Assuntos
Monoterpenos Cicloexânicos/efeitos adversos , Hipersensibilidade a Drogas/etiologia , Granulomatose Orofacial/induzido quimicamente , Hipersensibilidade Tardia/induzido quimicamente , Doenças Labiais/induzido quimicamente , Criança , Hipersensibilidade a Drogas/diagnóstico , Granulomatose Orofacial/diagnóstico , Humanos , Hipersensibilidade Tardia/diagnóstico , Doenças Labiais/diagnósticoAssuntos
Crioterapia , Doenças Labiais/induzido quimicamente , Doenças Labiais/terapia , Transtornos da Pigmentação/induzido quimicamente , Transtornos da Pigmentação/terapia , Adulto , Analgésicos/efeitos adversos , Antibacterianos/efeitos adversos , Humanos , Doenças Labiais/patologia , Masculino , Transtornos da Pigmentação/patologiaAssuntos
Detergentes/toxicidade , Hidróxidos/toxicidade , Doenças Labiais/induzido quimicamente , Doenças da Boca/induzido quimicamente , Úlceras Orais/induzido quimicamente , Compostos de Potássio/toxicidade , Doenças da Língua/induzido quimicamente , Adulto , Humanos , Masculino , Ilustração MédicaRESUMO
Immune checkpoint inhibitors (ICIs) are among the most promising drugs in the field of immuno-oncology; they represent monoclonal antibodies that modulate the effects of immune checkpoints, such as Programmed Cell Death protein 1 (PD-1) which is a co-inhibitory signal responsible for immune suppression. Dermatologic immune-related toxicity is a common type of toxicity associated with these agents. However, oral skin reactions are rare. Herein, we describe an unusual case of a patient that developed oral lichen planus during treatment with anti-PD-1 inhibitor nivolumab.
Assuntos
Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Líquen Plano/induzido quimicamente , Doenças Labiais/induzido quimicamente , Nivolumabe/efeitos adversos , Idoso , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Doenças Labiais/patologia , Masculino , Nivolumabe/uso terapêuticoAssuntos
Toxinas Botulínicas Tipo A/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Doenças Labiais/induzido quimicamente , Fármacos Neuromusculares/efeitos adversos , Idoso , Blefaroptose/induzido quimicamente , Abrasão Química/efeitos adversos , Dermatite de Contato/complicações , Dermatoses Faciais/complicações , Feminino , Humanos , Inflamação/etiologia , Lasers de Estado Sólido/efeitos adversos , Pessoa de Meia-Idade , Fotoquimioterapia/efeitos adversos , Distúrbios da Fala/induzido quimicamenteRESUMO
This article discusses complications that may occur after procedures on the lips, specifically focusing on injectable fillers. Evidence-based guidelines and suggested methods to manage these complications are presented in a systematic format.
Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Edema/induzido quimicamente , Doenças Labiais/induzido quimicamente , Transtornos da Pigmentação/induzido quimicamente , Equimose/induzido quimicamente , Granuloma de Corpo Estranho/induzido quimicamente , Granuloma de Corpo Estranho/cirurgia , Humanos , Infecções/induzido quimicamente , Lábio , RejuvenescimentoAssuntos
Amálgama Dentário/efeitos adversos , Granulomatose Orofacial/induzido quimicamente , Hipersensibilidade Tardia/etiologia , Índio/efeitos adversos , Doenças Labiais/induzido quimicamente , Granulomatose Orofacial/patologia , Humanos , Hipersensibilidade Tardia/patologia , Doenças Labiais/patologia , Testes do EmplastroAssuntos
Dalbergia/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Ocupacional/etiologia , Doenças Labiais/induzido quimicamente , Música , Dermatite Alérgica de Contato/diagnóstico , Dermatite Ocupacional/diagnóstico , Humanos , Doenças Labiais/diagnóstico , Masculino , Pessoa de Meia-IdadeRESUMO
Ecstasy (MDMA) is a mood-lifting drug with numerous somatic side effects, for example, dehydration or continuous chewing and biting. We describe the case of a young woman who underwent a forensic medical examination for suspected sexual assault. She claimed to have suffered from a memory lapse, and she had a painful swelling of her lips with a plaque-like coating on her lips and buccal mucosa. The attending physician suspected that these findings might have been caused by strong sucking pressure on her lips within the context of a sexual assault. A toxicological examination of a blood specimen verified that she had been under the influence of an extremely high dose of ecstasy (1.456 mg/L MDMA and 0.0213 mg/L MDA). Pursuant to the forensic medical assessment, the described findings on her lips, and buccal mucosa were interpreted as an allergic and mechanical reaction (through continuous chewing and biting) to ecstasy.
Assuntos
Hipersensibilidade a Drogas/etiologia , Edema/induzido quimicamente , Drogas Ilícitas/efeitos adversos , Doenças Labiais/induzido quimicamente , N-Metil-3,4-Metilenodioxianfetamina/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Feminino , Humanos , Mucosa Bucal/patologia , Adulto JovemAssuntos
Compostos Azo/efeitos adversos , Dermatite Alérgica de Contato/tratamento farmacológico , Inibidores Enzimáticos/uso terapêutico , Hidroxicloroquina/uso terapêutico , Doenças Labiais/tratamento farmacológico , Tatuagem/efeitos adversos , Idoso , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Feminino , Humanos , Doenças Labiais/induzido quimicamente , Doenças Labiais/patologiaRESUMO
BACKGROUND: Ace inhibitor-induced angioedema, characterized by sudden-onset swelling of the mucous membrane, skin, or both, is a rare occurrence in the Kingdom of Saudi Arabia. Because of its safety and efficacy, perindopril is a commonly prescribed angiotensin-converting enzyme inhibitor. Here we describe the clinical manifestations, management, and outcome of perindopril-induced angioedema of the lips and tongue in a 65-year-old Saudi man. CASE PRESENTATION: A 65-year-old Saudi Arab man presented to an emergency department with lip and tongue swelling and dysphagia. There were no systemic symptoms and no past history of a similar event. He had been consuming perindopril 5 mg and amlodipine 5 mg for the last 3 weeks: brand name, Coveram, from the company Servier (Ireland) Industries Ltd.; one tablet of Coveram contains 3.395 mg perindopril corresponding to 5 mg perindopril arginine and 6.935 mg amlodipine besilate corresponding to 5 mg amlodipine. A physical examination revealed considerable swelling of his lips and tongue. Examinations of other systems, including his cardiovascular and respiratory systems, revealed unremarkable findings. All laboratory parameters were also normal. Electrocardiography demonstrated sinus rhythm, a normal P axis, and V-rate of 50-99. A clinical diagnosis of perindopril-induced angioedema was made, and perindopril was discontinued. The angioedema resolved completely after the administration of antihistamines and corticosteroids. CONCLUSIONS: Angioedema caused by angiotensin-converting enzyme inhibitors is an uncommon occurrence in Saudi Arabia. The findings from this case are expected to raise awareness about this condition among clinicians in this country.
Assuntos
Angioedema/induzido quimicamente , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Doenças Labiais/induzido quimicamente , Perindopril/efeitos adversos , Doenças da Língua/induzido quimicamente , Corticosteroides/uso terapêutico , Idoso , Angioedema/tratamento farmacológico , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Doenças Labiais/tratamento farmacológico , Masculino , Arábia Saudita , Doenças da Língua/tratamento farmacológicoRESUMO
INTRODUCTION: Remarkable advances have occurred in the management of acute ischemic stroke, especially in regards to reperfusion treatments. With advances in reperfusion treatments come the risk of complications associated with these treatments. Areas covered: The article focuses on three acute complications that can occur in the setting of acute ischemic stroke: cerebral edema, hemorrhagic transformation, and orolingual angioedema following administration of alteplase, a recombinant tissue plasminogen activator. Predictors of the development of these complications are reviewed. The management of cerebral edema and hemorrhagic transformation is also reviewed in depth including potential new treatments targeting the blood-brain barrier. The article also reviews the management of the rare but potentially fatal complication of orolingual angioedema secondary to alteplase. Expert commentary: An understanding of the pathophysiology leading to the development of malignant cerebral edema and hemorrhagic transformation allows the clinician to anticipate and properly manage these acute complications. Regardless of a patient's age or comorbidities, the decision to pursue decompressive hemicraniectomy in patients with malignant cerebral edema should be based on an honest assessment of expected outcome and guided by the patient's prior wishes regarding an acceptable quality of life.
Assuntos
Angioedema/induzido quimicamente , Edema Encefálico/etiologia , Isquemia Encefálica/complicações , Hemorragia Cerebral/etiologia , Fibrinolíticos/efeitos adversos , Doenças Labiais/induzido quimicamente , Doenças da Boca/induzido quimicamente , Acidente Vascular Cerebral/complicações , Ativador de Plasminogênio Tecidual/efeitos adversos , Administração Intravenosa , Angioedema/tratamento farmacológico , Edema Encefálico/terapia , Isquemia Encefálica/tratamento farmacológico , Humanos , Doenças Labiais/tratamento farmacológico , Doenças da Boca/tratamento farmacológico , Qualidade de Vida , Reperfusão , Acidente Vascular Cerebral/tratamento farmacológicoRESUMO
Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML). All-trans retinoic acid (ATRA) is the first-choice therapy for the treatment of this disease, but has been associated with side effects, the most serious of which is retinoic acid syndrome (RAS). RAS is characterized by unexplained fever, dyspnea, pulmonary infiltrate, leukocytosis and nephropathy. Genital ulcers have been described in some cases, but only two cases of oral ulcers related to this syndrome have been described in the literature. This paper describes the third case of oral ulceration related to ATRA in a 32-year-old white man with diagnosis of APL. Clinicians should know the side effects of ATRA and identify oral ulcers resulting from this therapy. The prompt identification of these ulcers enables the institution of appropriate treatment and can therefore contribute to continuation of the patient's cancer treatment.
Assuntos
Antineoplásicos/efeitos adversos , Leucemia Promielocítica Aguda/tratamento farmacológico , Doenças Labiais/induzido quimicamente , Tretinoína/efeitos adversos , Úlcera/induzido quimicamente , Adulto , Humanos , MasculinoAssuntos
Cloroquina/efeitos adversos , Hiperpigmentação/induzido quimicamente , Fatores Imunológicos/efeitos adversos , Doenças da Boca/induzido quimicamente , Doenças da Unha/induzido quimicamente , Transtornos da Visão/induzido quimicamente , Cloroquina/farmacocinética , Cloroquina/uso terapêutico , Feminino , Humanos , Fatores Imunológicos/farmacocinética , Fatores Imunológicos/uso terapêutico , Doenças Labiais/induzido quimicamente , Lúpus Eritematoso Discoide/tratamento farmacológico , Melaninas/metabolismo , Pessoa de Meia-Idade , Mucosa Bucal/patologiaAssuntos
Broncodilatadores/efeitos adversos , Budesonida/efeitos adversos , Hipersensibilidade a Drogas/diagnóstico , Edema/induzido quimicamente , Hipersensibilidade Imediata/diagnóstico , Doenças Labiais/induzido quimicamente , Administração por Inalação , Asma/tratamento farmacológico , Broncodilatadores/administração & dosagem , Budesonida/administração & dosagem , Diagnóstico Diferencial , Hipersensibilidade a Drogas/etiologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
The long-term use of novel antipsoriatic systemic biotechnological drugs may increase susceptibility to opportunistic infections. Several cases of visceral leishmaniasis have been reported in immunosuppressed individuals, including those who have been treated with tumour necrosis factor alpha (TNFα) blocking agents. Simultaneous occurrence of cutaneous and visceral involvement has been more rarely recorded in the medical literature. Herein, we describe a case of mucosal leishmaniasis occurring in a farmer living in an endemic region, who was treated with golimumab because of psoriatic arthritis. This highlights the importance of recognizing cutaneous lesions as a first indicator of possible underlying kala-azar disease.
Assuntos
Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Artrite Psoriásica/tratamento farmacológico , Leishmaniose Mucocutânea/induzido quimicamente , Leishmaniose Mucocutânea/diagnóstico , Leishmaniose Visceral/induzido quimicamente , Leishmaniose Visceral/diagnóstico , Doenças Labiais/induzido quimicamente , Doenças Labiais/diagnóstico , Infecções Oportunistas/induzido quimicamente , Infecções Oportunistas/diagnóstico , Fator de Necrose Tumoral alfa/efeitos adversos , Idoso , Biópsia , Medula Óssea/patologia , Diagnóstico Diferencial , Humanos , Leishmania donovani , Leishmaniose Mucocutânea/patologia , Leishmaniose Visceral/patologia , Doenças Labiais/patologia , Masculino , Infecções Oportunistas/patologia , Fator de Necrose Tumoral alfa/uso terapêuticoRESUMO
BACKGROUND AND PURPOSE: Orolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE. METHODS: We prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE. RESULTS: Of 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6-9.7; P=0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5-16.5; P=0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6-11.9; P=0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3-8.1; P=0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3-2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1-1.8), and death (adjOR, 1.1; 95% CI, 0.3-3.8). CONCLUSIONS: OLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.
Assuntos
Obstrução das Vias Respiratórias/induzido quimicamente , Angioedema/induzido quimicamente , Isquemia Encefálica/tratamento farmacológico , Fibrinolíticos/efeitos adversos , Doenças Labiais/induzido quimicamente , Terapia Trombolítica/efeitos adversos , Ativador de Plasminogênio Tecidual/efeitos adversos , Doenças da Língua/induzido quimicamente , Idoso , Idoso de 80 Anos ou mais , Angioedema/epidemiologia , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Córtex Cerebral/irrigação sanguínea , Infarto Cerebral/tratamento farmacológico , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Doenças Labiais/epidemiologia , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Estudos Prospectivos , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Ativador de Plasminogênio Tecidual/uso terapêutico , Doenças da Língua/epidemiologiaRESUMO
The strive for proficient cosmetic facial appearance is growing in the past decades. Fillers for tissue augmentation are gaining wide popularity. Uncertified products based on oleic solutions are applied by untrained staff, thus growing the risk for certain complications such as infections, allergic and irritant contact dermatitis, and lipogranuloma formation. We present a series of three cases lipogranuloma after liquid vitamin E injection for lip augmentation. In all cases, painful edema at the injected area followed the procedure. The patients were presented with erythema, firm indurations of the lips and the perioral skin, and tenderness. Histological examination of skin biopsies showed round-ovoid cavities of varying sizes, resulting in a Swiss cheese-like appearance, consistent with a lipogranuloma. In this paper, we propose a protocol for treatment of this specific complication with systemic corticosteroids and a broad spectrum antibiotics.
Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Granuloma de Corpo Estranho/induzido quimicamente , Doenças Labiais/induzido quimicamente , Rejuvenescimento , Vitamina E/efeitos adversos , Adolescente , Corticosteroides/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Biópsia , Preenchedores Dérmicos/administração & dosagem , Quimioterapia Combinada , Feminino , Granuloma de Corpo Estranho/diagnóstico , Granuloma de Corpo Estranho/tratamento farmacológico , Humanos , Injeções Subcutâneas , Doenças Labiais/diagnóstico , Doenças Labiais/tratamento farmacológico , Resultado do Tratamento , Vitamina E/administração & dosagem , Adulto JovemRESUMO
INTRODUCTION: Fixed drug eruption (FDE) is a specific skin reaction and the only exclusively medicinal dermatosis. Among the drugs usually responsible are the antituberculous antibiotics including rifampicin and, less often, isoniazid and pyrazinamide. FDE after taking ethambutol is rarely described. CASE REPORT: A 32-year old HIV negative patient presented a FDE localized to the internal surface of the lips and the interdigital folds during the 4th month of antituberculous treatment comprising rifampicin, isoniazid and ethambutol. The diagnosis was supported by the characteristic appearances of the lesions of FDE and their early reappearance in the same areas after accidental reintroduction of antituberculous triple therapy including ethambutol. Double-agent therapy with rifamicin and isoniazid was tolerated well. CONCLUSION: Discovery of FDE requires a rigorous search for the responsible medicine. During antituberculous treatment, the practitioner has to bear in mind the potential role of ethambutol, which is possibly potentiated by rifampicin.