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Assessment – Nutrition-Focused Physical Exam to Detect Micronutrient Deficiencies
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Common physical signs of micronutrient deficiencies exhibited on the lips include cheilosis, or angular stomatitis (Figure 7.4). Cheilosis is an inflammation of one or both corners of the mouth, and appears as fissures and sores on the lips, which may split and bleed. Potential micronutrient deficiencies associated with this condition include vitamins B2, B3 and B6, as well as iron. Potential non-nutrient causes include dehydration, chapping from harsh climates, and herpes and/or other infectious diseases.4,8
Experimental Stomatology
Published in Samuel Dreizen, Barnet M. Levy, Handbook of Experimental Stomatology, 2020
Samuel Dreizen, Barnet M. Levy
Ten of the women developed symptoms similar to pellagra sine pellagra between the 94th and 130th day. There was maceration of the angles of the mouth, reddening of the lips along the line of closure, and thinning and denudation of the mucosa. The word “cheilosis” was coined to describe the morbid condition of the lips. In addition to the lip lesions, the subjects developed a scaly, greasy desquamation in the nasolabial folds, on the alae nasi, in the vestibule of the nose, and — in a few instances — on the ears and eyelids. In all ten women with cheilosis, the lesions did not respond to the administration of nicotinic acid but did disappear following riboflavin therapy. They recurred after riboflavin was discontinued and responded again when therapy was reinstituted. Of the eight women who did not develop cheilosis by the 139th day, four were given a daily preventive dose of riboflavin and four were not. Of the latter, two developed cheilosis on the 191st and 203rd day, and one had a slight maceration at the angles of the mouth on the 200th day.
Vitamins
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Vitamin B2 is a component of flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD). These two coenzymes catalyze a variety of oxidation–reduction reactions, including glucose oxidation and amino acid deamination. The vitamin is found in fish, poultry, dairy products, and leafy vegetables. Poor intestinal absorption of riboflavin limits its toxicity. The deficiency state (ariboflavinosis) is rare and often masked by other nutritional insufficiencies. Early symptoms include cheilosis (fissures in the mouth), glossitis (inflammation of the tongue), interstitial ophthalmic keratosis, and dermatitis.
All-trans retinoic acid in anticancer therapy: how nanotechnology can enhance its efficacy and resolve its drawbacks
Published in Expert Opinion on Drug Delivery, 2021
Gabriel Silva Marques Borges, Flávia Alves Lima, Guilherme Carneiro, Gisele Assis Castro Goulart, Lucas Antônio Miranda Ferreira
Administration of ATRA can lead to the appearance of the differentiation syndrome (DS), early called retinoic acid syndrome, in leukemic patients [109,110]. During DS, ATRA may induce the release of several cytokines and promote the adhesion of blasts to the endothelium, generating a combination of increased vascular permeability and endothelial damage. This leads to fever, tachycardia and, if not treated, patients can eventually progress to shock and multi-organ failure [111]. Besides DS, in the clinical trials with non-APL cancer patients, Vesanoid® led to hypertriglyceridemia, headache, nausea, skin toxicity, cheilosis, and liver dysfunction events [4–7,39,112–114]. In animal studies, it has been reported that free ATRA administration causes renal and hepatic toxicity in mice [115].
Superficial radiotherapy for non-melanoma skin cancer of the lip: a 44-year Italian experience
Published in Journal of Dermatological Treatment, 2020
Roberta Piccinno, Simona Tavecchio, Valentina Benzecry
Since the lips dominate the appearance of the lower face, frequently patients are diagnosed of non-melanoma skin cancer (NMSC) of the lip at an early stage of the disease, without lymph node involvement. In terms of persistence and recurrence, the lip is considered a high-risk anatomical area for both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Lip SCC accounts for 25–30% of all oral cancers, often preceded by actinic cheilosis, associated to risk factors such as male sex, older age, fair skin, and sun exposure, with a trend to decline in incidence (1). BCC of the lip is more common in female sex and more frequently observed on upper lip, but data are not homogeneous. On the whole SCC is nearly four times as common as BCC in lower lip, that is the opposite ratio respect to all anatomical sites, with a ratio of BCC to SCC of 4:1 (2).
46,XX,der(9)t4;9)(q31.1;p24) as a novel genetic marker for spontaneous resolution of foetal pleural effusion
Published in Journal of Obstetrics and Gynaecology, 2018
E. H. Comert, E. S. Guvendag Guven, S. Guven, C. Kart, A. Cansu, A. Cebi
Primary pleural effusion is defined as the accumulation of pleural fluid and it may be isolated or can be combined with other congenital malformations such as hydrops (acid, pericardial effusion, polyhydroamnios, thickening of the placenta, skin edema). It is a rare condition, with an estimated incidence of 1:10,000–15,000 pregnancies (Longaker et al. 1989). It is usually cheilosis and this type is called ‘primary foetal pleural effusion (PPE)’ or ‘congenital chylothorax’ (May et al. 1993). PPE depends on many secondary causes such as chromosomal abnormalities, malformations and hydrops, therefore, the underlying cause determines the prognosis in developing of pleural effusion (Klam et al. 2005). Advanced isolated pleural effusion may make pressure on the vena cava and heart, this may lead to heart failure. Isolated pleural effusion should be noted as the first sign of foetal hydrops (May et al. 1993). PPE is often associated with polyhydroamnios because of compression on the oesophagus. This condition may increase the risk of preterm birth (Murayama et al. 1987).