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Dermatologic Therapy Jan 2021Dysgeusia is the first recognized oral symptom of novel coronavirus disease (COVID-19). In this review article, we described oral lesions of COVID-19 patients. We... (Review)
Review
Dysgeusia is the first recognized oral symptom of novel coronavirus disease (COVID-19). In this review article, we described oral lesions of COVID-19 patients. We searched PubMed library and Google Scholar for published literature since December 2019 until September 2020. Finally, we selected 35 articles including case reports, case series and letters to editor. Oral manifestations included ulcer, erosion, bulla, vesicle, pustule, fissured or depapillated tongue, macule, papule, plaque, pigmentation, halitosis, whitish areas, hemorrhagic crust, necrosis, petechiae, swelling, erythema, and spontaneous bleeding. The most common sites of involvement in descending order were tongue (38%), labial mucosa (26%), and palate (22%). Suggested diagnoses of the lesions were aphthous stomatitis, herpetiform lesions, candidiasis, vasculitis, Kawasaki-like, EM-like, mucositis, drug eruption, necrotizing periodontal disease, angina bullosa-like, angular cheilitis, atypical Sweet syndrome, and Melkerson-Rosenthal syndrome. Oral lesions were symptomatic in 68% of the cases. Oral lesions were nearly equal in both genders (49% female and 51% male). Patients with older age and higher severity of COVID-19 disease had more widespread and sever oral lesions. Lack of oral hygiene, opportunistic infections, stress, immunosuppression, vasculitis, and hyper-inflammatory response secondary to COVID-19 are the most important predisposing factors for onset of oral lesions in COVID-19 patients.
Topics: COVID-19; Humans; Mouth Diseases; SARS-CoV-2
PubMed: 33236823
DOI: 10.1111/dth.14578 -
Polski Merkuriusz Lekarski : Organ... Oct 2020Crohn's disease (CD) is a chronic and granulomatous inflammatory disease of the entire gastrointestinal tract. The etiopathogenesis is not fully elucidated. The most...
UNLABELLED
Crohn's disease (CD) is a chronic and granulomatous inflammatory disease of the entire gastrointestinal tract. The etiopathogenesis is not fully elucidated. The most common symptoms in the active phase of the disease include abdominal pain, prolonged diarrhea, fever, fatigue, malaise and weight loss. Oral manifestations of CD are classified into specific for CD with granulomatous changes and non-specific ones. This rare extraintestinal manifestation of CD in adults may precede gastrointestinal tract involvement, occur together or appear after years of its duration. Oral lesions can be initiated by malnourishment, poor absorption of nutrients or side-effect of medications.
A CASE REPORT
We describe a 28-year-old female with a 9-years CD history, who presented in the active disease with oral lesions. They were classified as non-specific ones, and included oral candidiasis, irregular erythematous patches on the cheek mucosa, exfoliative lip inflammation, and angular cheilitis. The patient was treated with azathioprine, and since the last exacerbation of symptoms, induction therapy with adalimumab, (anti-TNF-alpha), has been prescribed. Nystatin was applied to treat the oral lesions, based on the microbiological assessment of the Candida albicans susceptibility, and symptomatic treatment. After a two-week treatment the oral mucosa was healed and angular cheilitis showed marked improvement compared to the initial presentation.
CONCLUSIONS
The young female with active CD presented the nonspecific lesions in the oral cavity. The lesions coexisted with the active inflammatory process in the intestinal tract with characteristic clinical symptoms, and were associated with sideropenic anemia. The implementation of the local therapy, systemic CD treatment and supplementation of micronutrient deficiencies have led to a healing of the oral lesions. We emphasize a personalized approach to treatment and close cooperation between the dentist and the gastroenterologist.
Topics: Adalimumab; Adult; Azathioprine; Crohn Disease; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Tumor Necrosis Factor-alpha
PubMed: 33130798
DOI: No ID Found -
Oral Diseases Oct 2021To assess the presence of oral lesions and the impact of oral health-related quality of life (OHRQoL) on individuals with psoriasis.
OBJECTIVES
To assess the presence of oral lesions and the impact of oral health-related quality of life (OHRQoL) on individuals with psoriasis.
METHODS
This case-control study comprised 295 individuals with psoriasis and 359 controls. Oral examination to assess different types of oral lesions as angular cheilitis (AC), geographic tongue (GT), white (WP), and red plaque or red macule (RPM) was performed. To evaluate OHRQoL, the Oral Impact on Daily Performance (OIDP) questionnaire was applied. Data were analyzed using the chi-squared, Fisher, Kruskal-Wallis, Mann-Whitney, and Bootstrap Intervals tests.
RESULTS
Individuals with psoriasis had significantly more oral lesions than controls (OR = 3.66, 95% CI: 2.33-5.85; p < .001) and higher global OIDP scores (12.17 case versus 6.93 controls; p = .008). Higher occurrence of GT (p < .001) and AC (p < .001) was observed in individuals with psoriasis. The final multivariate model demonstrated higher OIDP scores related to the following variables: alcohol use, diabetes, anxiolytics use, AC, and GT, showing worse OHRQoL.
CONCLUSION
Psoriatic individuals had a higher frequency of AC and GT than controls. Worse OIDP scores in frequency and severity were observed in psoriatic individuals with oral lesions, revealing the negative impacts of these lesions on OHRQoL.
Topics: Case-Control Studies; Humans; Oral Health; Oral Ulcer; Quality of Life; Surveys and Questionnaires
PubMed: 33107194
DOI: 10.1111/odi.13695 -
Oral Diseases Apr 2022
Topics: COVID-19; Cheilitis; Humans
PubMed: 33043573
DOI: 10.1111/odi.13675 -
Acta Medica (Hradec Kralove) 2020Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms...
INTRODUCTION
Oral manifestations of deficiency of iron, vitamin B12 and folic acid are thought to be common. Prevalence of these deficiencies among patients with compatible symptoms is not well known. The goal of this study was to summarize evidence from a dental practice of iron, vitamin B12 and folic acid deficiency in patients presenting with compatible oral manifestations.
METHODS
250 patients who presented with burning mouth syndrome, angular cheilitis, recurrent aphthous stomatitis, papillar atrophy of the tongue dorsum or mucosal erythema were identified. Patients underwent clinical examination, and the blood samples were taken.
RESULTS
250 patients (208 females; 42 males, mean age 44.1 years) with at least one corresponding symptom or sign were identified. The nutritional deficiency of one or more nutrients was found in 119 patients (47.6%). Seven times more females than males were noted to have one type of deficiency (104 females, 15 males). Iron deficiency as defined was diagnosed in 62 patients (24.8%), vitamin B12 or folic acid deficiency in 44 patients (17.6%) and both deficiencies (iron + vitamin B12/folic acid) in 13 patients (5.2%). The only predictive factor was gender and only for iron deficiency. The presence of more than one deficiency was noted in 10 patients (4.9%).
CONCLUSION
The most commonly observed deficiency in dental practice over the course of 11 years was an iron deficiency in the female population. Age, diet and reported co-morbidities did not show statistically significant predictable value in recognizing these deficiencies.
Topics: Adult; Czech Republic; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Iron Deficiencies; Male; Malnutrition; Mouth Diseases; Practice Patterns, Dentists'; Sex Factors; Vitamin B 12; Vitamin B 12 Deficiency
PubMed: 33002395
DOI: 10.14712/18059694.2020.25 -
International Journal of Organ... 2020Patients with chronic liver failure (CLF) faced serious medical conditions including the oral cavity.
BACKGROUND
Patients with chronic liver failure (CLF) faced serious medical conditions including the oral cavity.
OBJECTIVE
To investigate the prevalence of oral mucosal lesions, saliva flow rate, and dental complications in candidates of liver transplant surgery.
METHODS
In this cross-sectional study, oral and dental health of 77 patients with CLF and 77 healthy individuals were assessed for oral mucosal lesions, salivation rate, DMFT (decayed, missing, filled teeth) index, and bone level. To carefully determine the indices and examine the patients thoroughly, a panoramic radiography was also taken from each participant.
RESULTS
The frequency of oral mucosal lesions in patients was significantly (p<0.001) higher than the comparison group. The most frequent lesion identified was angular cheilitis followed by candidiasis. The mean saliva flow rate in the patients (0.85 g/min) was also significantly (p<0.001) lesser than that in healthy individuals (1.58 g/min). The DMFT index and bone level were not significantly different between the two groups. Nor was a correlation between the MELD score and each of DMFT index, bone loss, or oral mucosal lesions.
CONCLUSION
Mucosal lesions, especially fungal-related lesions, are more prevalent in the oral cavity of patients with CLF. The saliva production rate is reduced due to various medications used in this group. Patients with CLF are prone to oral infections and a thorough oro-dental examination is crucial in this group of patients. Vigorous oral hygiene instructions should be offered to liver cirrhosis individuals.
PubMed: 32913587
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Aug 2020Background and Objectives Over the last years, inflammatory bowel disease (IBD) has been reported on a high incidence in pediatric populations and has been associated...
UNLABELLED
Background and Objectives Over the last years, inflammatory bowel disease (IBD) has been reported on a high incidence in pediatric populations and has been associated with numerous extraintestinal manifestations, making its management a real challenge for the pediatric gastroenterologist. Dermatological manifestations in IBD are either specific, related to the disease activity or treatment-associated, or non-specific. This literature review aims to identify and report the dermatological manifestations of IBD in children, the correlation between their appearance and the demographical characteristics, the relationship between these lesions and disease activity, and to highlight the impact of dermatological manifestations on an IBD treatment regime.
MATERIALS AND METHODS
A systemic literature review was performed, investigating articles and case reports on dermatological manifestations in children with IBD starting from 2005. A total of 159 potentially suitable articles were identified and after the exclusion process, 75 articles were selected.
RESULTS
The most common dermatological manifestations reported in pediatric IBD are erythema nodosum and pyoderma gangrenosum. More rare cases of metastatic Crohn's disease, epidermolysis bullosa acquisita, small-vessel vasculitis, necrotizing vasculitis, leukocytoclastic vasculitis, cutaneous polyarteritis nodosa, and Sweet's syndrome have been reported. Oral manifestations of IBD are divided into specific (tag-like lesions, mucogingivitis, lip swelling with vertical fissures, aphthous stomatitis, and pyostomatitis vegetans) and non-specific. IBD treatment may present with side effects involving the skin and mucosa. Anti-tumor necrosis factor agents have been linked to opportunistic skin infections, psoriasiform lesions, and a potentially increased risk for skin cancer. Cutaneous manifestations such as acrodermatitis enteropathica, purpuric lesions, and angular cheilitis may appear secondary to malnutrition and/or malabsorption.
CONCLUSIONS
The correct diagnosis of dermatological manifestations in pediatric IBD is of paramount importance because of their impact on disease activity, treatment options, and a patient's psychological status.
Topics: Biological Factors; Child; Colitis, Ulcerative; Crohn Disease; Humans; Immunosuppressive Agents; Malabsorption Syndromes; Receptors, Tumor Necrosis Factor; Skin Diseases
PubMed: 32842528
DOI: 10.3390/medicina56090425 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2020Candidiasis is the most frequent mycotic infection of the oral cavity. The aim of this study was to investigate the presence of clinical oral candidiasis and Candida...
BACKGROUND
Candidiasis is the most frequent mycotic infection of the oral cavity. The aim of this study was to investigate the presence of clinical oral candidiasis and Candida albicans yeast in a population diagnosed of primary Sjögren's syndrome (pSS) and to study the possible factors associated with this infection.
MATERIAL AND METHODS
An observational cross-sectional study was conducted in 61 pSS patients (60 women, 1 man, mean age 57.64±13.52) where patient based information (demographic and medical, tobacco and alcohol consumption history), intraoral parameters (presence of dentures, clinical signs of candidiasis), salivary analytical information (number of Candida albicans as colony-forming units per millilitre (CFU/mL), salivary pH levels, unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were collected.
RESULTS
13.1% of pSS patients presented oral signs of candidiasis. Denture stomatitis and angular cheilitis were the most common lesions. 87.5% of patients with clinical candidiasis presented reduced pH levels and salivary flow in both UWS and SWS. A significant statistical negative correlation was found between CFU/mL of Candida albicans and levels of UWS and SWS. A negative correlation was found between pH levels and CFU/mL, although not statistically significant.
CONCLUSIONS
A reduced salivary flow may predispose pSS patients to Candida albicans overgrowth, which may show with clinical signs. Preventive measures are of great importance to avoid and to treat this condition promptly.
Topics: Adult; Aged; Candidiasis, Oral; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Risk Factors; Saliva; Sjogren's Syndrome
PubMed: 32683379
DOI: 10.4317/medoral.23719 -
Shanghai Kou Qiang Yi Xue = Shanghai... Feb 2020To investigate the category and prevalence rate of denture-related oral mucosal lesions (DML) in 185 patients with removable denture and analyze the influencing factors.
PURPOSE
To investigate the category and prevalence rate of denture-related oral mucosal lesions (DML) in 185 patients with removable denture and analyze the influencing factors.
METHODS
A total of 185 patients with removable denture who visited the department of stomatology of our hospital from October 2015 to June 2018 were investigated by questionnaire. DML types and locations were recorded in detail, and patients were followed up after treatment. Based on the data of this study, the differences of DML reports in other regions of China were analyzed by comparing the results searched from databases. SPSS 17.0 software package was used for statistical analysis.
RESULTS
In this study, the DML prevalence rate was 42.7%, significantly higher in male patients than in female patients (54.17% vs 35.40%, P<0.05). DML was more common in complete denture wearers than that in partial denture wearers (66.67% vs 31.20%, P<0.05). The categories of DML were as followed (prevalence rate from high to low): denture stomatitis (54.43%), traumatic ulcer (34.18%), inflammatory hyperplasia (6.33%), and angular cheilitis (5.06%).
CONCLUSIONS
DML is affected by multiple factors. Among them, denture related factors include denture type, denture wearing time, denture lasting time and cleaning method. DML is more influenced by the type of denture than the wearing time. Gender, ethnicity and systemic diseases may affect the prevalence of DML, but further studies are needed. The results of domestic studies in various regions cannot objectively reflect the current prevalence rate of DML, thus a multi-center epidemiological investigation is needed.
Topics: China; Denture, Complete; Denture, Partial; Denture, Partial, Removable; Female; Humans; Male; Mouth Diseases; Stomatitis, Denture
PubMed: 32524128
DOI: No ID Found -
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