The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*

ABSTRACT Salmon skin extract contains high proline and hydroxyproline, and has been suggested as a potential topical agent for traumatic oral ulcer healing. The aim of this study was to evaluate the effect of salmon skin extract as traumatic oral ulcer healing. A total of 32 Wistar rats (200 g to 250 g) were distributed into four groups. Group 1 served as the control group (no treatment), Group 2 was topically treated with salmon skin extract agent 4%, Group 3 was topically treated with salmon skin extract agent 5%, and Group 4 was topically treated with salmon skin extract agent 6%. Traumatic ulcers at lip mucosa were performed in all rats and 0.1 ml salmon skin extract was applied on the ulcer twice daily for seven days. The animals were euthanised on the last day of treatment. Biopsy specimens were taken from the lip mucosa in all rats for epithelial thickness evaluation and the study for number of fibroblasts by histological analysis. Significant increase in epithelial thickness and the number of fibroblasts (p > 0.05) was observed in salmon skin extract treatment groups as compared to the control group. Salmon skin extract 6% treatment group had the highest epithelial thickness and the number of fibroblasts amongst the study groups. Salmon skin extract promises an innovative topical application treatment for traumatic oral ulcer healing. Salmon skin extract 6% was the most effective concentration for traumatic oral ulcer healing.
Epithelial Cells ; Fibroblasts ; Oral Ulcer--therapy

ABSTRACT Granulomatosis with polyangiitis (GPA) is a rare multisystem disease. Although GPA is rare, it commonly presents in a localised stage where its manifestation involves the upper or lower respiratory tract before progressing to a generalised stage. Therefore, most patients with GPA will visit an oral surgeon or an otolaryngologist to seek treatment. However, the diagnosis of GPA is often delayed as GPA is not frequently considered as a differential diagnosis in common oral and facial diseases. The lack of gold standard investigation for the diagnosis of GPA makes management of this case, a diagnostic conundrum. We herein report a patient who was diagnosed with bilateral acute otitis media and left mastoiditis complicated with facial nerve palsy, and later developed tongue ulceration one month after his initial presentation. The ear, facial and oral symptoms represent a diagnostic red herring to a full-blown generalised stage of GPA.
Facial Paralysis ; Oral Ulcer ; Granulomatosis with Polyangiitis

PURPOSE: Behcet's disease is a chronic, recurrent, multisystemic disorder, which visual prognosis is poor. The clinical and epidemiological characteristics of Behcet's disease in Korean were evaluated. METHODS: The clinical records on 3,175 patients with Behcet's disease diagnosed at Behcet's disease clinic in Severance Hospital between November 1983 and December 1999 were reviewed. RESULTS: Among all 3,175 patients, the men/women ratio of Behcet's disease was 1:1.6. The age of disease onset was the highest in the thirties (33.8%). The most frequent major and minor symptom was oral ulcer (97.7%) and arthritis (32.8%) respectively, and the proportion of ocular symptom was 19.3%. The most frequent initial symptom was oral ulcer (77.4%). The ratio of men/women with ocular symptom was 1:0.98. The mean interval between the initial symptom and ocular symptom was 34 months, and the most common ocular symptom was iritis (79.0%). The most frequent systemic drug administered in patients with ocular involvement was colchicines (35%). Visual acuity was worsened in 56% of the eyes followed for over 24 months. CONCLUSIONS: The authors notice the characteristics of Behcet's disease in Korean and suggest that the continuous and nationwide survey is further necessary.
Arthritis ; Humans ; Iritis ; Oral Ulcer ; Prognosis ; Visual Acuity

OBJECTIVEIn order to observe the therapeutic efficacy of food control to recurrent oral ulcer (ROU), alimentary control of certain foods was employed to relieve outbreak of ROU.

METHODSThe kits for food intolerant IgG of certain food were used to test the intolerant food of fifty patients with ROU. Observations and assessments for alimentary control were made after three months' treatment on these patients.

RESULTSThe top three of intolerant foods were crab, egg and milk and the remission rate of ROU reached 74% after treatment.

CONCLUSIONThe result of food intolerant IgG testing has certain function to alimentary control therapy for remitting the outbreak of ROU.

OBJECTIVETo compare therapeutic effects of acupuncture and routine western medicine is an recurrent oral ulcer of the type of accumulation of heat in the heart and spleen.

METHODSSeventy-four cases were randomly divided into 2 groups. The acupuncture group of 37 cases were treated with acupuncture at Tongli (HT 5), Gongsun (SP 4), Neiting (ST 44), Hegu (11 4), etc. The control group of 37 cases were treated with VitB2 , VitC. Their therapeutic effects were compared.

RESULTSThe total effective rate was 83.8% in the treatment group and 48.6% in the control group with a very significant difference between the two groups (P<0.01).

CONCLUSIONThe therapeutic effect of acupuncture is significantly better than that of the control group, and acupuncture is an effective therapy for recurrent oral ulcer of type of accumulation of heat in the heart and spleen.

OBJECTIVETo provide content-measuring evidences for establishing the quality criteria of dexamethasone acetate ulcer pasta.

METHODSContent of dexamethasone acetate was assayed by the isonicotinyl hydrazine (INH) colorimetry.

RESULTSThe good linear range was 6-16 microg/mL (r = 0.999 1). The average recovery of dexamethasone acetate was 98.9%, and relative standard deviation was low than 1% (n = 5).

CONCLUSIONIt is easy, convenient, accurate and dependable for INH colorimetry to determine the content of dexamethasone acetate.

Mycophenolate mofetil (MMF) is being widely used as a maintenance imunosuppressive therapy in renal transplant patients. Myelotoxicity and gastrointestinal symptoms are the well-known adverse effects of this immunosuppressant. However, there areexistonly two reports on oral ulceration associtated with MMF. Although oral ulcerations are not life-threatening, they may seriously affect the quality of life. We report ourthe experience of a case of a 57-year-old female patient with painful oral mucosal ulcerations that improved following MMF discontinuation.
Female ; Humans ; Kidney Transplantation ; Middle Aged ; Mycophenolic Acid ; Oral Ulcer ; Quality of Life ; Transplants ; Ulcer

Psoriasis is a chronic inflammatory disease with epidermal hyperplasia. Th 1 cells are thought to be important in the pathogenesis of psoriasis and Behcet's disease. However, both diseases rarely develop in the same patient. We report here a case of a 50-year-old man who was diagnosed with psoriasis 15 years prior. During the last three years, ulcers and erosions had recurrently developed on the perianal area and oral mucosa. In addition, the patient had mild arthralgia on the both knees and hand for two years. In this case, Behcet's disease accompanying psoriasis was suspected.
Arthralgia ; Hand ; Humans ; Hyperplasia ; Knee ; Middle Aged ; Mouth Mucosa ; Oral Ulcer ; Psoriasis ; Ulcer

Behcet's disease (BD) is a chronic inflammatory disorder of unknown cause, characterized by recurrent oral ulcerations, genital ulcerations, ocular and skin lesions. Although the exact pathogenesis for BD is not completely understood, it has been suggested that the disease is triggered in genetically susceptible individuals by environmental factors, such as microbial agents. It is noted that multiple genes, including MHC and non-MHC genes, are implicated in the pathogenesis of BD. Although the HLA-B51 is known to be the candidate gene showing the strongest association with BD, it is necessary to be determined whether this HLA molecule is directly involved in the pathogenesis of BD. Cross-reactivity between microbial 65-kD and human 60-kD heat shock proteins is demonstrated to cause an increased T cell (particularly gammadelta T cell) response. The resultant overexpression of pro-inflammatory cytokines (mainly Th-1 type) from several immune cells seems to be responsible for the enhanced inflammatory reaction, and this may be associated with the genetic factors.
Cytokines ; Heat-Shock Proteins ; HLA-B51 Antigen ; Humans ; Oral Ulcer ; Skin ; Ulcer