Conventional systemic treatments associated with therapeutic sites of local lesions of secondary syphilis in the oral cavity in patients with AIDS.

Patients with HIV infection may develop common diseases with atypical clinical features. HIV infection can change the classic clinical course of syphilis and increase the incidence of malignant syphilis. Malignant syphilis is a rare subtype of secondary syphilis that presents special clinical and histological features and has been associated with several processes characterized by variable degrees of immunosuppression. It is necessary to consider the possibility of this entity in the differential diagnoses in HIV-infected patients with cutaneous lesions. The dental surgeon (or oral surgeon) is vital to the medical team for promoting the health and improving the quality of life of syphilis patients. A patient with HIV infection was referred to us for complaints of a white patch on the tongue, stinging and burning sensation on the tongue, loss of taste, and dryness of the mouth. On clinical examination, the patient was found to have a tabetic gait (the Prussian soldier gait) associated with Charcot arthropathy. We also identified bilateral lesions with ulceration and exposure of the tissue that were tender, characterized by discrete necrosis. The treatment that was initiated at that time involved cleaning the area with gauze to remove all the white patches, followed by rinsing with bicarbonate in water (one teaspoon of baking soda dissolved in half a glass of water) four times a day. Additionally, fluconazole (100 mg/day for 7 days) was prescribed. We diagnosed secondary malignant syphilis of approximately 5 days duration. As an adjunctive therapy, we performed low-intensity laser treatment using a GaAsAl (gallium-aluminum arsenide) laser at 790 nm. With this treatment there was progressive resolution of the lesions.

Diagnóstico: tratamento cirúrgico e proservação de um caso clínico de mucocele / Diagnosis, surgical treatment and proactive observation of a case of mucacele

O mucocele é uma lesão comum da mucosa bucal, que resulta da ruptura de um ducto deotglândula salivar e consequente derramamento de mucina para o interior dos tecidos moles circunjacentes. Pode surgir em vários sítios da cavidade bucal sendo o lábio inferior região mais prevalente, contabilizando mais de 80% dos casos. Como forma de tratamento, pode ser realizada a exérese local, com a enucleação e remoção da glândula salivar, e ou tratada por eletrocirurgia, criocirurgia ou pela vaporização com laser de C02. O objetivo deste trabalho é apresentar uma revisão de literatura a respeito do mucocele, bem como um relato de caso clinico e a opção de tratamento escolhida.

The mucocele is a common injury of the oral mucosa, resulting from a ruptured salivarygland duct and consequent spillage of mucin into the interior of the surrounding soft tissues. Can arise in various sites of the oral cavity and the lower lip area was the most prevalent, accounting for more than 80% of cases. As a form of treatment can be performed local excision with enucleation and remova I of the salivary gland, and I or treated by electrosurgery, cryosurgery or laser vaporization of C02. The aim of this paper is to present a review of the literature regarding the mucocele and one case report and treatment option chosen.

A abordagem dos aspectos atuais do eritema multiforme e a Odontologia / The approach of the current erythema multiforme and dentistry

O eritema multiforme é um processo inflamatório agudo, que pode ser desencadeado por diversos fatores. Apresenta lesões muco-cutâneas com características próprias da doença. É dever do cirurgião-dentista saber diagnosticá-lo e tratá-lo, uma vez que, na maior parte dos casos, as lesões são evidenciadas na mucosa oral, podendo inclusive, serem restritas a esta área. Por esse motivo, este trabalho se destina, através de uma revisão da literatura, elucidar aos cirurgiões-dentistas conhecimentos relacionados aos aspectos clínicos, etiológicos, prognósticos, tipos de tratamentos e proservação dos casos de eritema multiforme.

The objective of the current research is to add dental surgeons information related to erythema multiforme. By means of literary review, this paper presents clinical and histological aspects, as well as etiology, prognosis, treatments and maintenance treatments for some specific cases. Erythema multiforme is an acute inflammatory process triggered by several factors. Patients may present characteristic mucocutaneous lesions and most cases present oral mucosal lesions which can often be limited to this site. Thus, it is the dental surgeon to diagnose and treat it.