Psoriasis is a common skin disorder; knowledge of the factors that may induce, trigger, or exacerbate the disease is of primary importance in clinical practice. Drug intake is a major concern in this respect, as new drugs are constantly being added to the list of factors that may influence the course of this disease. Drug ingestion may result in exacerbation of pre-existing psoriasis, in induction of psoriatic lesions on clinically uninvolved skin in patients with psoriasis, or in precipitation of the disease in persons without family history of psoriasis or in predisposed individuals. In view of their relationship to drug-provoked psoriasis, therapeutic agents may be classified as drugs with strong evidence for a causal relationship to psoriasis, drugs about which there are considerable but insufficient data to support the induction or aggravation of the disease, and drugs that are occasionally reported to be associated with aggravation or induction. This review focuses on the most common causative agents for drug-induced, drug-triggered, or drug-aggravated psoriasis, such as β-blockers, lithium, synthetic antimalarial drugs, nonsteroidal anti-inflammatory agents, and tetracyclines, and the mechanisms of action of these drugs in the pathogenesis of psoriasis.

Introduction:Rapid maxillary expansion (RME) is an orthopedic treatment procedure routinely used to treat constricted maxillary arches and also a potential additional treatment in children presenting with sleep-disordered breathing (SDB).Aims and Objectives:The main objective of this study was to evaluate the effects of RME on sleep characteristics in children.Materials and Methods:Polysomnography was done on children of 8-13 years of age before expansion (T0), after expansion (T1) and after a period of 3 months after retention (T2). Bonded rapid maxillary expander was cemented in all children. Inter-molar distance was also measured at T0 and T2.Statistical Analysis:Nonparametric Friedman test was used for comparing the averages of sleep parameters at different time period (T0, T1, T2). Wilcoxon signed ranks test was used for comparing the averages of inter-molar width (T0-T2). P < 0.05 were considered as significant.Results:All children showed an improvement in sleep parameters with an increase in sleep efficiency, decreased in arousal and desaturation index after expansion. Total sleep time showed a statistically significant increase after expansion. A statistically significant increase in inter-molar distance was obtained after expansion.Conclusions:Rapid maxillary expansion is a useful treatment option for improving quality of sleep even in normal children without SDB. It also induces widening of the maxilla, corrects posterior crossbites and improves maxillary and mandibular dental arch coordination.

Rarely cases have been reported regarding depigmented lesions of the oral cavity. On reviewing the literature, only few cases of gingival vitiligo or similar lesions have been reported till date. These lesions pose a cosmetic challenge. We present here a case of vitiligo affecting gingiva. Vitiligo has been defined as an acquired, slowly progressive loss of cutaneous pigment which occurs as irregular, sharply defined patches which may or may not be surrounded by macroscopic hyperpigmentation. Differential diagnosis, detailed clinical history, histopathology, immunohistochemistry, and pathogenesis of this condition are discussed.