Lesions associated with drug reactions

An interesting potential reaction to warfarin

Warfarin is an oral anticoagulant, used routinely for patients with atrial fibrillation, deep vein thrombosis, pulmonary embolism and those with a mechanical prosthetic valve. There are several noted adverse reactions associated with its use, in particular the risk of haemorrhage. Other adverse reactions include: hypersensitivity, rash, alopecia, diarrhoea, unexplained drop in haematocrit, purple toes, skin necrosis, jaundice, hepatic dysfunction, nausea, vomiting and pancreatitis. In this case report, an interesting potential adverse reaction to warfarin is discussed. The reaction described affected the patient's tongue, without affecting any other aspect of the oral cavity or body.

CLINICAL RELEVANCE

This case report highlights the potential problems that can be encountered by patients on warfarin therapy, specifically, the possibility for hypersensitivity type reactions.

Oral lichenoid drug eruption: a report of a pediatric case and review of the literature

Lichenoid drug eruptions are seen most frequently on the skin and seldomly affect the mucosal surfaces. Oral involvement-known as oral lichenoid drug eruption-is more common in the adult population and has been associated with numerous medications. Pediatric-onset oral lichenoid drug eruption is an exceptionally rare finding with only isolated cases published in the literature. The nonspecific appearance and latent presentation of pediatric oral lichenoid drug eruption can cause confusion in diagnosis and treatment. We report a case of oral lichenoid drug eruption occurring in a 15-year-old and explore challenges in the clinical and histologic recognition of this condition.

Oral manifestations of systemic disease

Most systemic diseases can affect the oral cavity. Some oral changes are nonspecific, whereas others directly lead to the diagnosis of a particular disorder. A systems approach is used here to catalog these oral changes. In some instances it is difficult to separate the oral manifestations of pharmacotherapy for a particular disease from that entity. The oral manifestations of pharmacotherapy are presented for selected disease processes. This article introduces the most common oral manifestations of systemic disease.