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Martins F, Pallos D, Candeia J, Zerbinati R, Braz-Silva PH, Campos L. Noninvasive Techniques for Management of Erythema Multiforme. Case Rep Dent 2023; 2023:9938939. [PMID: 38149304 PMCID: PMC10751166 DOI: 10.1155/2023/9938939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023] Open
Abstract
An 18-year-old man was referred for a diagnosis of extensive oral lesions. During the interview, he reported a medical history of ganglionic tuberculosis, type 2 herpes infection, and significant weight loss due to dysphagia. Intraoral exam revealed multiple painful and ulcerated lesions covered by pseudomembrane. Lesions were observed on the labial and buccal mucosa, tongue, and soft palate. The laboratory findings included serum positivity for the Epstein-Barr virus, and salivary tests showed positive values for herpes simplex virus (HSV-2) and human herpesvirus (HHV-7). The diagnostic hypothesis was based on clinical findings and viral infection detected in the saliva, which triggered an immunological disorder, that is, erythema multiforme (EM). The treatment consisted of antimicrobial photodynamic therapy (aPDT), with substantial improvement in pain and healing as seen in the following twenty-four hours. Complete resolution of the lesions was achieved five days after the first session. Once the diagnosis of virus-induced EM was confirmed, noninvasive techniques (e.g., salivary tests and aPDT) were very successful and can be indicated for managing these lesions.
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Affiliation(s)
- Fabiana Martins
- Postgraduate Program in Dentistry, School of Dentistry, University of Santo Amaro, Rua Prof. Enéas de Siqueira Neto, 340-Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
- Department of Stomatology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-000, Brazil
| | - Debora Pallos
- Postgraduate Program in Dentistry, School of Dentistry, University of Santo Amaro, Rua Prof. Enéas de Siqueira Neto, 340-Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
| | - Jodkandlys Candeia
- Postgraduate Program in Dentistry, School of Dentistry, University of Santo Amaro, Rua Prof. Enéas de Siqueira Neto, 340-Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
| | - Rodrigo Zerbinati
- Laboratory of Virology (LIM-52), Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, Rua Prof. Enéas Carvalho de Aguiar, 470-Cerqueira Cesar, São Paulo, SP 05403-000, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227, São Paulo, SP 05508-000, Brazil
- Laboratory of Virology (LIM-52), Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, Rua Prof. Enéas Carvalho de Aguiar, 470-Cerqueira Cesar, São Paulo, SP 05403-000, Brazil
| | - Luana Campos
- Postgraduate Program in Dentistry, School of Dentistry, University of Santo Amaro, Rua Prof. Enéas de Siqueira Neto, 340-Jardim das Imbuias, São Paulo, SP 04829-300, Brazil
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Wang ZZ, Zeng R, Wu ZW, Wang C, Jiang HQ, Wang HS. Overview and Current Advances in Dapsone Hypersensitivity Syndrome. Curr Allergy Asthma Rep 2023; 23:635-645. [PMID: 37804376 DOI: 10.1007/s11882-023-01109-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE OF REVIEW As a sulfone antibacterial agent, dapsone has been widely used to treat leprosy. Moreover, dapsone is also used in many immune diseases such as herpetic dermatitis because of its anti-inflammatory and immunomodulatory effects. However, dapsone can cause several adverse effects, the most serious being dapsone hypersensitivity syndrome. Dapsone hypersensitivity syndrome is characterized by a triad of eruptions, fever, and organ involvement, which limits the application of dapsone to some extent. RECENT FINDINGS In this article, we review current research about the interaction model between HLA-B*13:01, dapsone, and specific TCR in dapsone-induced drug hypersensitivity. In addition to the proposed mechanisms, we also discussed clinical features, treatment progress, prevalence, and prevention of dapsone hypersensitivity syndrome. These studies reveal the pathogenesis, clinical features, and prevalence from the perspectives of genetic susceptibility and innate and adaptive immunity in dapsone hypersensitivity syndrome, thereby guiding clinicians on how to diagnose, prevent, and treat dapsone hypersensitivity syndrome.
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Affiliation(s)
- Zhen-Zhen Wang
- Hospital of Skin Diseases and Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, St. 12 Jiangwangmiao, Nanjing, Jiangsu, China
| | - Rui Zeng
- Hospital of Skin Diseases and Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, St. 12 Jiangwangmiao, Nanjing, Jiangsu, China
| | - Zi-Wei Wu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chen Wang
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hai-Qin Jiang
- Hospital of Skin Diseases and Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, St. 12 Jiangwangmiao, Nanjing, Jiangsu, China.
| | - Hong-Sheng Wang
- Hospital of Skin Diseases and Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, St. 12 Jiangwangmiao, Nanjing, Jiangsu, China.
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
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Tirupathi S, Gopalakrishnan D, Deshkar S. Herbal topical anesthetics in dentistry: an exploratory review. J Dent Anesth Pain Med 2022; 22:419-426. [PMID: 36601130 PMCID: PMC9763823 DOI: 10.17245/jdapm.2022.22.6.419] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/23/2022] [Accepted: 11/09/2022] [Indexed: 12/03/2022] Open
Abstract
Topical anesthetics are routinely used in dental practice for various purposes. They are usually available at higher dosages and have serious potential adverse reactions, such as seizures, anaphylaxis, and acquired methemoglobinemia. To date, the scope of application of herbal plants and their extracts, which have medicinal properties, has been elaborated in the field of dentistry. The growing interest in herbal medication can be attributed to the increased safety profile of herbal agents, in contrast to synthetic preparations that have a higher risk of systemic complications. Herbal preparations can induce topical anesthesia with minimal side effects. Recently, many studies have reported the use of topical herbal preparations. The current review aimed to evaluate data from various articles comparing the capacity of herbal topical anesthetic formulations and conventional synthetic anesthetics in reducing pain perception when used as local anesthesia before dental procedures.
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Affiliation(s)
- Sunnypriyatham Tirupathi
- Department of Pediatric and Preventive Dentistry, Dr.D.Y. Patil Dental College and Hospital, Dr.D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr.D.Y. Patil Dental College and Hospital, Dr.D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Sanjeevani Deshkar
- Department of Pharmaceutics, Dr.D.Y. Patil Institute of Pharmaceutical Sciences & Research, Dr.D.Y. Patil Unitech Society, Pimpri, Pune, Maharashtra, India
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Pejcic AV, Milosavljevic MN, Folic M, Fernandes D, Bentes J, Djesevic M, Jankovic S. Amoxicillin-associated Stevens-Johnson syndrome or toxic epidermal necrolysis: systematic review. J Chemother 2022; 35:75-86. [PMID: 35285784 DOI: 10.1080/1120009x.2022.2051128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our aim was to explore and summarize available cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) suspected to be associated with amoxicillin reported in the literature. Electronic searches were conducted in several databases. Fifty-one publications describing a total of 64 patients who satisfied inclusion criteria were included in the review. The age of the patients ranged from 1.5-80 years (median: 24.5 years). TEN, SJS and SJS/TEN overlap were diagnosed in 30 (46.9%), 28 (43.8%) and 1 (1.6%) patients, respectively. SJS/TEN may occur promptly after administration of amoxicillin, but it could also be a delayed adverse effect. The total length of hospital stay ranged from 3-70 days (median: 16 days). Amoxicillin-induced SJS/TEN is accompanied by frequent occurrence of serious complications, long-term ocular and skin sequelae and high mortality rate. Clinicians should be aware that amoxicillin alone or combined with clavulanic acid can cause SJS/TEN in patients of all ages.
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Affiliation(s)
- Ana V Pejcic
- Faculty of Medical Sciences, Department of Pharmacology and toxicology, University of Kragujevac, Kragujevac, Serbia
| | - Milos N Milosavljevic
- Faculty of Medical Sciences, Department of Pharmacology and toxicology, University of Kragujevac, Kragujevac, Serbia
| | - Marko Folic
- Faculty of Medical Sciences, Department of Pharmacy, University of Kragujevac, Kragujevac, Serbia.,Clinical Pharmacology Department, University Clinical Centre Kragujevac, Kragujevac, Serbia
| | | | - João Bentes
- Federal University of Roraima, Boa Vista, Brazil
| | - Miralem Djesevic
- Department of Cardiology, Private Policlinic Center Eurofar Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Slobodan Jankovic
- Faculty of Medical Sciences, Department of Pharmacology and toxicology, University of Kragujevac, Kragujevac, Serbia.,Clinical Pharmacology Department, University Clinical Centre Kragujevac, Kragujevac, Serbia
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