An Unusual Granular Ulcer Secondary Oral Tuberculosis of Vestibule Mandibular Mucosa

Valenzuela-Narváez, Rocío Violeta; Valenzuela, Daniel A.; Valenzuela, Daniel R; Bailón, Aguilar; Machco, Heriberto; Mena, Carla; Córdova, María; Mejía, Cris; Estrada, Ana

doi:10.1055/s-0040-1709919

Cited by 5 publications

(15 citation statements)

References 14 publications

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“…Crohn's disease, an immunological condition, was the next excluded diagnosis due to no history of gastrointestinal disorders 13,14 . Infectious lesions, especially tuberculosis and syphilis, were excluded after that because of no significant medical and social history 15 . Consequently, trauma was suspected.…”

Section: Discussionmentioning

confidence: 99%

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Toothbrushing‐induced vestibular ulcerations with severe gingival defects

Liu,

Cao,

et al. 2023

Gerodontology

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BackgroundDaily toothbrushing is a routine approach for helping to keep the oral cavity healthy. However, using a toothbrush as an ordinary oral hygiene habit can also lead to adverse events.Case PresentationA 75‐year‐old man was referred by a periodontist for vestibular ulcerations with gingival defects. The patient reported no significant medical or social history, which might be associated with his symptoms. On examination, wide labio‐buccal gingival defects, white attached gingiva and linear vestibular ulcerations were observed. With the help of the periodontist, a diagnosis of inappropriate toothbrushing‐induced traumatic ulcerations was reasoned via an approach of aetiological elimination. The patient was put on a trial course of topical dexamethasone powder with lincomycin. The resolution of vestibular ulcerations was apparent after two weeks. He reported no similar oral ulcerations during the following nine years.ConclusionTo our knowledge, this is the first case reported in the literature of vestibular ulcerations with severe gingival defects caused by inappropriate toothbrushing. The establishment of a correct diagnosis needs a close collaboration between periodontists and oral medicine specialists. Instruction on correct toothbrushing, especially for older people can be beneficial.

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Section: Discussionmentioning

confidence: 99%

“…13,14 Infectious lesions, especially tuberculosis and syphilis, were excluded after that because of no significant medical and social history. 15 Consequently, trauma was suspected. Improper toothbrushing was supposed to be clinically relevant.…”

Section: Discussionmentioning

confidence: 99%

Toothbrushing‐induced vestibular ulcerations with severe gingival defects

Liu,

Cao,

et al. 2023

Gerodontology

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“…Oral TB most often represents a secondary infection from the initial pulmonary foci. 19 Likewise, oral deep fungal infections usually manifest along with the disseminated form of diseases. These infections mainly occur in immunocompromised settings and frequently appear as chronic oral ulcerations with surface irregularity similar to EBVMCU.…”

Section: Discussionmentioning

confidence: 99%

Multifocal Oral Epstein–Barr Virus-Positive Mucocutaneous Ulcers Associated with Dual Methotrexate and Leflunomide Therapy: A Case Report

2022

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Epstein–Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) is a unique clinicopathologic entity of lymphoproliferative disorder, occurring in immunosuppressed patients. Due to its rarity, EBVMCU may be under-recognized by clinicians as well as pathologists. In addition, its clinical and histopathologic features overlap with other benign and malignant conditions, making a diagnosis challenging. This report presents an unusual case of multifocal oral EBVMCUs in a 52-year-old female patient with rheumatoid arthritis, receiving the combination of methotrexate and leflunomide for 5 years. The patient presented with persistent multiple large painful ulcers involving her palate and gingiva for 6 months. The histopathologic examination revealed extensive ulceration with diffuse polymorphic inflammatory infiltrate admixed with scattered atypical lymphoid cells showing occasional Hodgkin and Reed/Sternberg-like cell features. These atypical cells showed immunoreactivity for CD20, CD30 and MUM1/IRF4. EBV-encoded small RNA in situ hybridization was positive, validating the presence of EBV-infected cells. Two months after discontinuation of both immunosuppressive medications, oral lesions gradually regressed. At 9-month follow-up, no evidence of relapsing oral EBVMCU has been observed. The multifocal presentation of EBVMCU is rare and could be resulted from the overwhelming immune suppression by long-term use of dual immunosuppressants. Its diagnosis requires comprehensive correlation of patient history, clinical findings, histopathologic, and immunophenotypic features. The ability of EBVMCU to regress following removal of immunosuppressive causes is in drastic contrast to a variety of its potential clinical and histopathologic mimics. Therefore, accurate diagnosis is crucial to avoid unnecessary patient management and achieve optimal patient outcomes.

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“…Thus, more specialized treatments and greater investment in the treatment of periodontal disease is required. [2][3][4][5][6] Chronic kidney disease (CKD), defined as the loss of renal function, is a public health problem related to premature mortality with important social and economic implications. Timely early diagnosis is necessary for appropriate monitoring and interventions.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, more specialized treatments and greater investment in the treatment of periodontal disease is required. 2–6…”

Section: Introductionmentioning

confidence: 99%

Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults

Valenzuela-Narváez

et al. 2021

J Int Med Res

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Objective The aim of this study was to evaluate periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults. Methods A total of 1159 adults aged 65 to 80 years and diagnosed with periodontal disease and CKD (stages 1, 2, and 3) were randomly selected for a cross-sectional study. Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) and CKD was staged using the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines. Results In patients with stage 1 CKD, the odds ratios (ORs) (95% confidence intervals [CIs]) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.13 (0.83–1.55), 1.47 (1.13–1.81), 1, and 1, respectively. In patients with stage 2 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1.49 (1.14–1.93), 1.37 (1.02–1.78), 3.07 (2.81–3.25), and 3.65 (3.49–3.71), respectively. In patients with stage 3 CKD, the ORs (95% CIs) for CPITN-1, CPITN-2, CPITN-3, and CPITN-4 were 1, 1, 4.61 (4.47–5.21), and 5.23 (5.14–5.47), respectively. Conclusion The highest CPITN values (CPITN-3 and CPITN-4) were associated with CKD stages 2 and 3. Thus, periodontal disease may be associated with progression of CKD.

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An Unusual Granular Ulcer Secondary Oral Tuberculosis of Vestibule Mandibular Mucosa

Cited by 5 publications

References 14 publications

Toothbrushing‐induced vestibular ulcerations with severe gingival defects

Toothbrushing‐induced vestibular ulcerations with severe gingival defects

Multifocal Oral Epstein–Barr Virus-Positive Mucocutaneous Ulcers Associated with Dual Methotrexate and Leflunomide Therapy: A Case Report

Periodontal disease as a predictor of chronic kidney disease (CKD) stage in older adults

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