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UREMIC STOMATITIS: A CASE REPORT
OOOO Volume 129, Number 1 UREMIC STOMATITIS: A CASE REPORT. GABRIEL CAMPOS LOUZEIRO, VALESCA SANDER KOTH, MARIANA KLEIN, DIENI DA SILVEIRA TEIXEIRA, MARIA ANTONIZA ZANCANARO DE FIGUEIREDO, KAREN CHERUBINI and, FERNANDA GONCALVES ¸ SALUM Uremic stomatitis represents an unusual condition associated with uremia in patients with renal failure. A 29-year-old man with chronic renal failure on hemodialysis was referred by nephrology service because of complaint of multiple painful oral lesions. The patient had been hospitalized for fever associated with severe pancytopenia and elevated levels of creatinine and urea (16.10 mg/dL and 251 mg/dL, respectively). On physical examination, the patient presented with whitish plaques interspersed by reddish areas of atrophy and epithelial erosion and few ulcerated areas dispersed in the upper and lower labial mucosa, bilateral buccal mucosa, bilateral tongue border, ventral surface of tongue, floor of the mouth, labial commissures, soft palate, and lower lip vermillion. Chlorhexidine 0.12% mouthwash was prescribed to assist in oral antisepsis. Laser therapy was performed periodically for local analgesia. The oral lesions regressed spontaneously as the serum levels of urea decreased with hemodialysis.
ACANTHOLYTIC SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY. HELENA AYRES ALONSO DOS SANTOS, RAFFAEL MARON, ELLEN BRILHANTE CORTEZZI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MARIO JOSE e ROMANACH and, MICHELLE AGOSTINI Acantholytic squamous cell carcinoma (AcSCC) is a rare variant of poorly differentiated oral SCC of aggressive behavior that contains marked acantholysis, resulting in an adenoid appearance. A 58-year-old man presented an extensive painful and necrotic mass affecting the lower lip mucosa and skin, which appeared ulcerated and hardened for the last 5 months. The patient’s cervical lymph nodes were palpable, and previous heavy tobacco use was reported. Intraoral examination showed an 8 £ 6 cm ulcerated mass affecting lower anterior alveolar ridge with extension to the floor of the mouth and anterior mandible, which was completely destroyed in the image of panoramic radiograph. An incisional biopsy was performed, and microscopically, infiltrative malignant nests containing many acantholytic and dyskeratotic squamous cells were observed. The final diagnosis was of AcSCC, and the patient was referred for treatment. Oral AcSCC may appear as an exuberant infiltrative mass causing extensive bone destruction.
SUTTON SYNDROME: CASE REPORT. INGRID CARLA GUEDES DA SILVA, RAYLANE FARIAS DE ALBUQUERQUE, IGOR HENRIQUE DE MORAIS SILVA, ANDREZA BARKOKEBAS SANTOS DE FARIA, LUIZ ALCINO MONTEIRO GUEIROS, JAIR CARNEIRO LEAO and, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO Sutton disease has no known etiology and is a severe and painful clinical variant of recurrent aphthous stomatitis. The patient attended our oral medicine unit complaining of a painful ulcerated lesion, which did not regress after use of triamcinolone
ABSTRACTS
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acetonide for 1 week. The intraoral clinical examination revealed the presence of an ulcer on the right side of the floor of the mouth, about 1 cm in diameter, presenting whitish pseudomembrane; it had defined edges, was erythematous, and had hardened surfaces. The following complementary examinations were performed: full blood cell count, coagulogram, and fasting blood glucose, which were within the normal range. An incisional biopsy with diagnostic hypothesis of Sutton disease and differential diagnosis of squamous cell carcinoma was performed. The report of the histopathologic examination indicated nonspecific chronic inflammatory active ulcerative process. The lesion regressed spontaneously after 15 days of biopsy, leaving a scar.
VENLAFAXINE CHLORIDRATE-ORAL LICHENOID REACTION: CASE REPORT. INGRID CARLA GUEDES DA SILVA, ADRIANA MACHADO ZARZAR, RAYLANE FARIAS DE ALBUQUERQUE, IGOR HENRIQUE DE MORAIS SILVA, LUIZ ALCINO MONTEIRO GUEIROS, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO and, JAIR CARNEIRO LEAO Venlafaxine hydrochloride is a structurally novel antidepressant that inhibits reuptake of 5-hydroxytryptamine and noradrenaline but, unlike the older antidepressants, has few adverse effects. A 57-year-old female patient, a smoker with anxiety, on psychiatric treatment with venlafaxine hydrochloride attended our oral medicine unit complaining of a white spot on the right cheek with 1 year since the onset, which did not regress after the use of nystatin and triamcinolone acetonide. The intraoral clinical examination revealed the presence of white striae and leucoplastic plaque on the buccal mucosa and on the right lateral border of the tongue with no symptoms. The following complementary examinations were performed: full blood cell count, coagulogram, fasting blood glucose, and incisional biopsy, with a diagnostic hypothesis of lichenoid reaction and differential diagnosis of lichen planus. Histopathologic findings revealed a chronic lymphocytic inflammatory reaction characteristic of the lichenoid reaction.
ORAL MANIFESTATIONS IN PATIENT WITH WILLIAMS-BEUREN SYNDROME: CASE REPORT. JOYCE HELENA MONTEIRO BARBOSA, SAMIR COSTA NUNES, ALEXANDRA GABRIELLY DE SOUSA BENTES, CRISLYNE MENDES DA e VERA CRUZ, INGRID CAROLINE MARANHAO MOURATO, VANESSA SANTOS RODRIGUES CANUTO and, ERICK NELO PEDREIRA Williams-Beuren syndrome (SWB) has genetic etiology, is caused by microdeletions in the region of chromosome 7 q11-23, and presents as clinical manifestations facial dysmorphology, short stature, hypotonia, mental retardation, congenital heart disease, infantile hypercalcemia, and dental anomalies. This study describes a 10-year-old male patient, clinically diagnosed as having SWB, with congenital aortic stenosis and mental retardation, who was followed up by a cardiologist, psychologist, geneticist, speech therapist, and physiotherapist. The patient attended the dental service, evidencing the presence of a mixed dentition, dental calculus, and edematous gingiva as a consequence of poor hygiene. The treatment plan was established through radiographic examinations of the elements 16, 26, 36, and 46;
ACANTHOLYTIC SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY. HELENA AYRES ALONSO DOS SANTOS, RAFFAEL MARON, ELLEN BRILHANTE CORTEZZI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MARIO JOSE e ROMANACH and, MICHELLE AGOSTINI Acantholytic squamous cell carcinoma (AcSCC) is a rare variant of poorly differentiated oral SCC of aggressive behavior that contains marked acantholysis, resulting in an adenoid appearance. A 58-year-old man presented an extensive painful and necrotic mass affecting the lower lip mucosa and skin, which appeared ulcerated and hardened for the last 5 months. The patient’s cervical lymph nodes were palpable, and previous heavy tobacco use was reported. Intraoral examination showed an 8 £ 6 cm ulcerated mass affecting lower anterior alveolar ridge with extension to the floor of the mouth and anterior mandible, which was completely destroyed in the image of panoramic radiograph. An incisional biopsy was performed, and microscopically, infiltrative malignant nests containing many acantholytic and dyskeratotic squamous cells were observed. The final diagnosis was of AcSCC, and the patient was referred for treatment. Oral AcSCC may appear as an exuberant infiltrative mass causing extensive bone destruction.
SUTTON SYNDROME: CASE REPORT. INGRID CARLA GUEDES DA SILVA, RAYLANE FARIAS DE ALBUQUERQUE, IGOR HENRIQUE DE MORAIS SILVA, ANDREZA BARKOKEBAS SANTOS DE FARIA, LUIZ ALCINO MONTEIRO GUEIROS, JAIR CARNEIRO LEAO and, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO Sutton disease has no known etiology and is a severe and painful clinical variant of recurrent aphthous stomatitis. The patient attended our oral medicine unit complaining of a painful ulcerated lesion, which did not regress after use of triamcinolone
ABSTRACTS
e71
acetonide for 1 week. The intraoral clinical examination revealed the presence of an ulcer on the right side of the floor of the mouth, about 1 cm in diameter, presenting whitish pseudomembrane; it had defined edges, was erythematous, and had hardened surfaces. The following complementary examinations were performed: full blood cell count, coagulogram, and fasting blood glucose, which were within the normal range. An incisional biopsy with diagnostic hypothesis of Sutton disease and differential diagnosis of squamous cell carcinoma was performed. The report of the histopathologic examination indicated nonspecific chronic inflammatory active ulcerative process. The lesion regressed spontaneously after 15 days of biopsy, leaving a scar.
VENLAFAXINE CHLORIDRATE-ORAL LICHENOID REACTION: CASE REPORT. INGRID CARLA GUEDES DA SILVA, ADRIANA MACHADO ZARZAR, RAYLANE FARIAS DE ALBUQUERQUE, IGOR HENRIQUE DE MORAIS SILVA, LUIZ ALCINO MONTEIRO GUEIROS, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO and, JAIR CARNEIRO LEAO Venlafaxine hydrochloride is a structurally novel antidepressant that inhibits reuptake of 5-hydroxytryptamine and noradrenaline but, unlike the older antidepressants, has few adverse effects. A 57-year-old female patient, a smoker with anxiety, on psychiatric treatment with venlafaxine hydrochloride attended our oral medicine unit complaining of a white spot on the right cheek with 1 year since the onset, which did not regress after the use of nystatin and triamcinolone acetonide. The intraoral clinical examination revealed the presence of white striae and leucoplastic plaque on the buccal mucosa and on the right lateral border of the tongue with no symptoms. The following complementary examinations were performed: full blood cell count, coagulogram, fasting blood glucose, and incisional biopsy, with a diagnostic hypothesis of lichenoid reaction and differential diagnosis of lichen planus. Histopathologic findings revealed a chronic lymphocytic inflammatory reaction characteristic of the lichenoid reaction.
ORAL MANIFESTATIONS IN PATIENT WITH WILLIAMS-BEUREN SYNDROME: CASE REPORT. JOYCE HELENA MONTEIRO BARBOSA, SAMIR COSTA NUNES, ALEXANDRA GABRIELLY DE SOUSA BENTES, CRISLYNE MENDES DA e VERA CRUZ, INGRID CAROLINE MARANHAO MOURATO, VANESSA SANTOS RODRIGUES CANUTO and, ERICK NELO PEDREIRA Williams-Beuren syndrome (SWB) has genetic etiology, is caused by microdeletions in the region of chromosome 7 q11-23, and presents as clinical manifestations facial dysmorphology, short stature, hypotonia, mental retardation, congenital heart disease, infantile hypercalcemia, and dental anomalies. This study describes a 10-year-old male patient, clinically diagnosed as having SWB, with congenital aortic stenosis and mental retardation, who was followed up by a cardiologist, psychologist, geneticist, speech therapist, and physiotherapist. The patient attended the dental service, evidencing the presence of a mixed dentition, dental calculus, and edematous gingiva as a consequence of poor hygiene. The treatment plan was established through radiographic examinations of the elements 16, 26, 36, and 46;