Oral lesions in patients with COVID-19 hospitalized in an intensive care unit: a case-series study

Abstract This study evaluated the presence of oral lesions in patients with COVID-19 hospitalized in an intensive care unit (ICU). Data included demographic, clinical, and laboratory information. Clinical assessment of the oral cavity was performed on the 2 nd and 5 th days of orotracheal intubation. Thirty-eight patients were evaluated and 16 (42.1%) presented oral lesions during their ICU stay. The median age and length of stay were 75 years and 15 days, respectively. Among the patients with oral lesions, ulcerative oral lesions were reported in 14 (87.5%) patients, of which 11 (78.6%) were found on the lips. This study highlights the importance of oral examination for patients admitted to the ICU with COVID-19.

The correlation between the classification of atrophic glossitis and changes of vitamin B12, folic acid and blood cell parameters / 口腔疾病防治

Objective@# To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters@*Methods@#A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package.@*Results@#The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P<0.05). The levels of mean red blood cell volume (MCV) (104.90 ± 11.13) fL, mean corpuscular hemoglobin (MCH) (34.83 ± 4.56) pg, mean corpuscular hemoglobin concentration (MCHC) (331.09 ± 13.60) g·L-1 were higher than those in the simple type AG group (P<0.05). There was no significant difference in FOL content between these two groups (P>0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). @*Conclusion@#VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Neural network analysis of the correlation between malnutrition-induced stomatitis and vitamin B12 and folic acid / 口腔疾病防治

Objective@# A model was built by neural network analysis to study the relationship between different degrees of vitamin B12 and folic acid deficiency and malnutrition-induced stomatitis.@*Methods@# Data from 30 healthy volunteers and 30 patients with malnutrition-induced stomatitis were collected. The distribution of lesions, the number of affected sites and clinical manifestations were recorded, and the severity was scored. The levels of vitamin B12 and folic acid in the peripheral blood of the two groups were simultaneously measured. The SPSS software was used to analyze the correlation between vitamin B12 and folic acid levels in the peripheral blood of patients with malnutrition-induced stomatitis and healthy volunteers, and the MATLAB software package was used to analyze the data via a neural network.@*Results@#The levels of vitamin B12 and folic acid significantly correlated with the grade of malnutrition-induced stomatitis. Simultaneous B12 and folic acid deficiency linearly correlated with the occurrence and severity of malnutrition-induced stomatitis. Based on this correlation, a thermogram model of malnutrition-induced stomatitis was constructed.@*Conclusion@# Malnutrition-induced stomatitis is closely related to vitamin B12 and folic acid deficiency. Their synergistic effect may promote the occurrence and development of malnutrition-induced stomatitis. The construction of the malnutrition-induced stomatitis model aids the targeted etiological treatment of patients with moderate and severe deficiency to prevent malnutrition-induced stomatitis.

Alergias alimentarias en pacientes con glositis migratoria benigna / Food allergies in patients with benign migratory glossitis

Introducción: la glositis migratoria benigna, también conocida como lengua geográfica, es una variante normal, que presenta zonas superficiales circulares. Según la literatura revisada, dentro de sus causas figuran los procesos alérgicos, en los que están las alergias alimentarias. Se decidió realizar esta investigación para determinar la prevalencia de las alergias alimentarias frecuentes en estos pacientes mediante pruebas cutáneas. Materiales y métodos: se realizó un estudio descriptivo, longitudinal y prospectivo. La muestra estuvo compuesta por 27 pacientes en el período de enero hasta agosto de 2018 en portadores de glositis migratoria benigna, a los cuales se les realizaron pruebas alérgicas de tipo cutáneas para la determinación de alergias alimentarias. Resultados: el 59,3 % fue mujer y el antecedente alérgico más frecuente fue la rinitis alérgica. El antecedente de alergia alimentaria más frecuente fue los lácteos. Respecto a los resultados de las pruebas para la leche y los mariscos, estas dieron positivas en la mayoría de los pacientes, seguidos por el pescado, los huevos y los frutos secos. La prevalencia de positividad para por lo menos una prueba fue de 85,2%. Discusión: actualmente no existe suficiente literatura que hable sobre las posibles etiologías de la glositis migratoria benigna. Dentro de los antecedentes alérgicos, la rinitis alérgica fue la más frecuente, seguida de la alergia alimentaria. Hasta ahora existen pocas investigaciones que estudien esta prevalencia de alergias alimentarias en los pacientes de forma específica. Conclusión: la lengua geográfica no tiene factor epidemiológico predominante. El antecedente alérgico puede ser un factor predisponente, la alergia alimentaria puede ser desencadenante de la presentación de la lengua geográfica.

Introduction: The benign migratory glossitis, also known as geographic tongue, is a normal variant, which presents circular or irregular depapillated superficial areas. According to the literature reviewed, its causes include allergic processes, among these are food allergies. It was decided to carry out this investigation to determine the prevalence of frequent food allergies in these patients using skin tests. Materials and methods: A descriptive, longitudinal, prospective study was carried out. The sample consisted of 27 patients in the period January-August 2018, carriers of geographic tongue who underwent skin-type allergic tests to determine food allergies. Results: 59.3% were women without statistically significant predominance, the most frequent allergic history was allergic rhinitis. The most frequent history of food allergy was to dairy. Regarding the results of the tests for milk and shellfish, they were positive in 55.6%, followed by fish 14.8%, eggs and nuts with 11.1% respectively. The prevalence of positivity for at least one test was 85.2% with a statistically significant predominance over the negative result. Discussion: There is currently not enough literature that discusses the possible etiologies of benign migratory glossitis. Within the allergic history, allergic rhinitis was the most frequent, followed by food allergy. Until now there are few investigations that study this prevalence of food allergies in patients in a specific way. Conclusion: Geographic tongue does not have a predominant epidemiological factor, an allergic history can be a predisposing factor, food allergy can be a trigger for presentation of geographic language.

Chronic pain and vitamin B12 deficiency, a challenging and important differential diagnosis. Case report / Dor crônica e deficiência de vitamina B12, um diagnóstico diferencial desafiador e importante. Relato de caso

ABSTRACT BACKGROUND AND OBJECTIVES: The study's objective was to present a case of diffuse chronic pain with 36 months of development, associated with recurrent oral aphthous ulcers and glossitis, highlighting the importance of the wide differential diagnosis and the possibility of vitamin B12 deficiency as a cause. CASE REPORT: Male patient, 39 years-old, white, reported diffuse pain predominantly in the cervical, thoracic, abdominal, thighs and left knee regions, besides the presence of frequent oral aphtae, lasting more than 5 days, multiple and painful, predominantly on the tongue, for 6 months. The condition was attributed to Behçet's disease, but there was complete and permanent remission after treatment with vitamin B12. CONCLUSION: It's important to insert vitamin B12 deficiency for differential diagnosis in chronic pain scenarios.

RESUMO JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo foi apresentar um caso de dor crônica difusa com 36 meses de evolução, associada com aftas orais de repetição e glossite, destacando a importância do amplo diagnóstico diferencial e da possibilidade da deficiência de vitamina B12 como causa. RELATO DO CASO: Paciente do sexo masculino, 39 anos, branco, referindo dores difusas que predominavam em região cervical, torácica, abdominal, coxas e joelho esquerdo, além da presença de aftas orais frequentes, com duração superior a 5 dias, múltiplas e dolorosas, predominando na língua, há 6 meses. O quadro foi atribuído à doença de Behçet, mas houve remissão total e permanente após tratamento com vitamina B12. CONCLUSÃO: É importante inserir a deficiência de vitamina B12 para o diagnóstico diferencial em quadros de dor crônica.

Migratory Glossitis Associated with Cleft Tongue: Case Report / Glossite Migratória Associada a Língua Fissurada: Relato de Caso

Benign migratory glossitis, also known as geographic tongue, is characterized by the tongue inflammation and is associated with pain and difficulty eating due to the lingual papillae atrophy. It may appear in association with the fissured tongue. This paper reports the case of a 47-year-old male patient who sought dental care with the main complaint of burning, discomfort, increased sensitivity and a burning sensation on the tongue. He was diagnosed with migratory glossitis associated with a fissured tongue. The patient treatment was performed with an ointment based on triamcinolone acetonide (Omcilon- A Orabase®), which showed improvement in the clinical signs after seven days. The therapy used in this patient was effective in restoring the tongue papillae and improving signs and symptoms.

A glossite migratória benigna, também conhecida como língua geográfica, caracteriza-se por inflamação da língua e está associada a dor e dificuldade na alimentação devido a atrofia das papilas linguais. Pode aparecer em associação à língua fissurada. Este trabalho relata o caso de um paciente do sexo masculino com idade de 47 anos que buscou atendimento odontológico com queixa principal de ardência, desconforto, sensibilidade aumentada e sensação de queimação na língua. Foi diagnosticado com glossite migratória associada a língua fissurada. O tratamento do paciente foi realizado com pomada à base de triancinolona acetonida (Omcilon- A Orabase®) demonstrou melhora no quadro clinico após sete dias. A terapêutica usada neste paciente foi eficaz no restabelecimento das papilas da língua e melhora dos sinais e sintomas.

Evaluation of the Th17 pathway in psoriasis and geographic tongue

Abstract Background: Psoriasis is a skin-articular disease with unclear etiopathogenesis. It has been suggested that the disease is immune-mediated by T-lymphocytes, predominantly Th17 cells. Similar to psoriasis, geographic tongue is an inflammatory disease with participation of Th17 cells and direct correlation with psoriasis. Objective: To investigate and compare the inflammatory responses and the Th17 pathway in psoriasis and geographic tongue. Methods: This was a cross-sectional study with 46 participants that were categorized into three groups: (A) patients with psoriasis vulgaris; (B) patients with geographic tongue and psoriasis; (C) patients with geographic tongue without psoriasis. All patients underwent physical examination, and a skin and oral biopsy for histopathological examination and immunohistochemical analysis with anti-IL6, anti-IL17, and anti-IL23 antibodies. Results: Histological analysis of all lesions showed mononuclear inflammatory infiltrate. However, moderate intensity was prevalent for the patients with geographic tongue and psoriasis and geographic tongue groups. Immunopositivity for the antibodies anti-IL6, anti-IL17, and anti-IL23 revealed cytoplasmic staining, mainly basal and parabasal, in both psoriasis and geographic tongue. Regarding IL-6, in patients with geographic tongue and psoriasis cases the staining was stronger than in patients with geographic tongue without psoriasis cases. IL-17 evidenced more pronounced and extensive staining when compared to the other analyzed interleukins. IL-23 presented similar immunopositivity for both geographic tongue and psoriasis, demonstrating that the neutrophils recruited into the epithelium were stained. Study limitation: This study was limited by the number of cases. Conclusion: The inflammatory process and immunostaining of IL-6, IL-17, and IL-23 were similar in geographic tongue and psoriasis, suggesting the existence of a type of geographic tongue that represents an oral manifestation of psoriasis.

Geographic stomatitis with palate involvement

Abstract: Benign migratory glossitis or geographic tongue is a benign condition that usually manifests as asymptomatic erythematous and migratory circinate patches, involving the lateral and dorsal aspects of the tongue. Extra-lingual lesions uncommonly occur and are mainly located on labial and buccal mucosae, lips and floor of the mouth. The present report describes one patient with a geographic lesion on the hard palate associated with lingual lesions and another patient who had multiple geographic lesions both in the hard and soft palate without lingual lesions. We found 64 cases in the English literature of ectopic locations with 22 palate involvement. No case of simultaneous involvement of the hard and the soft palate was found.

Glossite migratória benigna em paciente pediátrico: relato de caso / Benign migratory glossitis in odontopediatric pacient: case report

Glossite migratória benigna, ou, língua geográfica, é uma desordem inflamatória assintomática de etiologia desconhecida que afeta o epitélio da língua. É diagnosticada clinicamente pela perda de papilas filiformes de maneira localizada e pelo aparecimento e remissão dessas perdas de modo migratório. Na maioria dos casos, não há necessidade de recorrer a um tratamento, no entanto, na presença de incômodos, analgésicos podem ser indicados. O objetivo deste estudo é trazer informações sobre o tema retratando suas peculiaridades e importância de conhecimento clínico(AU)

Benign migratory glossitis, or, geographic tongue, is an asymptomatic inflammatory disorder of unknown etiology that affects the tongue epithelium. It is diagnosed clinically by the loss of filiform papillae in a localized way and by the appearance and remission of these losses in a migratory way. In most cases, there is no need to resort to a treatment, however, in the presence of discomfort, analgesics may be indicated. The objective of this study is to bring information about the theme portraying its peculiarities and importance of clinical knowledge(AU)

Correlation of feline immunodeficiency virus status and the severity of feline chronic gingivostomatitis / Correlação do status sorológico para FIV e a gravidade da gengivoestomatite crônica felina

Feline chronic gingivostomatitis (FCGS) is a challenge for the veterinary practitioner since its etiology and treatments are still undefined. The present paper investigated the role of the feline immunodeficiency virus (FIV) in the severity of the FCGS. Oral mucosal biopsies obtained from 19 cats with FCGS were divided into two groups according to their FIV serology status. Later, the clinical lesion score was correlated with the histopathological grade of FCGS lesions and the degree of immunostaining in both groups. Most of the animals had significant histological changes; however, no correlation with FIV immunostaining intensity was observed. It was concluded that the presence of FIV infection or the animal's seropositivity status does not seem to interfere with the severity of clinical signs nor the degree of histopathological changes when compared to the seronegative group.(AU)

A gengivoestomatite crônica felina (FCGS) é um desafio para o veterinário, uma vez que a sua etiologia e tratamentos permanecem indefinidos. O presente trabalho investigou o papel do vírus da imunodeficiência felina (FIV) na gravidade do FCGS. Biópsias da mucosa oral de 19 gatos com FCGS foram divididas em dois grupos de acordo com o status sorológico de FIV. Mais tarde, o escore de lesão clínica foi correlacionado com o grau histopatológico das lesões FCGS e o grau de imunocoloração em ambos os grupos. A maioria dos animais apresentou alterações histológicas significativas, porém não foi observada correlação com a intensidade de imunocoloração para FIV. Concluiu-se que a presença de infecção por FIV ou o estado soropositivo dos animais não parece interferir com a gravidade dos sinais clínicos nem com o grau de alterações histopatológicas quando comparado ao grupo soronegativo.(AU)

Prevalence and heritability of psoriasis and benign migratory glossitis in one Brazilian population

Abstract: Background: An oral condition associated to psoriasis is benign migratory glossitis. The review of the literature does not show any publication about heritability in both soriasis and benign migratory glossitis and prevalence of psoriasis in the Brazilian population. Objective: This research was carried out in order to determine the prevalence of psoriasis and benign migratory glossitis in the Brazilian population from a Brazilian sample, as well as the heritability in these conditions. Methods: Six thousand patients were studied from the records of the outpatient dermatology department. The sample had 129 patients with cutaneous psoriasis, 399 with benign migratory glossitis without psoriasis and a control group with 5,472 patients. After data collection, the statistical analysis was made using Woolf, Chi-square and Falconer tests. Results: The prevalence of psoriasis was 2.15% and the benign migratory glossitis was 7.0%. The prevalence of benign migratory glossitis in the psoriasis group was high (16.3%), and that was statistically significant. Family history in the psoriasis group was 38% for the condition itself and 2,75% for benign migratory glossitis and in the benign migratory glossitis group was 17.54% for the condition itself and 1.5% for psoriasis. The study of heritability was 38.8% for psoriasis and 36.6% for benign migratory glossitis, both with medium heritability. Study limitations: This study was only in the state of São Paulo. Conclusion: This is the first publication that quantifies how much of these conditions have a genetic background and how important the environmental factors are in triggering them.

Clinical Observation of Kangfuxin Solution Combined with rhEGF Solution for External Use in the Treat-ment of Vitamin B12 Deficiency Atrophic Glossitis / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Kangfuxin solution combined with rhEGF solution for external use in the treatment of vitamin B12 deficiency atrophic glossitis. METHODS:Totally 94 patients with vitamin B12 deficien-cy atrophic glossitis in Xinjiang Production and Construction Corps Hospital during Jul. 2012-Jun. 2015 were divided into observa-tion group and control group according to random number table,with 47 cases in each group. Both groups received etiological treat-ment of vitamin B12 supplement. Control group was additionally given rhEGF solution for external use on tongue surface,qid. Based on control group,observation group was additionally given Kangfuxin solution and applied medical gauze saturated with liq-uid medicine to the affected area,more than 30 min each time,tid. Treatment course of 2 groups lasted for 4 week,a referral of the week. Clinical efficacies were compared between 2 groups as well as average pain indexes and lesion areas of tongue before and after treatment,and the occurrence of ADR. RESULTS:Cure rate(76.6% vs. 57.4%)and total response rate(97.9% vs. 83.0%) of observation group were significantly higher than those of control group,with statistical significance (P0.05). 1-4 weeks after treatment,average pain indexes and lesion areas of tongue in 2 groups were significantly decreased,with statistical sig-nificance compared to before treatment (P<0.05). The average pain indexes of observation group were significantly lower than those of control group (3,4 weeks after treatment),and lesion areas of tongue was significantly smaller than control group (2-4 weeks after treatment),with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For vita-min B12 deficiency atrophic glossitis,Kangfuxin solution combined with rhEGF solution for external use can significantly improve tongue lesion and have good analgesic effect and safety.

Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review

Abstract: Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue.

Avaliação do traço e estado de ansiedade em pacientes com Glossite Migratória Benigna / Evaluation of trait and state anxiety in patients with Benign Migratory Glossitis

Objetivo: avaliar estado e traço de ansiedade em pacientes com glossite migratória benigna (GMB). O estudo consistiu de 78 pacientes com GMB, apresentando ou não ocorrência simultânea de língua fissurada. Um grupo controle de 48 pacientes, sem lesões orais e/ou cutâneas, também foi incluído no estudo. Foi aplicado o Inventário de Traço-Estado de Ansiedade (STAI). Resultados: estado moderado e pontuações de ansiedade-traço foram observados nos grupos. Não houve diferenças estatisticamente significativas nos escores de ansiedade entre os grupos GMB e controle. Conclusão: a ansiedade não parece desempenhar um papel significativo na GMB, apesar dos níveis moderados observados em pacientes com GMB. No entanto, o estado emocional pode ser um fator determinante para as diferentes formas de manifestações de GMB.

Objective: To assess state and trait anxiety in patients with benign migratory glossitis (GMB). The study consisted of 78 patients with GMB, presenting or not simultaneous occurrence of fissured tongue. A control group of 48 patients without oral lesions and / or skin, was also included in the study. Inventory -Trait State Anxiety (STAI) was applied. Results: moderate state and trait anxiety scores were observed in groups. There were no statistically significant differences in anxiety scores between the GMB and control groups. Conclusion: The anxiety seems to play a significant role in the GMB, despite moderate levels observed in patients with GMB. However, the emotional state can be a determining factor for the different forms of manifestations of GMB.

Prevalencia de Lengua Geográfica en Niños Chilenos de 7 a 10 Años de Edad / Prevalence of Geographic Tongue in Chilean Children between 7 and 10 Years of Age

El objetivo del estudio fue determinar la prevalencia de lengua geográfica y evaluar su asociación con el estrés emocional, irritación crónica, lengua fisurada y tipo de establecimiento educacional, en niños de 7 a 10 años de edad en la ciudad de Viña del Mar, Chile. De un total de 27.234 escolares, cursando 2 a 5 año básico, pertenecientes a colegios de la ciudad de Viña del Mar, Chile, se examinaron 436 niños.Se realizó un estudio descriptivo transversal de alumnos provenientes de tres tipos de establecimientos educacionales diferentes: particular, particular con subvención del estado de Chile y municipalizado. Las variables estudiadas fueron edad, sexo y establecimiento educacional. Adicionalmente, en los alumnos con lengua geográfica y 23 alumnos sin este diagnóstico se evaluó la presencia de lengua fisurada, irritación lingual crónica y estrés emocional. Se determinó la prevalencia mediante el cálculo de una proporción, las variables discretas se analizaron mediante Chi-cuadrado de Pearson o la prueba de Fisher y para determinar medidas de asociación con lengua geográfica se realizó regresión logística binaria, considerándose significativo un p<0,05. De los 436 niños, 23 presentaron lengua geográfica, evidenciando una prevalencia de 5,28%, con un IC 95% de 3,37% a 7,81%. No se evidenciaron diferencias respecto al sexo, edad ni tipo de establecimiento educacional. No se determinaron factores asociados a lengua geográfica. La prevalencia de LG determinada es similar a otros estudios que abarcan la misma población de rangos etarios. Al igual que en otros estudios no se pudo demostrar que el estrés emocional, irritación crónica, lengua fisurada y tipo de establecimiento educacional constituyeron factores asociados a la presencia de lengua geográfica.

The aim of this study was to determine the prevalence of geographic tongue and evaluate its association with emotional stress, chronic irritation, fissured tongue and type of educational establishment, in children between 7 and 10 years of age, in the city of Viña del Mar, Chile. From a total of 27,234 students attending 2nd through 5th grade, we examined 436 children. A descriptive study of students was carried out from three different educational institutions: private, private with state funding and public schools. The variables studied were age, sex and the educational establishment the children attended. Additionally in the students with geographic tongue and in 23 students without this diagnosis, we evaluated the presence of fissured tongue, tongue irritation and chronic emotional stress. Prevalence was determined by calculating ratio, discrete variables were analyzed using Pearson Chi-square test or Fisher, and in order to determine association measures with geographic tongue, binary logistic regression was considered significant at p <0.05. Of the 436 children, 23 had geographic tongue, showing a prevalence of 5.28% with a 95% CI 3.37% to 7.81%. No differences regarding sex, age and type of educational establishment were found. No factors associated with geographic tongue were determined. The prevalence of the LG is similar to other studies covering the same age ranges. Furthermore, and as in other works, our study did not to show that emotional stress, chronic irritation, fissured tongue and the type of educational establishment constituted factors associated with the presence of geographic tongue.

Cefuroxime axetil induced glossitis: a case report.

Cefuroxime axetil is a semi synthetic cephalosporin antibiotic, which is prescribed for different types of infections such as lung, ear, throat, urinary tract, and skin. This is the drug of choice in the treatment and prevention of streptococcal infections. In this case, the patient was prescribed cefuroxime axetil, diclofenac, and paracetamol for pharyngitis. The patient developed glossitis 3 hrs after ingestion of above drugs which improved after withdrawing the offending drug. Glossitis is an uncommon, but serious adverse drug effect of cefuroxime axetil. It is important to recognize and manage it to prevent fatality. The case has been reported to the Pharmacovigilance Center Uttar Pradesh Rural Institute of Medical Sciences and Research Saifai, Etawah.

Matched case-control study to examine association of psoriasis and migratory glossitis in India.

Background: Psoriasis is a multifactorial disease. Genetic and environmental factors, which determine the disease epidemiology and clinical spectrum, are heterogeneous in different populations. A few case-control studies from other countries have shown an association between psoriasis and migratory glossitis (MG). The characteristics of the association (e.g. relationship with gender, severity of psoriasis, early- versus late-onset psoriasis, etc.) have not been clearly defined. Aim: To investigate the association of psoriasis and MG by conducting a matched case-control study in India. Methods: The study was conducted on 600 patients with psoriasis and 800 age- and sex-matched controls. Patients were examined for oral lesions and psoriasis severity was assessed by overall severity index (OSI) and psoriasis area and severity index (PASI). We compared the proportions of patients and controls with oral lesions, proportions of male and female patients who had MG, psoriasis severity scores of patients with or without MG, and proportions of early- and late-onset psoriasis patients who had MG. Results: Significantly, more patients had oral lesions than controls (P=0.0013). There was a strong association between psoriasis and MG (P<0.0001). MG and fissured tongue (FT) occurring in the same patient were also strongly associated with psoriasis (P=0.0003). There was a weak association of psoriasis with FT (P=0.0456). Significantly, higher proportion of male patients had MG compared to female patients (P=0.0246). Patients with MG had more severe psoriasis compared to those without the tongue lesions (P<0.0001). Similar proportions of patients with type 1 and type 2 psoriasis had MG (P=0.7268). Conclusions: The results suggest that MG is a rare manifestation of psoriasis which occurs more commonly in male patients and in those with severe disease, and that it occurs with equal frequency in early- and late-onset psoriasis. It will be interesting to follow those patients who have MG, but not psoriasis, to see whether they develop psoriasis phenotype in future.

Papillary atrophy of the tongue and nutritional status of hospitalized alcoholics / Glossite atrófica e estado nutricional de alcoolistas hospitalizados

BACKGROUND: Atrophy of the papillae, mucosa, and dorsum of the tongue are considered classical signs of nutritional deficiencies. OBJECTIVE: To assess the nutritional status of hospitalized alcoholics with or without papillary atrophy of the tongue. METHODS: This study was performed with 21 hospitalized alcoholics divided into Atrophic Glossitis Group (n=13) and Normal Tongue Group (n=8). Healthy, non-alcoholic volunteers composed the Control Group (n=8). Anthropometry and bioelectric impedance were performed, and serum vitamins A, E, and B12 were determined. RESULTS: There were no statistical differences in relation to age (46.7±8.7 vs. 46.8±15.8 years) or gender (92.3% vs. 87.5% male), respectively. Control Group volunteers were also paired in relation to age (47.5±3.1 years) and male predominance (62.5%). In relation to hospitalized alcoholics without atrophic lesions of the tongue and Control Group, patients with papillary atrophy showed lower BMI (18.6 ± 2,5 vs 23.8 ± 3.5 vs 26.7 ± 3,6 kg/m² ) and body fat content 7.6 ± 3.5 vs 13.3 ± 6.5 vs 19.5 ± 4,9 kg). When compared with the Control Group, alcoholic patients with or without papillary atrophy of the tongue showed lower values of red blood cells (10.8 ± 2.2 vs 11.8 ± 2.2 vs 14.5 ± 1,6g/dL) and albumin (3.6 ± 0.9 vs 3.6 ± 0.8 vs 4.4 ± 0.2g/dL). The seric levels of vitamins A, E, and B12 were similar amongst the groups. CONCLUSION: Hospitalized alcoholics with papillary atrophy of the tongue had lower BMI and fat body stores than controls, without associated hypovitaminosis.

FUNDAMENTOS: A deficiência crônica de nutrientes pode levar à hipotrofia das papilas e da mucosa e do dorso da língua, considerada um sinal clássico de subnutrição protéico-energética. OBJETIVO: O objetivo do presente estudo é comparar o estado nutricional, incluindo as dosagens dos níveis séricos de vitaminas A, E e B12 em pacientes alcoolistas com ou sem alterações tróficas das papilas linguais. MÉTODOS: O estudo caso-controle incluiu 21 pacientes adultos alcoolistas internados em um hospital universitário. Utilizando-se de um sistema de fotografia da cavidade oral, dois clínicos independentes classificaram os indivíduos alcoolistas de acordo com a presença ou não de alterações tróficas na língua. Foram registrados os dados antropométricos, a composição corporal pela impedância bioelétrica e os exames laboratoriais para avaliação clínica e nutricional, incluindo dosagens das vitaminas A, E e B12. O estudo incluiu ainda voluntários saudáveis, não alcoolistas como Grupo Controle (n=8). A comparação entre os grupos foi feita por ANOYA-F ou pelo teste de Kruskal-Wallis, de acordo com a curva de normalidade dos resultados. Foram considerados significativos diferenças com p < 0,05. RESULTADOS: De acordo com a presença de alterações tróficas nas papilas linguais, os pacientes alcoolistas foram alocados no Grupo Língua Despapilada (n=13) e Grupo Língua Normal (n=8), sem diferença estatística quanto à idade (46,7 ± 8,7 vs 46,8 ± 15,8 anos) e gênero masculino (92,3 vs 87,5%). Os voluntários do Grupo Controle apresentaram 47,5 ±3,1 anos, sendo 62,5% do gênero masculino. Os pacientes alcoolistas com hipotrofia papilar apresentaram menor IMC (18,6 ± 2,5 vs 23,8 ± 3,5 vs 26,7 ± 3,6 kg/m2) e gordura corporal (7,6 ± 3,5 vs 13,3 ± 6,5 vs 19,5 ± 4,9 kg), quando comparados com os demais grupos. Em relação ao Grupo Controle, os alcoolistas apresentaram menores valores de hemoglobina (10,8 ± 2,2 vs 11,8 ± 2,2 vs 14,5 ± 1,6 g/dL) e albumina sérica (3,6 ± 0,9 vs 3,6 ± 0,8 vs 4,4 ± 0,2 g/dL). Os níveis plasmáticos de vitaminas A, E e B12 foram similares entres os grupos. CONCLUSÃO: Os pacientes alcoolistas com achados físicos de hipotrofia de papilas linguais apresentam menores valores em medidas antropométricas, de hemoglobina e albumina séricas que os grupos Controle ou de alcoolistas sem língua despapilada. Não houve evidências de hipovitaminoses associadas.

TCM mechanism of Yin deficiency study of atrophic glossitis / 国际中医中药杂志

Based on TCM relative diagnostic theory and clinical experience,the author put forward that atrophic glossitis is caused by yin deficiency and should be treated from yin deficiency.During the past long-term clinical practice,the treatment from Yin deficiency has been proved a sound effect in the therapy of atrophic glossitis.

Glositis romboidal media: revisión a propósito de un caso clínico / glossitis Rhomboid average: review of a clinical case

La glositis romboidal media (GRM) es una alteración benigna, poco frecuente, que afecta ligeramente más a los varones. Suele localizarse en la línea media del dorso de la lengua por delante de la “V” lingual, en forma de área rojiza, romboidal, de superficie plana, como una mácula o a veces exofítica, mamelonada, que puede sobresalir de 2 a 5 mm y en la que no se observan papilas filiformes. Se presenta el caso clínico de un varón de 50 años de edad que consulta por presentar una lesión en dorso de lengua, situada en la línea media.

Median rhomboid glossitis (MRG) is an uncommon benign abnormality of the tongue, most frequently affecting men. It is typically located around the midline of the dorsum of the tongue, anterior to the lingual “V”, appearing as a reddish, rhomboid area, depapillated, flat maculate or mamillated and raised by2- 5 mm. This paper reports a case of rhomboid glossitis in a 50-year-old man who consulted for a lesion on the dorsum of the tongue, in a medial location.