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Mouth, tongue, lips and ears
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
A rare condition mainly affecting young men. You should think of it in any patient with recurrent oral and genital ulceration. The ulcers tend to be larger, deeper and last longer than aphthous ulcers. There will also be one or more of the following: iritis, arthritis, thrombophlebitis, vasculitis, sterile pustules on the skin (Fig. 6.04), erythema nodosum and meningo-encephalitis. Such patients should be referred to hospital for treatment.
Scientific Rationale for the Use of Single Herb Remedies in Ayurveda
Published in D. Suresh Kumar, Ayurveda in the New Millennium, 2020
S. Ajayan, R. Ajith Kumar, Nirmal Narayanan
Recurrent aphthous ulcers are among the most common oral mucosal diseases found in children and adults (Messier et al. 2012). These ulcers have varied etiology that includes bacterial infection by Streptococcus sanguinis, genetics, autoimmune causes and folic acid deficiency. Recurrent aphthous ulcers are treated by relieving pain, promoting healing and preventing secondary infection (Zunt 2001).
Benign Oral and Dental Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Konrad S. Staines, Alexander Crighton
As aphthous ulcers are driven by an immunological reaction, the process can be controlled using immunomodulatory therapy. In some cases, altering environmental factors such as avoiding sodium lauryl sulphate (SLS) containing toothpastes or dietary triggers (benzoate, chocolate, cinnamon) can reduce the triggering of lesions to a level low enough to satisfy the patient. In others, the use of topical immunosuppressants or immunomodulators can successfully alter the clinical course of the disease. As the immunological damage happens some days before the ulcer appears, it is critical that the treatment is started as soon as the patient becomes aware of the lesion. By the time the ulcer appears, it is too late for an immunomodulatory drug to be effective and the patient must rely on analgesic solutions or obturative pastes to manage their symptoms. Treatment options for aphthous ulcers are listed in Table 42.10. Systemic immunotherapy should only be used by a specialist with appropriate experience.
Comparisons of Clinical Features in Japanese Patients with Behçet’s Uveitis Treated in the 1990s and the 2000s
Published in Ocular Immunology and Inflammation, 2020
Hisae Nakahara, Toshikatsu Kaburaki, Rie Tanaka, Atsushi Yoshida, Mitsuko Takamoto, Mikiko Kawata, Yujiro Fujino, Hidetoshi Kawashima, Makoto Aihara
We used criteria revised in 2003 for diagnosis and typing of the disease.12 Briefly, recurrent aphthous ulcers in oral mucosa, skin lesions (erythema nodosum, acne, cutaneous hypersensitivity, etc.), ocular inflammation, and genital ulcers were considered to be major symptoms, while arthritis, intestinal ulcers, epididymitis, vascular lesions (obliteration, occlusion, aneurysm, etc.), and neuropsychiatric disease were minor symptoms. Patients presenting four major symptoms simultaneously or at different times were defined as complete-type BD, while those with three major symptoms simultaneously or at different times, two major and two minor symptoms, typical recurrent ocular inflammation and one or more major symptoms, or typical recurrent ocular inflammation and two minor symptoms were defined as incomplete-type BD. On the other hand, patients with one or two major symptoms including uveitis who did not satisfy the requirements for the incomplete type were defined as suspect-type BD. We included complete- and incomplete-type patients in the present study, and excluded suspect-type because we intended to obtain findings from definite cases of BD. Special-type BD patients, mainly those with neuropsychiatric disease, intestinal ulcers, or vascular lesions, were further defined as neuro-BD, intestinal BD, and vasculo-BD, respectively.
Pluronic lecithin organogel of 5-aminosalicylic acid for wound healing
Published in Drug Development and Industrial Pharmacy, 2018
Bharat Kumar Reddy Sanapalli, Elango Kannan, Shivaramakrishnan Balasubramanian, Jawahar Natarajan, Uday Krishna Baruah, Veera Venkata Satyanarayana Reddy Karri
5-Aminosalicylic acid (5-ASA) or Mesalazine or Mesalamine is an aminosalicylate anti-inflammatory drug currently being used for the treatment of inflammatory bowel disease, ulcerative colitis, inflamed anus or rectum, and maintaining remission in Crohn's disease [7,8]. Aphthous ulcer patients treated with 5-ASA cream show decreased discomfort, pain, and healing time [9]. 5-ASA promoted the rapid reestablishment of mucosal integrity in vitro by enhancing epithelial restitution and proliferation in the non-transformed small-intestinal epithelial cell line [10]. In another study by Raju et al., (2014) 5-ASA has shown significant re-epithelization in bronchi of Balb/C mice induced with Ovalbumin [11]. The above-described studies postulated the use of 5-ASA for healing various tissues by re-epithelization mechanisms and give an indication for its possible application as topical wound-healing agent. Hence in this present study, 5-ASA has been selected to study its possible wound-healing effects in excision wound model in rats. However, its poor solubility hinders its application and therapeutic efficacy topically [12]. Hence, in this study Pluronic lecithin organogel (PLO) has been employed as a drug delivery system to improve 5-ASA solubility as well as efficacy for its topical administration.
Supraglottic stenosis in a case of Behcet’s disease
Published in Scandinavian Journal of Rheumatology, 2018
M Hajialilo, M Nasemieh, A Khabbazi
A 43-year-old woman with known BD was admitted with dysphagia and stridor in June 2016. Her disease had presented 10 years previously with recurrent oral and genital aphthous ulcerations and pseudofolliculitis. She had been referred to the Connective Tissue Diseases Research Center (CTDRC) clinic in September 2014 because of the recurrent OAUs. Pathergy test was positive, so treatment with colchicine was started after diagnosing BD. Since her symptoms did not improve, treatment with prednisolone 7.5 mg/day and methotrexate 10 mg/week was started. However, she did not follow the treatment and discontinued her medications. In June 2016, she was referred to the CTDRC again because of the changes in her voice, lack of appetite, and mild dysphagia. On examination, six minor aphthous ulcers were observed in the tongue, soft palate, and pharynx. The patient had inspiratory stridor and her voice was nasalized. Other systems were normal on examination. Laboratory tests were as follows: white blood cell count 6.71 × 103/mm3, haemoglobin 11.5 g/dL, erythrocyte sedimentation rate 32 mm/h, C-reactive protein 11 mg/dL (0-6 mg/dL), aspartate transaminase 22 IU/L, alanine transaminase 28 IU/L, blood urea nitrogen 20 mg/dL, creatinine 0.8 mg/dL, human leucocyte antigen (HLA)-B5 positive, HLA-B51 positive, anti-nuclear antibody negative, and urine analysis normal.