The myelodysplastic syndromes. Case report and review

Gingival enlargement in myelodysplastic syndrome

The myelodysplastic syndrome (MDS) is characterized by peripheral blood cytopenias and increased risk of transformation to acute myeloid leukemia. This syndrome affects blood cell production and behavior. MDS is difficult to diagnose because of the absence of symptoms in the early stage of the disease. Often it is accidentally discovered during a routine physical exam/blood test. Till date, only a few cases of gingival enlargement associated with MDS are reported in the literature. Here is a remarkable case of gingival enlargement heralding the presence of MDS.

Skin findings in internal malignant diseases

PURPOSE

A skin finding may be an indicator of internal malignant diseases. In this report, we investigated the skin findings of the cases who have had internal malignancy within the last 1 month.

PATIENTS AND METHODS

Seven hundred cases who were diagnosed as internal malignancy and who did not have any treatment for the malignancy were enrolled in our study between February 2002 and September 2003. A form was completed for all of the cases, including name, surname, and the carcinoma type. All cases were examined in detail, and the observed skin findings or dermatosis was recorded.

RESULTS

The most frequent skin findings among the cases were tinea pedis/onychomycosis, followed by xerosis and pruritus. The skin findings in terms of frequency were determined mostly in hematological malignancies (68.96%).

CONCLUSION

We would like to emphasize that the skin is an indicator of the functions of internal organs and their disorders.

Severe Gingival Bleeding in a Myelodysplastic Patient: Management and Outcome

BACKGROUND

The myelodysplastic syndromes (MDS) are a group of stem cell disorders characterized by a reduction in one or more elements of the peripheral blood. Oral manifestations of the disease and oral complications of medical management may result in significant symptoms and have an impact on the systemic condition of the patient. The removal of the infectious focus, such active teeth infection or severe periodontal disease, remains controversial in these patients, due to the increased risk of bleeding and systemic infection.

METHODS

This paper reports a case of MDS with spontaneous gingival hemorrhage and generalized gingival hyperplasia associated with periodontal disease. This patient underwent several platelet transfusions due to these oral complications. The patient received periodontal therapy, resulting in an improvement of the oral clinical situation and a decrease of gingival hyperplasia.

RESULTS

The patient did not present any episode of gingival hemorrhage after the periodontal treatment.

CONCLUSION

The results of this study suggest that periodontal therapy should be performed in MDS patients presenting thrombocytopenia, gingival hyperplasia, and gingival bleeding, with the intent of preventing further hemorrhagic episodes and possible systemic infection.

The diagnosis and management of recurrent aphthous stomatitis: a consensus approach

BACKGROUND

Recurrent aphthous stomatitis, or RAS, is a common oral disorder of uncertain etiopathogenesis for which symptomatic therapy only is available. This article reviews the current data on the etiopathogenesis, diagnosis and management of RAS in a primary care setting.

METHODS

The authors reviewed publications on Medline from 1995 through 2000, the period since the last major reviews were published.

RESULTS

RAS may have an immunogenetic background owing to cross-reactivity with Streptococcus sanguis or heat shock protein. Predisposing factors seen in a minority include haematinic (iron, folate or vitamin B12) deficiency, stress, food allergies and HIV infection. While topical corticosteroids remain the mainstay for therapy, a number of other immunomodulatory modalities now are available.

CONCLUSIONS

There is still no conclusive evidence relevant to the etiopathogenesis of RAS, and therefore therapy can attempt only to suppress symptoms rather than to address the basic issues of susceptibility and prevention.

CLINICAL IMPLICATIONS

In the majority of patients, symptomatic relief of RAS can be achieved with topical corticosteroids alone, with other immunomodulatory topical agents or by combination therapy.

Gingival hemorrhage, myelodysplastic syndromes, and acute myeloid leukemia. A case report

Myelodysplasia syndrome (MDS) presenting as spontaneous gingival hemorrhage is described. Gingival hemorrhage is recognized as a symptom of MDS, a rare group of potentially fatal hematological disorders, but it has not previously been documented as a presenting sign. The diagnostic pitfalls are discussed with the case, and the need for careful interpretation of laboratory findings in conjunction with clinical signs is emphasized. Finally, the MDSs are defined, classified and discussed with respect to their relevance to the clinical periodontist, from a diagnostic, therapeutic, and management standpoint.