A case of Sturge-Weber Syndrome is presented in a male neonate with severe gangrenous ulcerative stomatitis involving the angiomatous skin lesion and leaving sequele of cleft lip and nasal disfiguration.
Cleft Lip* ; Congenital Abnormalities* ; Gingivitis, Necrotizing Ulcerative ; Humans ; Infant, Newborn ; Male ; Skin ; Sturge-Weber Syndrome*

Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.
Alveolar Bone Loss ; Anti-Bacterial Agents ; Chlorhexidine ; Clinical Protocols ; Dental Scaling ; Diagnosis* ; Gingivitis ; Gingivitis, Necrotizing Ulcerative* ; Humans ; Mouth ; Periodontal Diseases ; Prescriptions

PURPOSE: The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. METHODS: We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. RESULTS: In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. CONCLUSIONS: Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively.
Adult ; Chlorhexidine ; Clinical Protocols ; Decapitation ; Female ; Fusobacteria ; Gingivitis, Necrotizing Ulcerative ; Humans ; Hydrogen Peroxide ; Necrosis ; Palate ; Palate, Hard ; Spirochaetales ; Stomatitis* ; Suppuration ; Ulcer

OBJECTIVE: The purpose of this study was to evaluate value of methotretrexate (MTX) in the treatment of tubal pregnancy. METHODS: 28 patients with unruptured tubal pregnancy were treated alternately with four doses of intramuscular MTX (1.0 mg/kg) and four doses of intramuscular citrovorum factor (0.1 mg/kg). Patients considered eligible for MTX treatment of tubal pregnancy were those with unruptured tubal pregnancy ulcerative stomatitis, dermatitis, pneumonitis and alopecia. CONCLUSION: MTX is safe and effective as a primary therapy for those with unruptured tubal pregnancy Alopecia ; Bone Marrow ; Chorionic Gonadotropin ; Dermatitis ; Diagnosis ; Diarrhea ; Female ; Fetal Heart ; Gestational Age ; Gestational Sac ; Gingivitis, Necrotizing Ulcerative ; Humans ; Leucovorin ; Methotrexate* ; Pneumonia ; Pregnancy ; Pregnancy, Tubal* ; Salpingectomy ; Ultrasonography ; Vomiting

Necrotizing ulcerative stomatitis (NUS) refers to ulceration of the oral mucosa that precedes rapid orofacial soft- and hard-tissue destruction. NUS on the upper lip is considered a reconstructive challenge because of the functional importance and complex multidimensional structure of the facial units that are involved, and is most commonly found in developing countries. Therefore, few studies have been conducted on NUS. Moreover, reconstruction options vary from local regional flaps to free-tissue transfers. We report a very interesting case in which we performed regional flap surgery using bilateral cheek advancement in a patient with NUS. A 75-year-old woman with a history of diabetes mellitus and hypertension, but no other immunological diseases, presented with skin necrosis on the upper lip. At presentation, necrotic tissue covered the upper lip and philtrum, but it had not invaded the nose or lower lip. After debridement of the necrotic tissue, approximately 70% of the upper lip was missing. We therefore designed a bilateral cheek advancement and rotation flap, in which the flap was sutured in 3 layers. There was no need to perform additional procedures, as the flap healed well and showed no other complications or recurrence. The patient exhibited good voluntary muscle control and oral competence while eating and drinking, and she was also very satisfied with the cosmetic results. Thus, regional flap surgery using a simple advancement flap may result in good recovery of both functional and aesthetic units in patients with NUS.
Aged ; Cheek* ; Debridement ; Developing Countries ; Diabetes Mellitus ; Drinking ; Eating ; Female ; Gingivitis, Necrotizing Ulcerative* ; Humans ; Hypertension ; Immune System Diseases ; Lip* ; Mental Competency ; Mouth Mucosa ; Muscle, Skeletal ; Necrosis ; Noma ; Nose ; Reconstructive Surgical Procedures ; Recurrence ; Skin ; Surgical Flaps ; Ulcer*

necrotizing ulcerative gingivitis (ANUG). The results were satisfactorty so we report this case. 31 years old male patient showed sore throat, gingival ulceration, palpable both submandibular lymph node, and sulcular pus formation around posterior decayed teeth. This is the third time he has suffered from this symptom. Tentative diagnosis was acute necrotizing ulcerative gingivitis. Antibiotic therapy was started. But, intraoral symptom got worse in process of time. Especially ulcer of marginal gingiva got worse. Viral disease was suspected. We carried out viral cultivation. At the same time topical application of antiviral ointment (herpecid(R)) was performed on oral ulcer unilaterally for the purpose of diagnosis and reducing pain experimentally. The next day pain was decreased dramatically on application area. Basing on the viral cultivation and clinical effect of antiviral ointment (herpecid(R)), we have diagnosed it as a recurrent herpes-stomatitis and concluded that viral infection was major cause of disease and bacterial infection was secondary.]]>
Bacterial Infections ; Ganglia, Sensory ; Gingiva ; Gingivitis, Necrotizing Ulcerative ; Herpes Simplex ; Herpesvirus 1, Human ; Humans ; Lymph Nodes ; Male ; Methylmethacrylates ; Mouth ; Oral Ulcer ; Pharyngitis ; Polystyrenes ; Suppuration ; Tooth ; Ulcer ; Virus Cultivation ; Virus Diseases