administered group and a control group. The results showed that radiation-induced oral mucositis was suppressed in mice administered melatonin before and after irradiation. It was suggested that the mechanism involved the inhibition of apoptosis and the inhibition of DNA damage. From these findings, we confirmed that melatonin has a protective effect against radiation-induced oral mucositis
Topics: Animals; Mice; Melatonin; Stomatitis; Mouth Mucosa; Head; Apoptosis
PubMed: 37681910
DOI: 10.3390/cells12172178 -
Current Opinion in Allergy and Clinical... Aug 2023Recent studies have been clarifying the pathogenesis and early diagnostic markers of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Additionally,... (Review)
Review
PURPOSE OF REVIEW
Recent studies have been clarifying the pathogenesis and early diagnostic markers of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Additionally, the efficacy of tumor necrosis factor alpha inhibitors is attracting attention. This review provides) recent evidence for the diagnosis and management of SJS/TEN.
RECENT FINDINGS
Risk factors for the development of SJS/TEN have been identified, particularly the association between HLA and the onset of SJS/TEN with specific drugs, which has been intensively studied. Research on the pathogenesis of keratinocyte cell death in SJS/TEN has also progressed, revealing the involvement of necroptosis, an inflammatory cell death, in addition to apoptosis. Diagnostic biomarkers associated with these studies have also been identified.
SUMMARY
The pathogenesis of SJS/TEN remains unclear and effective therapeutic agents have not yet been established. As the involvement of innate immunity, such as monocytes and neutrophils, in addition to T cells, has become clear, a more complex pathogenesis is predicted. Further elucidation of the pathogenesis of SJS/TEN is expected to lead to the development of new diagnostic and therapeutic agents.
Topics: Humans; Stevens-Johnson Syndrome; Immunologic Factors
PubMed: 37284785
DOI: 10.1097/ACI.0000000000000914 -
Dental and Medical Problems 2023Diet and eating habits significantly affect health and quality of life. Various diets and food eliminations can lead to nutritional deficiencies and malnutrition. This... (Review)
Review
Diet and eating habits significantly affect health and quality of life. Various diets and food eliminations can lead to nutritional deficiencies and malnutrition. This article discusses the relationship between nutrition, nutritional deficiencies, and the condition of the periodontium and oral mucosa. An analysis of PubMed materials was conducted to assess the impact of nutrition on the condition of the oral mucosa and periodontium. We also considered dietary habits such as vegetarianism, the ketogenic diet, the Paleo diet, the Mediterranean diet, the Western diet, and intermittent fasting. Vitamin deficiencies, both watersoluble and fat-soluble, as well as macroand microelements, can manifest in the oral cavity, among others, as gingivitis and bleeding, recurrent aphthous stomatitis, enamel hypomineralization, cheilitis, angular cheilitis, halitosis, glossitis, lingual papillae atrophy, and stomatitis. Malnutrition does not cause periodontal disease, but it increases the risk of its occurrence and accelerates disease progression. Inadequate nutrition, combined with other predisposing factors, may contribute to an increased risk of oral cancer and the development of leukoplakia.
Topics: Humans; Mouth Mucosa; Cheilitis; Quality of Life; Periodontium; Malnutrition
PubMed: 38133993
DOI: 10.17219/dmp/156466 -
Supportive care and antiviral treatments in primary herpetic gingivostomatitis: a systematic review.Clinical Oral Investigations Nov 2023Herpes simplex virus 1 (HSV-1) is the main pathogen responsible for herpes infections. In 13-30% of the cases, primary HSV-1 leads to the primary herpetic... (Review)
Review
OBJECTIVES
Herpes simplex virus 1 (HSV-1) is the main pathogen responsible for herpes infections. In 13-30% of the cases, primary HSV-1 leads to the primary herpetic gingivostomatitis (PHGS), often a self-limiting infection; however, it can limit the ability to drink/eat with, sometimes, the need for hospitalization. Multiple therapeutic methods have been proposed. This systematic review aims to collect and critically appraise the available evidence about the clinical management of PHGS.
MATERIALS AND METHODS
Literature search including three databases (PubMed, Scopus, Embase), study design, and data analysis were performed following PRISMA guidelines, according to the PICO tool (PROSPERO n° CRD42023391386). Risk of bias was assessed with RoB 2 and ROBINS-I.
RESULTS
Five studies on a total of 364 patients (average age: 7.6 years) were identified. The treatment regimens were summarized in acyclovir; acyclovir + honey; fluids and analgesic; maalox + diphenhydramine; lidocaine; chlorhexidine (CHX); CHX + ialuronic acid; CHX + Mucosyte®; antimicrobial photodynamic therapy (aPDT); topical antiviral; topical antiviral + aPDT; and others.
CONCLUSIONS
Although PHGS is a disease with a high worldwide prevalence, the lack of consensus about therapeutic management indicates gaps in existing evidence. Most of the proposed treatment consists in symptomatic drugs with empiric regimens which are ineffective for the viral replication. The main limit to realize randomized clinical trial is due to the rapid onset and remission of the disease. In fact, the diagnostic delay, estimated in 72 h, decreases the effectiveness of any antiviral drugs.
CLINICAL RELEVANCE
Out of the five studies included in this systematic review, only one was able to provide some weak evidence that ACV is an effective treatment, improving healing of oral lesions and reducing duration of symptoms.
Topics: Humans; Child; Stomatitis, Herpetic; Delayed Diagnosis; Antiviral Agents; Acyclovir; Lidocaine; Randomized Controlled Trials as Topic
PubMed: 37733027
DOI: 10.1007/s00784-023-05250-5 -
International Journal of Dermatology Dec 2023Chikungunya is a viral disease transmitted by female Aedes mosquitoes that has been increasingly reported in many parts of the world across the geographical borders. In... (Review)
Review
Chikungunya is a viral disease transmitted by female Aedes mosquitoes that has been increasingly reported in many parts of the world across the geographical borders. In addition to fever and joint pain, mucocutaneous manifestations of chikungunya have been reported in 40-75% of infected patients. Dermatological manifestations of chikungunya are often under-recognized and misdiagnosed as clinicians are not sensitized or educated regarding these. The early-onset cutaneous manifestations of chikungunya fever, occurring within 1 month of the fever, include maculopapular rashes, vesiculobullous eruptions, Steven-Johnson syndrome/toxic epidermal necrolysis-like eruptions, flagellate lesions, scrotal dermatitis, oro-genital ulcers, and exacerbation of preexisting dermatoses like psoriasis. Hyperpigmentation, lichenoid eruptions, diffuse hair fall, and exacerbation of acne usually occur as a late manifestation. Diagnosis of these mucocutaneous manifestations can be challenging as they often resemble other common dermatoses. This review article elaborates on various mucocutaneous manifestations of chikungunya fever, based on literature review and authors' clinical experience.
Topics: Humans; Female; Chikungunya Fever; Drug Eruptions; Stevens-Johnson Syndrome; Psoriasis; Fever
PubMed: 37781980
DOI: 10.1111/ijd.16853 -
Cureus Sep 2023Denture stomatitis (DS), a common oral condition among denture wearers, is frequently associated with () colonization. This systematic review and meta-analysis aimed to... (Review)
Review
Denture stomatitis (DS), a common oral condition among denture wearers, is frequently associated with () colonization. This systematic review and meta-analysis aimed to provide a comprehensive assessment of DS prevalence and its relationship with in the Indian population. We conducted a thorough search of multiple databases for studies without any limitation to the publication timeframe, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were assessed for quality and included in the meta-analysis. Data regarding DS prevalence, risk factors, and colonization were extracted and analyzed. A total of four studies comprising 415 participants were included in the review. The overall odds ratio (OR) and risk ratio (RR) for the prevalence of in DS patients were 0.75 (95% CI 0.56 to 0.99) and 0.83 (95% CI 0.70 to 1.00), respectively, indicating a statistically significant association between DS and colonization. Several risk factors, including continuous denture wearing, advanced denture age, poor denture hygiene, and high sugar intake, were identified as contributing to DS development. This systematic review and meta-analysis highlight the substantial burden of DS and its association with colonization in the Indian population. The findings emphasize the need for comprehensive oral care, improved denture hygiene, dietary counseling, and interventions to enhance salivary flow in denture wearers to mitigate the risk of DS. These insights can inform healthcare providers and policymakers to develop targeted strategies for DS prevention and management in India. Furthermore, this study emphasizes the significance of oral health awareness and preventive strategies in groups with a high frequency of denture usage in a larger population.
PubMed: 37842362
DOI: 10.7759/cureus.45182