A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*

Pyostomatitis vegetans is a rare oral condition characterized by miliary pustules that primarily affect the labial gingiva as well as the buccal and labial mucosa. It is consistently associated with inflammatory bowel disease (IBD) and is a highly specific marker for IBD. Authors are reporting a 45 year-old female patient who developed pyostomatitis vegetans after she was diagnosed as having ulcerative colitis. Our experience indicates that there is an intimate relationship between pyostomatitis vegetans and inflammatory bowel disease (IBD). In a pyostomatitis vegetans patient whose IBD is in dormant state, the diagnosis of IBD can be missed. It is imperative, therefore, to suspect IBD in a patient with pyostomatitis vegetans who has no gastrointestinal symptoms and recommend thorough investigational study of the gatrointestinal system.
Colitis, Ulcerative* ; Diagnosis ; Female ; Gingiva ; Humans ; Inflammatory Bowel Diseases ; Middle Aged ; Mucous Membrane ; Oral Ulcer ; Ulcer*

The diagnostic criteria of Behcet' s disease - which requires the presence of recurrent oral ulceration plus any two of recurrent genital ulceration, typical defined eye lesions, typical defined skin lesions or a positive pathergy test - was proposed by the International Study Group for Behcet' s Disease (ISGBD). Intestinal Behcet' s disease most commonly affects the ileocecal region, but esophageal involvement of Behcet' s disease is rare, only 8 cases have previously been reported in Korea. A 23-year old female who had a 10-year history of recurrent oral and genital ulcer and recurrent erythematous skin eruption, was admitted to our hospital because of dysphagia and substernal pain. Endoscopic exami-nation showed multiple small sized ulcers on oral cavity and two diffuse deep ulcers surrounded with irregularly nodular and hyperemic edematous mucosa at distal esophagus. The pathologic finding was subepithelial accumulation of chronic inflammatory cells, especially around the vessels. So she was treated with steroid under the diagnosis of esophageal involvement of Behcet' s disease. She has been followed in improvement status without recurrence.
Deglutition Disorders ; Diagnosis ; Esophagus ; Female ; Humans ; Korea ; Mouth ; Mucous Membrane ; Oral Ulcer ; Recurrence ; Skin ; Ulcer* ; Young Adult

Actinomycosis is a chronic suppurative and granulomatous bacterial infection most commonly presenting as an abscess, soft tissue swelling, or mass in the cervicofacial region. Although the organisms often invade soft tissues through damaged oral mucosa, actinomycosis presenting acutely as a superficial oral ulcer is extremely rare. We report a case of actinomycosis in a 6-year-old boy who presented a painful ulcer on the right buccal mucosa. Histopathologic examination showed sulfur granules and granulation tissue with mixed inflammatory infiltrate in the dermis. The granules contained numerous Gram-positive filamentous organisms consistent with actinomycosis. We propose that actinomycosis should be kept in mind in the diagnosis of oral ulcerations.
Abscess ; Actinomycosis* ; Bacterial Infections ; Child* ; Dermis ; Diagnosis ; Granulation Tissue ; Humans ; Male ; Mouth Mucosa ; Oral Ulcer* ; Sulfur ; Ulcer

We report a case of atypical pityriasis rosea in a 24-year-old Malay man. He presented with an 11-month history of three recurrent and persistent episodes of pityriasis rosea associated with oral ulcers. The first episode lasted for one month and recurred within 14 days. The second episode lasted for three months and recurred within nine days. The third episode lasted for seven months. Although all three episodes were not preceded by any prodromal symptoms, a herald patch was noted on three different sites (the left iliac fossa, abdomen and chest) on each successive episode. Recurrent pityriasis rosea and its association with oral ulcers, although quite uncommon, have been reported in the literature. However, reports of multiple recurrences, with prolonged duration of each episode and very short remissions in between, have not been made. To the best of our knowledge, this is the first report of such unique presentation.
Adult ; Diagnosis, Differential ; Exanthema ; diagnosis ; pathology ; Humans ; Male ; Oral Ulcer ; complications ; diagnosis ; Pityriasis Rosea ; diagnosis ; pathology ; Recurrence ; Treatment Outcome

OBJECTIVETo analyze the clinical and pathological features of 40 patients with secondary syphilis.

METHODSA total of 40 cases of secondary syphilis confirmed by serology were collected during 1994-2004 and were first diagnosed on presentation with oral lesions.

RESULTSThe white patch in oral mucosa was found in 32 cases with painless or slight pain in most cases. The most common site of the lesion was the tongue. The histological examination on eight cases was initially misdiagnosed as oral candidosis or lichen planus, but confirmed as syphilis after serology revealed nonspecific inflammation with intraepithelial microabscess and dense perivascular infiltration of lymphocytes and plasma cells in connective tissue. The symptoms showed dramatic improvement in 16 cases after benzathine penicillin treatment.

CONCLUSIONSThe oral manifestations of syphilis have specific clinical and pathological feature and attention should be paid to the suspicious oral lesions when patients are first presented in a dental office.

Adult ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; pathology ; Oral Ulcer ; etiology ; Syphilis ; complications ; diagnosis ; pathology

Adult ; Coinfection ; HIV Infections ; complications ; Humans ; Male ; Oral Ulcer ; complications ; diagnosis ; Syphilis ; complications ; diagnosis ; Tongue Diseases ; complications ; diagnosis

BACKGROUND AND AIMS: Gastric candidiasis is an uncommon disorder. But in recent years this diagnosis has increased as a result of the greater use of broad-spectrum antibiotics, immunosuppressive and chemotherapeutic agents or of the use of drugs that reduce the gastric acid production, such as H2 receptor antagonists. Our aim of the present study was to investigate clinical characteristics of gastric candidiasis including endoscopic findings and histopathology. METHODS: We reviewed 28 cases of gastric candidiasis who have under-went endoscopic biopsy at Wonkwang University Hospital from January 1995 to eptember 1996. RESULTS: 1) The prevalence rate of gastric candidiasis was 0.8% (28/3400). 2) In benign and malignant gastric ulcer patients, occurrence of other clinical findings were cardio-vascular disease in 5 cases, diabetes mellitus in 3 cases, hepatobiliary disease in 5 cases, bronchopulmonary disease in 10 cases, renal disease in 1 case, immunosuppressive therapy in 1 case, peptic ulcer therapy in 4 cases, and nongastric neoplasm in 1 case. 3) Locations of benign and malignant gastric ulcers in patients with candidial infection were prepyloric area in 8 cases, angle in 7 cases, body in 11 cases, cardia and fundus in 2 cases. 4) Sizes of ulcer cases were almost > or =2 cm in benign ulcer (76.5%), all cases were > or =3 cm in malignant ulcer. 5) According to endoscopic criteria, thrush type were in 22 cases, ulcerated type in 6 cases and depth of candidial infection in ulcer base were suppurative type in 18 cases, fibrinoid type in 10 cases. 6) After 6 weeks of therapy, endoscopic and clinical cure occurred in 60% (3/5) of patients treated by H2 blocker, antacid, and occurred in 100% (5/5) of patients treated by H2 blocker, antacid and antifungal agent. CONCLUSIONS: These results suggest that gastric candidiasis has a large and dirty ulcer base, white or green-white membrane and spread over inflammed area.
Anti-Bacterial Agents ; Biopsy ; Candidiasis* ; Candidiasis, Oral ; Cardia ; Diabetes Mellitus ; Diagnosis ; Endoscopy ; Gastric Acid ; Humans ; Membranes ; Peptic Ulcer ; Prevalence ; Stomach Ulcer ; Ulcer

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. Results are follow : 1. A total of 116 the nurses returned the questionaire. 2. According to 88.2% of the respondents, the policy with regard to oral hygine in determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occurred. 3. In only 34.5% of case was a penlight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complication observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms : 0.9% normal saline gargling(47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate that oral care in cancer patients undergoing chemotherapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.
Adult ; Candidiasis ; Chlorhexidine ; Surveys and Questionnaires ; Dentists ; Diagnosis, Oral ; Drug Therapy* ; Education, Nursing ; Hemorrhage ; Humans ; Incidence ; Lighting ; Mouth* ; Nursing ; Nursing Staff ; Oral Hygiene ; Problem Solving ; Stomatitis ; Ulcer

We presented here a rare case of intestinal Behecet's disease simulating Grohn's disease. A 20 year old female complained of recurrence of oral ulcer, genital ulcer, arthralgia, erythema nodosum, abdominal pain and diarrhea, but she had no anal ulcer or anal fistulas. The colonoscopic examanation disclosed diffuse colonie involvement with multiple longitudinal ulcers and inflammatory pseudopolyposis. In hospital, she received ileocecectomy because of distal ilea perforation. Postoperative specimen showed multiple geographic ulcer on ileocecal region, creeping mesenteric fat and thickening of cecal wall. Pathological examination showed perivasculitis, transmural inflammation, fissuring, multiple lymph follicles which are compatible with intestinal Behect's disease. There were no granuloma sugges tive of Crohn's disease. Clinically, the patient met the international criteria of Behcet's disease. Punched out ulcer in the ileocecal region and pathological findings described above confirmed the diagnosis of intestinal Behcet's disease.
Abdominal Pain ; Arthralgia ; Colon* ; Crohn Disease ; Diagnosis ; Diarrhea ; Erythema Nodosum ; Female ; Fissure in Ano ; Granuloma ; Humans ; Inflammation ; Oral Ulcer ; Rectal Fistula ; Recurrence ; Ulcer* ; Young Adult