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Cureus Aug 2021Background and objective In developing countries, the dermatological manifestation of the human immunodeficiency virus (HIV) has a high prevalence. Apart from the...
Background and objective In developing countries, the dermatological manifestation of the human immunodeficiency virus (HIV) has a high prevalence. Apart from the systemic infection that ensues HIV, skin manifestations form a major part of the disease burden. They can present with atypical forms, and necessary tools for diagnosis may not be available in rural and remote parts of the country. Hence, they can stay misdiagnosed or undiagnosed, contributing to the morbidity of the patients. We attempted to enumerate the dermatologic opportunistic infections (OIs) in Rajkot city, Gujarat, India, in order to disseminate knowledge regarding the same. Material and methods It is a retrospective observational study. A total of 253 patients under treatment for HIV/acquired immunodeficiency syndrome (AIDS) at the ART Center (anti-retroviral therapy center) from 2011 to 2019 were included. The data recorded in the registry during the above-mentioned period were utilized in the study. The diagnoses of OIs were made clinically by multiple health care providers experienced in the field. Result Two hundred twenty-seven (227) of 253 (89.72%) of the patients had some form of dermatologic OI during the course of their treatment. Overall, fungal infections (33.03%) were most common, followed by bacterial infections (28.18%) and viral (14.55%) infections. Among the non-infectious causes, cheilitis/angular stomatitis topped the list. Among the STDs, herpes was the most common skin manifestation seen with a 10.57% prevalence. The CD4+ cell count for fungal infection ranged from 353-467 and was seen in stage 2 of the disease course. Bacterial infections were seen mainly during the early and middle stages of the disease while viral infections were most prevalent in stage 2 of the disease. Conclusion Skin manifestations can be useful clinical predictors of the disease stage, especially in resource-limited settings and in developing countries. They can present with unusual and atypical forms. Hence, knowledge about the prevalence of these OIs in a particular geographical area can be very useful for physicians in treating them and decreasing the disease burden.
PubMed: 34513432
DOI: 10.7759/cureus.16852 -
BMC Oral Health Nov 2022Spondyloarthritis (SpA) is a group of autoinflammatory disorders, of which the primary extra-articular manifestation is inflammatory bowel disease (IBD). The oral cavity...
BACKGROUND AND AIMS
Spondyloarthritis (SpA) is a group of autoinflammatory disorders, of which the primary extra-articular manifestation is inflammatory bowel disease (IBD). The oral cavity being a part of gastrointestinal tract, is significantly compromised in IBD, and in many cases, it is the first site of clinical manifestations of IBD. This study aimed to identify changes in the oral mucosa associated with the onset of IBD and their association with endoscopic/histological findings.
MATERIALS AND METHODS
The study assessed 80 patients with SpA and 52 healthy controls. Oral, rheumatological, and gastroenterological assessments were performed. The ileocolonoscopy was performed via digital magnification chromoendoscopy. The statistical analysis consisted of Chi-square, Fisher's exact, and multiple correspondence discriminant analysis tests.
RESULTS
From the disease cohort, 63.0% patients showed oral lesions (p = 0.050). These manifestations ranged from gingivitis (55.0%, p = 0.001), aphthous stomatitis (3.8%, p = 0.091), angular cheilitis (2.6%, p = 0.200), and perioral erythema with scaling (1.3%, p = 0.300). All patients who presented with alterations in colonic mucosa also had oral lesions associated with IBD (p = 0.039), specifically gingivitis/aphthous stomatitis (p = 0.029).
CONCLUSION
The patients with SpA without IBD present significant oral signs and symptoms. Gingivitis seems to be the most relevant because of its associations with early endoscopic and histological findings.
CLINICAL RELEVANCE
An integral approach to the diagnostic tests that includes evaluations of oral, rheumatological and gastroenterological tissues may favor timely attention and improve patients' quality of life.
Topics: Humans; Stomatitis, Aphthous; Quality of Life; Spondylarthritis; Inflammatory Bowel Diseases; Oral Ulcer; Gingivitis; Chronic Disease; Rheumatic Diseases
PubMed: 36348398
DOI: 10.1186/s12903-022-02497-4 -
European Journal of Medical Research Dec 2022
PubMed: 36471451
DOI: 10.1186/s40001-022-00884-9 -
Scientific Reports Nov 2021Changes in the oral mucosa can appear in the course of inflammatory bowel disease in both children and adults. They often precede the appearance of gastrointestinal...
Changes in the oral mucosa can appear in the course of inflammatory bowel disease in both children and adults. They often precede the appearance of gastrointestinal symptoms. The aim of the study was to determine the nature of changes in the oral cavity at the time of diagnosis of inflammatory bowel disease in children compared to children without systemic diseases. 49 children diagnosed with inflammatory bowel disease and 60 children without systemic diseases were examined. The prevalence of the aphthae stomatitis and angular cheilitis was 24.5% in the examined group and 10% in the control group (p = 0.0772). Changes in the oral mucosa occurred more frequently in children with Crohn's disease 35.3% than with ulcerative colitis 18.7%. In children with Crohn's disease, the most frequently observed lesion was aphthous stomatitis 23.5%, and in ulcerative colitis, angular cheilitis 12.5%. Changes in the oral mucosa are a therapeutic problem requiring in general diseases patients both local and systemic treatment and interdisciplinary cooperation between dentists, paediatricians and gastroenterologists. The finding of repeated changes in the oral mucosa during a dental examination should be the reason for referring the patient to a paediatrician for the foreclosure or make a diagnosis of inflammatory bowel diseases.
Topics: Adolescent; Child; Female; Humans; Inflammatory Bowel Diseases; Male; Mouth; Mouth Mucosa; Pediatrics
PubMed: 34753969
DOI: 10.1038/s41598-021-01370-8 -
Journal of Oral Science Jan 2022The aim of this pilot study was to clarify the acceptability and clinical efficacy of an oxygen-enriched oil-based gel for treatment of angular cheilitis.
PURPOSE
The aim of this pilot study was to clarify the acceptability and clinical efficacy of an oxygen-enriched oil-based gel for treatment of angular cheilitis.
METHODS
A class IIb medical preparation, packaged in appropriate syringes, was tested. Patients were instructed how to use the gel for 10 days: finger rub application (3 times daily) on the dried lesion after meals, without eating, drinking, or speaking for at least 30 min thereafter. The Wilcoxon signed-rank test was used to assess whether there were any differences in the distributions of reported pain and lesion dimension. A microbiological examination was also performed with oral swabs; chi-squared test was used to compare the difference in the presence of microorganisms before and after treatment.
RESULTS
Thirty patients were treated. A significant improvement in reported outcome and a significant reduction in the initially measured largest dimension of the lesion were observed after use of the clinical protocol. Additionally, a significant reduction in the pathogen count was found.
CONCLUSION
Even if with limitations, data showed that this medical preparation facilitated prompt recovery from reported pain, without adverse reactions. Further work with a larger study population, and possibly a randomized control medication, will be needed.
Topics: Cheilitis; Humans; Oxygen; Pilot Projects; Prospective Studies; Treatment Outcome
PubMed: 34980827
DOI: 10.2334/josnusd.21-0428 -
Neurology India 2022Myopathies associated with systemic diseases results from several different disease processes. Myopathy as the initial presenting symptom in Crohn's disease is a rare...
Myopathies associated with systemic diseases results from several different disease processes. Myopathy as the initial presenting symptom in Crohn's disease is a rare presentation. We report a 20-yearr-old lady who presented with a painful proximal myopathy. On examination, she was malnourished with pallor, angular cheilitis, Bitots spots, and bilateral pitting pedal edema. Laboratory evaluation showed iron deficiency anemia, hypoalbuminemia, and very low vitamin D levels with elevated creatine phosphokinase levels. A possibility of osteomalacic metabolic myopathy due to vitamin D deficiency was considered. The malabsorption workup was negative. A colonoscopic biopsy showed noncaseating granulomatous inflammation suggestive of Crohn's disease. With supplementary therapy and specific treatment, she was asymptomatic at 6-months follow-up with no residual neurological deficits. A detailed history and an algorithmic approach will be very useful in making the differential diagnosis in any patient presenting with muscle weakness in myopathy associated with systemic illness.
Topics: Crohn Disease; Diagnosis, Differential; Female; Granuloma; Humans; Metabolism, Inborn Errors; Muscular Diseases; Vitamin D Deficiency
PubMed: 35864676
DOI: 10.4103/0028-3886.349639 -
Clinical, Cosmetic and Investigational... 2023Ichthyosis follicularis, atrichia, and photophobia (IFAP) syndrome is a rare autosomal recessive, X-linked, genetic disorder that involves a triad of follicular...
Ichthyosis follicularis, atrichia, and photophobia (IFAP) syndrome is a rare autosomal recessive, X-linked, genetic disorder that involves a triad of follicular ichthyosis, atrichia of the scalp, and photophobia. We report a case of an 8-year-old boy with alopecia of the scalp, eyebrows, and eyelashes, which occurred in his first year of age. His birth was uneventful, and his developmental milestones were normal. The alopecia was non-scarring and was accompanied by mild generalized xerosis, photophobia, and recurrent angular cheilitis. Moreover, numerous non-inflammatory, follicular, keratotic tiny papules were noticed. His deciduous teeth had retention with gum hyperplasia, and his feet showed symmetrical plantar keratoderma and nail dystrophy of the right big toe. The genetic testing confirmed an X-linked recessive inheritance of IFAP syndrome without BRESHECK syndrome due to the mutation in the MBTPS2 (300294) gene located on chromosome Xp22.12. The patient was given symptomatic treatment with urea cream for plantar keratoderma and was advised to apply constant moisturizers to avoid generalized xerosis. Dermatological and ophthalmological follow-ups were recommended. This is the first case reported from Saudi Arabia. This case report throws light on the characteristics of IFAP syndrome and denotes the points of differentiation from similar conditions.
PubMed: 38089015
DOI: 10.2147/CCID.S439288 -
Pharmacy (Basel, Switzerland) Sep 2023Oral mucosal conditions are commonly experienced in the general population and can have a negative impact on one's quality of life. This study evaluated the ability of...
BACKGROUND
Oral mucosal conditions are commonly experienced in the general population and can have a negative impact on one's quality of life. This study evaluated the ability of Australian pharmacists and final-year pharmacy students to recognise and manage these common oral mucosal diseases through the use of case vignettes.
METHODS
Australian pharmacists and final-year pharmacy students were invited through social media, university learning management systems, or email to complete an online questionnaire consisting of six case vignettes covering topics relating to common oral mucosal presentations.
RESULTS
A total of 65 pharmacists and 78 students completed the questionnaire. More than 50% of the participants reported having seen all types of oral mucosal presentations, except for denture stomatitis, in their practice. The provision of best practice recommendations was reported by only 14%, 15%, 8%, and 6% of the participants for geographic tongue, hairy tongue, angular cheilitis, and denture-associated stomatitis, respectively, whereas 82% offered an appropriate anti-viral treatment for cold sore and 33% provided the best practice recommendations for oral thrush.
CONCLUSION
This study emphasised the importance of further developing and integrating best practice oral healthcare training programs specifically tailored to the Australian pharmacy profession.
PubMed: 37736911
DOI: 10.3390/pharmacy11050139 -
Microorganisms Apr 2020Microbiota in the kangaroo gut degrade cellulose, contributing to the kangaroo's energy and survival. In this preliminary study, to discover more about the gut microbes...
Microbiota in the kangaroo gut degrade cellulose, contributing to the kangaroo's energy and survival. In this preliminary study, to discover more about the gut microbes that contribute to the survival of kangaroos, cellulose-degrading bacteria were isolated from kangaroo scats by selection on solidified media containing carboxymethyl cellulose as the main carbon source. One frequently occurring aerobic bacterium was , a microbe previously isolated in fruit powder and from a patient with angular cheilitis. The whole genome sequence of the kangaroo isolate was obtained using the Illumina MiSeq platform. Its sequence shared 97.98% identity of the Type strain, and the ability of the Type strain to degrade cellulose was confirmed. Analysis of the genomic data focused on the cellulose operon. In addition to genes from the operon, we suggest that a gene following the operon may have an important role in regulating cellulose metabolism by signal transduction. This is the first report of found within microbiota of the animal gut. Because of its frequent presence in the kangaroo gut, we suggest that plays a role in cellulose digestion for kangaroos.
PubMed: 32349400
DOI: 10.3390/microorganisms8050635 -
Clinical and Experimental Dental... Feb 2022Investigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)-infected children undergoing highly active antiretroviral therapy (HAART).
OBJECTIVE
Investigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)-infected children undergoing highly active antiretroviral therapy (HAART).
MATERIALS AND METHODS
Cross-sectional study of 66 HIV seropositive children, comprised of 28 (42.4%) females and 38 (57.6%) males (average age of 6 years). Study participants all required data regarding CD4+ T-helper cell counts and the viral load. All participants underwent an orofacial clinical examination by calibrated clinicians. Associations between the presence of oral mucosal lesions, CD4+ cell counts, and viral load were analyzed using Poisson regression.
RESULTS
The prevalence of oral manifestations was detected in 21 children (31.8%). Oral lesions were detected in 16 children with viral load copies <50 cells/mm and 22 children with CD4+ counts >500 cells/mm . Predominant lesions identified included angular cheilitis (36.7%), candidiasis (13.3%) and atypical oral ulcers (13.3%). The presence of one lesion was the most prevalent represented by 19 children. Oral lesions in relation to the CD4+ counts >500 resulted in; 14 children with one oral lesion, 5 with two lesions and 3 with three oral mucosal lesions. The other half of this CD4+ count patient group presented with no oral mucosal lesions. Oral lesions in relation Viral load copies <50 resulted in; 9 children with one oral lesion, 3 with two oral mucosal lesions and 4 with three oral mucosal lesions. The other half of this Viral load patient group presented with no oral mucosal lesions. No significant correlations were established between the presence of oral mucosal lesions and low CD4+ counts (p = 0.715) nor with high viral load counts (p = 0.638).
CONCLUSION
HIV-related oral mucosal lesions still presented in the participants despite management with HAART. Based on the results, CD4+ counts and viral load does not appear to be suitable markers of orofacial involvement in children.
Topics: Child; Cross-Sectional Studies; Female; HIV; HIV Infections; Humans; Male; Mouth Diseases; Prevalence; South Africa
PubMed: 34586712
DOI: 10.1002/cre2.484