ABSTRACT
Cheilitis granulomatosa (CG) can be associated with many different disorders. A 37-year-old male patient presented with CG as an early manifestation of Crohn's disease. Patients suffering from CG need a thorough diagnostic work-up for associated or underlying diseases. Clinical follow-up examinations are necessary as CG can precede the causative diseases.
Subject(s)
Crohn Disease/diagnosis , Melkersson-Rosenthal Syndrome/diagnosis , Adult , Anti-Infective Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Biopsy , Colonoscopy , Crohn Disease/drug therapy , Crohn Disease/pathology , Dapsone/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination , Histiocytes/pathology , Humans , Intestinal Mucosa/pathology , Lip/pathology , Male , Melkersson-Rosenthal Syndrome/drug therapy , Melkersson-Rosenthal Syndrome/pathology , Triamcinolone Acetonide/therapeutic useABSTRACT
BACKGROUND: Up to 100% relapse rate after successful electroconvulsive therapy (ECT) poses a challenge for patients and psychiatrists. The aim of the study was to evaluate the outcome of patients affected by major depression after the successful course of acute ECT. METHODS: 84 patients recruited in a randomized double blind multicenter study designed to investigate the optimal stimulation placement in acute ECT had a follow up under naturalistic conditions between the 5th and 7th month. Outcome, maintenance therapy and patients; attitude were evaluated with semi structured questionnaires by patients and the study raters. RESULTS: 82.14% (68/84) questionnaires of the patients and 83.3% (70/84) of the rater were returned. 98% of the patients had at least one antidepressant; only in 23% (20/68) lithium was prescribed. 35% (7/20) of the patients with lithium and 57% (16/28) without lithium had a relapse within the first 6 months (OR 0.6) in a median of 2.5 months. Only one institution offered maintenance ECT in 8.3% (7/84) patients. For 52.2% of the patients ECT was a helpful treatment an 49.3% would recommend the therapy to their relatives. The vast majority (59.4%) wishes a better information about the ECT and 21.4% feel frightening about the therapy. CONCLUSIONS: The results show a high relapse rate and highlight the meaning of maintenance medication especially for a lithium combination therapy, as stated before. In regard to the subjective sensation the patients claim a better education about the ECT and anyway one of four patients feel frightening about the therapy.
