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Blagec T, Glavina A, Špiljak B, Bešlić I, Bulat V, Lugović-Mihić L. Cheilitis: A cross-sectional study-multiple factors involved in the aetiology and clinical features. Oral Dis 2023; 29:3360-3371. [PMID: 36001068 DOI: 10.1111/odi.14359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/09/2022] [Accepted: 08/14/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Since the aetiologies of cheilitis are broad and overlapping, the purpose of this cross-sectional clinical study was to examine the multiple factors involved in aetiology and the disease's clinical features. SUBJECTS AND METHODS We analysed cheilitis prevalence, demography, clinical features, patients' habits, psychological stress, systemic diseases, vitamin B9, B12 and iron serum levels and allergy test results in a total of 130 subjects with cheilitis, plus 22 healthy subjects. RESULTS The most common cheilitis types were: cheilitis simplex and eczematous cheilitis (28.5%); herpetic cheilitis (16.9%); and exfoliative and angular cheilitis (7.7%). Concerning bad habits, there was a significant association/connection between self-reported saliva at the corners of the mouth and angular cheilitis, and between lip licking/biting and exfoliative cheilitis. Common associated conditions were skin diseases (56.5%) and atopy (84%). Vitamin B9 and B12 serum and iron values were mostly within the normal reference range. The patients suffering from herpetic cheilitis had significantly higher psychological/mental stress levels than the control group. CONCLUSION To our knowledge, this is the first study of cheilitis patients that has simultaneously analysed aetiological factors, characteristics of the disease and diagnostic parameters.
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Affiliation(s)
- Tadeja Blagec
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
| | - Ana Glavina
- Dental Clinic Split, Department of Oral Medicine and Periodontology, School of Medicine, School of Medicine, University of Split, Split, Croatia
| | - Bruno Špiljak
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
| | - Iva Bešlić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
| | - Vedrana Bulat
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
| | - Liborija Lugović-Mihić
- School of Dental Medicine, University of Zagreb, Zagreb, Croatia
- Department of Dermatovenereology, University Hospital Centre Sestre Milosrdnice, Zagreb, Croatia
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Goraya JS, Kaur S. Vitamin B 12 deficiency in mothers and children: risk of neuro-regression. Paediatr Int Child Health 2023; 43:50-56. [PMID: 36755398 DOI: 10.1080/20469047.2023.2171767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/17/2022] [Indexed: 02/10/2023]
Affiliation(s)
- Jatinder Singh Goraya
- Department of Pediatrics, Division of Pediatric Neurology, Dayanand Medical College and Hospital Ludhiana, Punjab, India
| | - Sukhjot Kaur
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Factors Participating in the Occurrence of Inflammation of the Lips (Cheilitis) and Perioral Skin. COSMETICS 2023. [DOI: 10.3390/cosmetics10010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Lip inflammation may manifest as mainly reversible cheilitis, mainly irreversible, or cheilitis connected to dermatoses or systemic diseases. Therefore, knowing a patient’s medical history is important, especially whether their lip lesions are temporary, recurrent, or persistent. Sometimes temporary contributing factors, such as climate and weather conditions, can be identified and avoided—exposure to extreme weather conditions (e.g., dry, hot, or windy climates) may cause or trigger lip inflammation. Emotional and psychological stress are also mentioned in the etiology of some lip inflammations (e.g., exfoliative cheilitis) and may be associated with nervous habits such as lip licking. To better manage cheilitis, it is also helpful to look for potential concomitant comorbidities and the presence of related diseases/conditions. Some forms of cheilitis accompany dermatologic or systemic diseases (lichen, pemphigus or pemphigoid, erythema multiforme, lupus, angioedema, xerostomia, etc.) that should be uncovered. Occasionally, lip lesions are persistent and involve histological changes: actinic cheilitis, granulomatous cheilitis, glandular cheilitis, and plasmacellular cheilitis. Perioral skin inflammation with simultaneous perioral dermatitis can have various causes: the use of corticosteroids and cosmetics, dysfunction of the skin’s epidermal barrier, a contact reaction to allergens or irritants (e.g., toothpaste, dental fillings), microorganisms (e.g., Demodex spp., Candida albicans, fusiform bacteria), hormonal changes, or an atopic predisposition. Epidermal barrier dysfunction can worsen perioral dermatitis lesions and can also be related to secondary vitamin or mineral deficiencies (e.g., zinc deficiency), occlusive emollient use, sunscreen use, or excessive exposure to environmental factors such as heat, wind, and ultraviolet light. Current trends in research are uncovering valuable information concerning the skin microbiome and disruption of the epidermal barrier of persons suffering from perioral dermatitis. Ultimately, an effective approach to patient management must take all these factors and new research into account.
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Wong S, Ahmad N, Rossetti AL. Vomiting as a Presenting Symptom of Infantile Vitamin B12 Deficiency. Cureus 2022; 14:e25134. [PMID: 35733471 PMCID: PMC9205382 DOI: 10.7759/cureus.25134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
An 8-month-old, exclusively breastfed girl presented with a five-month history of vomiting with subsequent failure to thrive and lethargy. Family history was notable for the maternal history of gastroschisis. Mother had no dietary restrictions and had successfully breastfed multiple children for >12 months without issue. Initial evaluation was notable for macrocytic anemia. Subsequent serum B12 levels were undetectable. Upon further questioning, the mother had significant bowel resection as an infant due to complications of gastroschisis. Maternal serum B12 levels were also undetectable. The infant’s symptoms resolved with supplementation.
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Arduino PG, Cabras M, Macciotta A, Longhi F, Gambino A, Broccoletti R. A single-center prospective pilot open-label study to assess the efficacy of topical application of an oxygen-enriched oil for the treatment of angular cheilitis. J Oral Sci 2022; 64:105-108. [PMID: 34980827 DOI: 10.2334/josnusd.21-0428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The aim of this pilot study was to clarify the acceptability and clinical efficacy of an oxygen-enriched oil-based gel for treatment of angular cheilitis. METHODS A class IIb medical preparation, packaged in appropriate syringes, was tested. Patients were instructed how to use the gel for 10 days: finger rub application (3 times daily) on the dried lesion after meals, without eating, drinking, or speaking for at least 30 min thereafter. The Wilcoxon signed-rank test was used to assess whether there were any differences in the distributions of reported pain and lesion dimension. A microbiological examination was also performed with oral swabs; chi-squared test was used to compare the difference in the presence of microorganisms before and after treatment. RESULTS Thirty patients were treated. A significant improvement in reported outcome and a significant reduction in the initially measured largest dimension of the lesion were observed after use of the clinical protocol. Additionally, a significant reduction in the pathogen count was found. CONCLUSION Even if with limitations, data showed that this medical preparation facilitated prompt recovery from reported pain, without adverse reactions. Further work with a larger study population, and possibly a randomized control medication, will be needed.
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Affiliation(s)
| | - Marco Cabras
- Department of Surgical Sciences, University of Turin
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Sharma A, Bhatia S, Ahuja R, Sahni K. Addisonian pigmentation responding to vitamin B12: The nails tell the story! Dermatol Ther 2021; 35:e15187. [PMID: 34738295 DOI: 10.1111/dth.15187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/19/2021] [Accepted: 10/30/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Ananya Sharma
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Bhatia
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rhea Ahuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Kanika Sahni
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Defo D, Chetcha B, Nchindo PMK, Tounouga DN, Kouotou EA. Hyperpigmentation of the hands and feet revealing vitamin B12 deficiency. Int J Dermatol 2021; 60:1425-1428. [PMID: 34216022 DOI: 10.1111/ijd.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Defo Defo
- Yaoundé Central Hospital, Yaoundé, Cameroon.,Cameroon Society of Dermatology, Yaoundé, Cameroon
| | - Bernard Chetcha
- Yaoundé Central Hospital, Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaoundé 1, Yaoundé, Cameroon
| | - Pius-May Kindong Nchindo
- Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - Emmanuel A Kouotou
- Yaoundé Central Hospital, Yaoundé, Cameroon.,Faculty of Medicine and Biomedical Sciences, Department of Internal Medicine and Subspecialties, University of Yaoundé 1, Yaoundé, Cameroon.,Cameroon Society of Dermatology, Yaoundé, Cameroon
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Rashid S, Meier V, Patrick H. Review of Vitamin B12 deficiency in pregnancy: a diagnosis not to miss as veganism and vegetarianism become more prevalent. Eur J Haematol 2021; 106:450-455. [PMID: 33341967 DOI: 10.1111/ejh.13571] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 01/23/2023]
Abstract
Vegetarianism and veganism are increasingly popular. The Food Standards Agency, biennial Food and You Survey of adults aged 16 years and over living in the UK, found that between 2012 and 2018 the proportion of people who reported never consuming dairy products had increased from 2% to 5%. However, veganism risks development of vitamin B12 deficiency as it is not available from plant sources. Moreover, its impact may be slow to be detected because body stores of vitamin B12 can last years. There is currently no published guidance on antenatal diagnosis and management of vitamin B12 deficiency. This paper reviews the metabolism, diagnosis and treatment of vitamin B12 in pregnancy. It concludes that national screening policymakers should consider introducing screening for B12 deficiency into the Antenatal and Newborn Screening Programmes for mothers and their infants if at risk of vitamin B12 deficiency. In the interim, national policy should be developed for prophylactic vitamin B12 supplementation in high-risk groups around the time of pregnancy.
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Affiliation(s)
- Sabia Rashid
- Lewisham and Greenwich NHS Trust, Queen Elizabeth Hospital, London, UK
| | - Violet Meier
- Library and Knowledge Services, University Hospital Lewisham, London, UK
| | - Hannah Patrick
- Lewisham and Greenwich NHS Trust, Queen Elizabeth Hospital, London, UK
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Altawil L, Alshihry H, Ahmed H, Shamseldin HE, Alkuraya F. Vitamin B12 deficiency secondary to cobalamin F deficiency simulating dyskeratosis congenita. JAAD Case Rep 2020; 6:882-885. [PMID: 32875039 PMCID: PMC7452181 DOI: 10.1016/j.jdcr.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Lama Altawil
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hind Alshihry
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hala Ahmed
- Department of Hematology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hanan E Shamseldin
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fowzan Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.,Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Cabras M, Gambino A, Broccoletti R, Lodi G, Arduino PG. Treatment of angular cheilitis: A narrative review and authors' clinical experience. Oral Dis 2020; 26:1107-1115. [PMID: 31464357 DOI: 10.1111/odi.13183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/12/2022]
Abstract
Angular cheilitis (AC) is a clinical entity first described in the XIX century, characterized by erythema, rhagades, ulcerations, and crusting of one or both lip commissures and perilabial skin, responsible of an unpleasant and painful discomfort. Aim of this manuscript was to examine and evaluate the therapeutic options actually available for AC. Despite antifungals being the first-line treatment for most of clinicians, very limited scientific evidence supports their reliability, with just two RCTs published between the 70's and the 80's. Furthermore, alternative topical treatments, various techniques of occlusal vertical dimension restoration, B-vitamin supplementation, anti-drooling prosthetic device, and photodynamic therapy have been experimented and proposed, mostly in the form of case reports or case series on a small number of individuals. Our group found in 1% isoconazole nitrate (ISN) and 0.1% diflucortolone valerate (DFV) ointment the most consistent AC treatment, due to the broad spectrum of ISN against many species of dermatohpytes and bacteria, and the anti-inflammatory properties displayed by DFV. However, further and well-designed trials on larger samples of patients are needed to assess the differential profile of consistency of the treatments outlined in literature and claimed by the authors of this paper.
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Affiliation(s)
- Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
- Department of Mechanical and Aerospace Engineering, Politecnico of Turin, Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Turin, Italy
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