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<span style="font-family: "Courier New",Courier,monospace;">Yamaguchi T, Dorfman HD, Eisig S. Cherubism: clinicopathologic features. Skeletal Radiol 1999;28:350–3.<br />Yarchoan R. Therapy for Kaposi’s sarcoma: recent advances and experimental approaches. J Acquir Immune Defic Syndr 1999;21 Suppl 1:S66–73.<br />Yonetsu K, Nakayama E, Yuasa K, et al. Imaging findings of some buccomasseteric masses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:755–9.<br />Yuwono M, Rossi TM, Fisher JE, Tjota A. Oncogene expression in patients with familial polyposis coli/Gardner’s syndrome. Int Arch Allergy Immunol 1996;111:89–95.</span></div>
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<span style="font-family: "Courier New",Courier,monospace;">Batsakis JG, Suarez P, el-Naggar AK. Proliferative verrucous leukoplakia and its related lesions. Oral Oncol 1999;35:354–9.<br />Beham A, Regauer S, Soyer HP, Beham-Schmid C. Keratoacanthoma: a clinically distinct variant of well differentiated squamous cell carcinoma. Adv Anat Pathol 1998;5:269–80.</span></div>
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<span style="font-family: "Courier New",Courier,monospace;">Additional Reading<br />White Lesions<br />Appleton SS. Candidiasis: pathogenesis, clinical characteristics, and treatment. J Calif Dent Assoc 2000;28:942–8.<br />Axell T, Pindborg JJ, Smith CJ, van der Waal I. Oral white lesions with special reference to precancerous and tobacco-related lesions: conclusions of an international symposium held in Uppsala, Sweden, May 18–21, 1994. International Collaborative Group on Oral White Lesions. J Oral Pathol Med 1996;25:49–54.</span><br />
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<span style="font-family: "Courier New",Courier,monospace;">Additional Reading 351<br />Birek C. Herpesvirus-induced diseases: oral manifestations and current treatment options. J Calif Dent Assoc 2000;28:911–21.<br />Cunningham MW. Pathogenesis of group A streptococcal infections. Clin Microbiol Rev 2000;13:470–511.<br />Dabelsteen E. Molecular biological aspects of acquired bullous diseases. Crit Rev Oral Biol Med 1998;9:162–78.</span></div>
<a name='more'></a><br />Egan CA, Yancey KB. The clinical and immunopathological manifestations of anti-epiligrin cicatricial pemphigoid, a recently defined subepithelial autoimmune blistering disease. Eur J Dermatol 2000;10:585–9.<br />Engineer L, Ahmed AR. Emerging treatment for epidermolysis bullosa acquisita. J Am Acad Dermatol 2001;44:818–28.<br />Fleming TE, Kerman NJ. Cicatricial pemphigoid. J Am Acad Dermatol 2000;43:571–91.<br />Korman NJ. New and emerging therapies in the treatment of blistering diseases. Dermatol Clin 2000;18:127–37.<br />Liesegang TJ. Varicella zoster viral disease. Mayo Clin Proc 1999;74:983–98. Marinkovich MP. Update on inherited bullous dermatoses. Dermatol Clin<br />1999;17:473–85. Nousari HC, Anhalt GJ. Pemphigus and bullous pemphigoid. Lancet<br />1999;354:667–72. Popovsky JL, Camisa C. New and emerging therapies for diseases of the<br />oral cavity. Dermatol Clin 2000;18:113–25. Sadick NS. Current aspects of bacterial infections of the skin. Dermatol<br />Clin 1997;15:341–9. Samonis G, Mantadakis E, Maraki S. Orofacial viral infections in the<br />immunocompromised host. Oncol Rep 2000;7:1389–94. Sciubba JJ. Autoimmune aspects of pemphigus vulgaris and mucosal pem-<br />phigoid. Adv Dent Res 1996;10:52–6. Scully C, Carrozzo M, Gandolfo S, et al. Update on mucous membrane<br />pemphigoid: a heterogeneous immune-mediated subepithelial blistering entity. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88: 56–68.<br />Scully C, Porter SR. The clinical spectrum of desquamative gingivitis. Semin Cutan Med Surg 1997;16:308–13.<br />Tay YK, Huff JC, Weston WL. Mycoplasma pneumoniae infection is associated with Stevens-Johnson syndrome, not erythema multiforme (von Hebra). J Am Acad Dermatol 1996;35(5 Pt 1):757–60.<br />
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<span style="font-family: "Courier New",Courier,monospace;">Uitto J, Pulkkinen L. Molecular complexity of the cutaneous basement membrane zone. Mol Biol Rep 1996;23:35–46.<br />Villarreal EC. Current and potential therapies for the treatment of herpesvirus infections. Prog Drug Res 2001;56:77–120.<br />Zillikens D. Acquired skin disease of hemidesmosomes. J Dermatol Sci 1999;20:134–54.</span></div>
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<span style="font-family: "Courier New",Courier,monospace;">Boshoff C, Chang Y. Kaposi’s sarcoma-associated herpesvirus: a new DNA tumor virus. Annu Rev Med 2001;52:453–70.<br />Boshoff C, Weiss RA. Epidemiology and pathogenesis of Kaposi’s sarcomaassociated herpesvirus. Philos Trans R Soc Lond B Biol Sci 2001;356: 517–34.</span></div>
<a name='more'></a><br />Ferreiro JA, Egorshin EV, Olsen KD, et al. Mucous membrane plasmacytosis of the upper aerodigestive tract. A clinicopathologic study. Am J Surg Pathol 1994;18:1048–53.<br />Lopez de Blanc S, Sambuelli R, Femopase F, et al. Bacillary angiomatosis affecting the oral cavity. Report of two and review. J Oral Pathol Med 2000;29:91–6.<br />Shovlin CL. Molecular defects in rare bleeding disorders: hereditary haemorrhagic telangiectasia. Thromb Haemost 1997;78:145–50.<br />Smith ME, Crighton AJ, Chisholm DM, Mountain RE. Plasma cell mucositis: a review and case report. J Oral Pathol Med 1999;28:183–6.<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-61484906865876855142012-11-24T23:40:00.000-08:002012-11-24T23:40:16.865-08:00Tuberculosis <br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Systemic therapy (prolonged treatment with at least 2 drugs)<br />• Isoniazid 300 mg daily × 6 mo • Rifampin 450–600 mg daily × 6 mo • Ethambutol 15 mg/kg daily for first 2 mo • Pyrazinamide 1.5–2.5 mg/kg for first 2 mo</span></div>
<a name='more'></a><br />Wegener’s Granulomatosis • Systemic therapy<br />• Sulfamethoxazole/trimethoprim (Bactrim DS) Septra DS 1 twice daily<br />• Prednisone 1 mg/kg daily • Cyclophosphamide<br />Zoster • See “Herpes Zoster.”<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-79071236050697613802012-11-24T23:38:00.003-08:002012-11-24T23:38:31.562-08:00Stevens-Johnson Syndrome <div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Topical therapy (compounded rinses)<br />• Option 1 – Diphenhydramine 200 mg, viscous lidocaine 90 mL, <br />Maalox suspension 90 mL, distilled water 180 mL – Swish 5 mL for 2 min and expectorate 3–4 times/d<br />• Option 2 – Dexamethasone 100 mg, viscous lidocaine 60 mL, <br />diphenhydramine 200 mg, sorbitol 15 mL, Maalox suspension to 275 mL– </span></div>
<a name='more'></a>Swish 5 mL for 2 min and expectorate 3–4 times/d • Systemic therapy<br />• Prednisone 5 mg tablets #80 – Take each morning with breakfast for 16 d as 8/d × 4 d, <br />6/d × 4 d, 4/d × 4 d, 2/d × 2 d, stop – Will reduce disease activity as topical corticosteroids or <br />systemic NSAIDs are started • Acyclovir 200 mg tablets #42 (if triggered by herpes simplex<br />virus infection); 1 tablet every 4 h for 7 d or 1 tablet bid-tid as prophylaxis<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-54022173110128065192012-11-24T23:37:00.003-08:002012-11-24T23:37:31.983-08:00Recurrent Herpes Simplex Labialis or Stomatitis <br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Topical therapy<br />• Penciclovir cream (Denavir) 1% 1.5 g tube; apply at the onset of symptoms every 2 h × 4 d<br />• Docosanol cream (Abreva) 10%; apply topically at the onset of symptoms q2–3h 5 times daily<br />• Acyclovir ointment 5% 3 g tube; apply at the onset of symptoms 6 times daily × 7 d</span></div>
<a name='more'></a><br />• Systemic therapy • Acyclovir 200 mg tablets #35<br />– 1 tablet 5 times daily × 7 d – Start medication with premonitory symptoms to shorten<br />the course of the episode. • Acyclovir 200 mg tablets<br />– 3 tablets daily to prevent reactivation in bone marrow transplant recipients<br />Sjögren’s Syndrome • Topical therapy<br />• Moisten mouth with cool water or ice chips. • Avoid alcohol-containing mouth rinses. • Avoid drugs that produce xerostomia. • Limit caffeine intake. • Use Vaseline on lips at night (a thin coating). • Drink milk with meals<br />• Saliva substitutes • Liquid, tablet, or gel forms • Available over the counter<br />• Systemic therapy • Pilocarpine (Salagen) 5 mg tablets #100; take 1 tablet <br />3 times daily • Cevimeline capsules (Evoxac) 30 mg capsules #100; take <br />1 capsule 3 times daily<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-27710976657044680082012-11-24T23:36:00.004-08:002012-11-24T23:36:41.441-08:00Recurrent Aphthous Stomatitis (Aphthosis) <div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Classify disease into simple versus complex • Simple aphthosis<br />• Amlexanox paste 5 g (Aphthasol); apply to ulcers after meals and at bedtime<br />• Fluocinonide 0.05% gel/cream 60 g – Apply to early lesions after meals and at bedtime. – Do not apply to ulcers.<br />• Compounded rinse option 1 – Diphenhydramine parenteral (or 12.5 mg/5 mL non-</span></div>
<a name='more'></a><br />alcoholic elixer) 200 mg, viscous lidocaine 90 mL, Maalox suspension 90 mL, distilled water 180 mL <br />Rinse 5 mL—expectorate 4–6 times daily. • Compounded rinse option 2<br />Dexamethasone (10 mg/mL) 10 mL, diphenhydramine 200 mg, viscous lidocaine 60 mL, Maalox suspension 85 to 275 mL Rinse 5 mL—expectorate 3–5 times daily. <br />• Complex aphthosis • Laboratory evaluation for “correctable causes”: CBC, red<br />serum iron studies, serum zinc<br />blood cell folate, serum ferritin, serum vitamin B 12, <br />• Topical therapy as for simple aphthosis • Systemic therapy for severe, painful, chronic complex<br />aphthosis – Prednisone 5 mg tablets #40<br />– Take each morning with breakfast for 8 d 8-8-6-6-4-42-2 mg, stop<br />– Will shorten the course of an individual episode but not change the natural history of the disease<br />– Colchicine 0.5 mg tablets – Take 1 each morning with breakfast for 1 wk; if <br />tolerated, increase to 2 tablets each morning – May suppress disease activity<br />– Pentoxifylline (Trental) 400 mg tablets; 1 tablet 3 times/d with meals<br />– Dapsone 25 mg tablets – Check baseline CBC, liver function tests, urinalysis<br />and glucose-6-phosphate dehydrogenase enzyme level before treatment.<br />
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<span style="font-family: "Courier New",Courier,monospace;">– Take each morning with breakfast, 1 × 3 d, 2 × 3 d, 3 × 3 d, 4 × 7 d, and 5 × daily thereafter<br />– Check CBC and liver function every month for 3 mo, then every 3 mo thereafter.<br />– Use for long-term control of disease.</span></div>
Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-76017994224365298572012-11-24T23:35:00.002-08:002012-11-24T23:35:45.538-08:00Plasma Cell Gingivitis<br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Identify contact allergen(s) and avoid exposure. • Topical therapy: fluocinonide gel/cream 0.05% 60 g; apply<br />after meals and at bedtime • Systemic therapy: griseofulvin 250 mg tablets #150; take 1<br />with each meal for 7 wk Pyostomatitis Vegetans<br />• Seek the underlying inflammatory bowel disease. • See “Crohn’s Disease.”</span></div>
<a name='more'></a><br />Radiation-Induced Mucositis • Topical therapy<br />• Benzydamine rinses • Saline/bicarbonate rinses 2.5 mL each in 125 mL water;<br />5 mL rinsed bid • Chlorhexidine 0.12% compounded as alcohol-free formula<br />– Store in a light-protective container. – 15–30 mL rinsed bid<br />• See “Drug-Induced Stomatitis.” • Systemic therapy: analgesics prn<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-89726549452447580722012-11-24T23:34:00.003-08:002012-11-24T23:34:44.684-08:00Pemphigus Vulgaris <div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Coordinate overall management with patient’s internist/primary<br />care physician since treatment of this disease requires systemic immunosuppression and/or use of anti-inflammatory drugs.<br />• Management of oral lesions will consist of systemic immunosuppressive agents.</span></div>
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<span style="font-family: "Courier New",Courier,monospace;">• Local/intralesional therapy may be a useful adjunct following an initial good measurable response to systemic glucocorticosteroid dosing.<br />• Systemic therapy: prednisone 10 mg tablets #150 • Take each morning with breakfast at a total daily dose of<br />1 mg/kg of body weight. • Taper slowly over several months as clinical response<br />permits to maintenance dosing. • Management of prednisone side effects is important.<br />• Corticosteroid-sparing systemic therapy • Azathioprine 1–3 mg/kg; dosing spaced morning and evening • Mycophenolate mofetil 500 mg tablets; 1.5 g bid<br />• Severe or unresponsive disease • Plasmapheresis • Pulse cyclophosphamide (Cytoxan) IV for 3 wk <br />– Monitor response. – Continue on orally administered immunosuppressants.<br />• IVIg therapy • Local therapy for focal residual lesions: intralesional<br />triamcinolone suspension 10 mg/mL</span></div>
Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-14169667345920737582012-11-24T23:33:00.004-08:002012-11-24T23:33:45.216-08:00Melkersson-Rosenthal Syndrome <br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• See “Fissured Tongue.” • Orofacial granulomatosis—see “Cheilitis Granulomatosa”<br />Nevus • All pigmented nevi should be excised, if reasonable from a</span></div>
<a name='more'></a><br />surgical point of view. Pemphigoid<br />• Refer to a dermatologist or an ophthalmologist, depending on organ involvement, for ongoing care, which may include systemic immunosuppressive and/or anti-inflammatory drugs.<br />• For localized oral pemphigoid/gingival pemphigoid, apply topical therapy: fluocinonide 0.05% gel/cream 60 g • Apply to early lesions after meals and at bedtime. • Do not apply to ulcers. • May be used for 1–2 h with mouthguard for occlusive therapy<br />• Systemic therapy for severe, chronic disease • Prednisone 5 mg tablets #80<br />– Take each morning with breakfast for 16 d as 8/d × 4 d, 6/d × 4 d, 4/d × 4 d, 2/d × 4 d, stop<br />– Will reduce disease activity as topical corticosteroids or systemic NSAIDs are started<br />• Dapsone 25 mg tablets – Check baseline CBC, liver function tests, urinalysis and <br />glucose-6-phosphate dehydrogenase enzyme level before treatment.<br />– Take each morning with breakfast, 1 × 3 d, 2 × 3 d, 3 × 3 d, 4 × 7 d, and 5 × daily thereafter<br />– Check CBC and liver function every month for 3 mo, then every 3 mo thereafter.<br />– Use for long-term control of disease • Tetracycline and niacinamide<br />– 500 mg of each administered tid – Use for long-term control of disease<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-36844574899153385592012-11-24T23:33:00.000-08:002012-11-24T23:33:01.446-08:00Lupus Erythematosus <br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Topical therapy<br />• Fluocinonide gel/cream 0.05% 60 g; apply after meals and at bedtime<br />• Tacrolimus (Protopic) ointment 0.1% 30 g; apply after meals 3 times daily, do not eat or drink for 30 min</span></div>
<a name='more'></a><br />• Intralesional therapy: triamcinolone acetonide 5–10 mg/mL; inject 1–3 mL per session with sessions at 3–4 wk intervals<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.comtag:blogger.com,1999:blog-7922687561954046722.post-65447849642874505452012-11-24T23:32:00.000-08:002012-11-24T23:32:01.566-08:00Lichen Planus <br /><div style="text-align: justify;">
<span style="font-family: "Courier New",Courier,monospace;">• Topical therapy<br />Therapeutics 343<br />• Betamethasone cream (0.1%) 60 g; apply after meals and at bedtime<br />• Fluocinonide gel/cream 0.05% 60 g; apply after meals and at bedtime</span></div>
<a name='more'></a><br />• Tacrolimus (Protopic) ointment 0.1% 30 g; apply after meals 3 times dailyand at bedtime, do not eat or drink for 30 min; taper frequency depending on response<br />• Intralesional therapy: triamcinolone acetonide 5–10 mg/mL; inject 1–3 mL per session with sessions at 3–4 wk intervals<br />• Systemic therapy • Prednisone 5 mg tablets #80<br />– Take each morning with breakfast for 16 d as 8/d × 4 d, 6/d × 4 d, 4/d × 4 d, 2/d × 4 d, stop<br />– Will reduce disease activity as topical corticosteroids or systemic NSAIDs are started<br />• Dapsone 25 mg tablets – Check baseline CBC, liver function tests, urinalysis, and <br />glucose-6-phosphate dehydrogenase enzyme level before treatment.<br />– Take each morning with breakfast, 1 × 3 d, 2 × 3 d, 3 × 3 d, 4 × 7 d, and 5 × daily thereafter<br />– Check CBC and liver function every month for 3 mos, then every 3 mo thereafter.<br />– Use for long-term control of disease. • Hydroxychloroquine (Plaquenil) 250 mg #100; 2 tablets<br />with breakfast for 4 wk, then 1 tablet daily for maintenance – Baseline ophthalmology consultation; repeat every 6 mo <br />to monitor for retinal toxicity<br />Anonymoushttp://www.blogger.com/profile/10190290519373263414noreply@blogger.com