ABSTRACT
Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown etiology that affects the lip. It is characterized histologically by a dense infiltrate of plasma cells with a variety of clinical features. The response to different therapeutic modalities is controversial, especially regarding the effectiveness of corticosteroids. We present a case of a 56-year-old Caucasian man with a painful ulcerated and crusted area in the lower lip, resembling a squamous cell carcinoma or actinic cheilitis. Topical corticosteroid was used for one week, which resulted in partial regression and motivated a biopsy. The histological examination provided the diagnosis of PCC. The patient has been disease-free for six months. We also provide a discussion on the criteria of differential diagnosis and management of this rare condition.
Subject(s)
Humans , Male , Middle Aged , Cheilitis/diagnosis , Plasma Cells/pathology , Diagnosis, Differential , Lip Diseases/diagnosisABSTRACT
O óxido nitroso, primeiro gás inalatório utilizado na sedação consciente, foi indentificado por Joseph Priestley. Esse composto ficou conhecido como gás hilariante, porém só em 1844 teve sua primeira aplicação em pacientes. Tem como características farmacológicas metabolização lenta no organismo, início e término de ação rápidos, mas alcançando concentrações cerebrais eficientes. Sua técnica baseia-se na administração de O2 seguida de N2O, até alcançar o nível de sedação ideal. Essas técnicas são indicadas para pacientes ansiosos, tensos e situações em que não existam contra-indicações, porém essas são técnicas apenas relativas e não absolutas, e estão relacionadas principalmente ao risco de hipóxia, aumento de volume ou pressão em espaços fechados, alterações hematológicas e neurológicas. Os benzodiazepínicos servem também como método de sedação consciente devido a sua ação ansiolítica: vale destacar o midazolam, diazepam, alprazolam, triazolam e lorazepam. Os efeitos colaterais são variados abrangendo degeneração da medula óssea, náuseas, teratogênese, entre outros. O objetivo deste trabalho é realizar uma revisão da literatura para mostrar a importância da sedação consciente nos procedimentos odontológicos.
Nitrous oxide, the first inhaled gas used in conscious sedation, was identified by Joseph Priestley. This compound was known as laughing gas, but only in 1844 had its first application in patients. Its pharmacological characteristics are don?t be metabolized in the body, beginning and ending of fast action, but reaching effi cient concentrations in the brain. Its technique is based on the administration of O2 followed by N2O, to achieve the optimal level of sedation. Such techniques are indicated for anxious and tense patients, and situations that have no contraindications, but these are only relative and not absolute, and are due mainly to the risk of hypoxia, volume or pressure increase in enclosed spaces, hematological and neurological changes. The benzodiazepines also serve as a conscious sedation method because of their anxiolytic action, highlight the valley midazolam, diazepam, alprazolam, triazolam and lorazepam. Side effects are varied covering bone marrow degeneration, nausea, teratogenesis, among others. The aim of this article is to realize a review in order to show the value of conscious sedation to dental procedures.