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Objective: The aim of this case report was to document a case of side effect reaction of the gingiva and oral mucosa after the use of Erythritol powder containing 0.3% chlorhexidine (Air Flow® Powder PLUS) and 0,2 % chlorhexidine digluconate oral antiseptic solution. Case report: A 49-year-old female patient presented with severe erosive and suspected necrotic changes on lips and gums, upper lip swelling and severe pain which was present for 15 days. Previously, chlorhexidine digluconate 0,2 % was used in treatments with diode laser following the prophylaxis treatment which included the use of Erythritol powder containing 0.3% chlorhexidine. The patient was prescribed and successfully treated with a combination of antibiotics: Amoxicillin (a 500 mg) and Metronidazole (a 250 mg), Lysobact oriblets (6-8 a day), Panthenol solution for rinsing (3 times a day), and a magistral medicine with Pronisone for local application. Conclusion: Due to the proven possible side effects of Erythritol powder containing 0.3% chlorhexidine and 0,2 % chlorhexidine digluconate, uncritical use of Erythritol powder containing 0.3% chlorhexidine and chlorhexidine digluconate should be avoided. The therapy applied in the presented case proved to be extremely effective in the treatment of changes that occurred as a side effect of the use of Erythritol powder containing 0.3% chlorhexidine and 0,2% chlorhexidine digluconate. [ABSTRACT FROM AUTHOR]

Methotrexate (MTX) is an antifolic drug used in the treatment of immune-mediated and neoplastic diseases. Initiation or dosage changes in MTX therapy can cause mucositis and bone marrow suppression. Skin lesions due to acute MTX toxicity are rare, but they serve as a herald for later-onset pancytopenia. Therefore, identification of those cutaneous lesions might help to initiate rescue strategies at an early stage. Here we describe a case with mucocutaneous ulcerations and pancytopenia due to overdosed MTX.

Methotrexate (MTX) is an antifolic drug used in the treatment of immune-mediated and neoplastic diseases. Initiation or dosage changes in MTX therapy can cause mucositis and bone marrow suppression. Skin lesions due to acute MTX toxicity are rare, but they serve as a herald for later-onset pancytopenia. Therefore, identification of those cutaneous lesions might help to initiate rescue strategies at an early stage. Here we describe a case with mucocutaneous ulcerations and pancytopenia due to overdosed MTX. [ABSTRACT FROM AUTHOR]

Objectives: Chronic ulcerative stomatitis (CUS) is a chronic, ulcerative condition of the oral cavity, clinically and histologically similar to oral lichen planus (OLP), first described as a new disease entity in 1990 by Parodi et al. In this review, 30 years after our first description of CUS, we aimed to systematically review the literature of CUS cases reported ever since., Methods: We present a systematic review of CUS literature cases, performed in compliance with the PRISMA statement., Results: Of 125 retrieved articles, 20 satisfied inclusion criteria. These described 76 CUS cases, all presenting orally evident disease: erosions (55%), white lesions (49%), erythema (49%), ulcerations (34%) were the most frequent signs; 54% experienced discomfort/pain. Topographically, buccal mucosa (68%) and gingiva (54%) were the most affected locations, followed by tongue (42%), hard palate (27%), labial mucosa (22%), and widespread involvement (15%). Great diagnostic delay (6.3 years) was evidenced highlighting CUS is an entity too often misdiagnosed. Histopathology found lichenoid features (46%) and non-specific inflammation (54%). Extra-oral involvement was reported in 21%, especially as LP (69%). Of DIF, 97% were positive; 3% negative, compensated by positive IIF, permitting diagnosis. Of patients on steroids, only 12% reported therapeutic success; most steroid-non-responsive patients passed to antimalarials, with 91.66% success when used alone, 100% success in combination therapy., Conclusion: Dermatologists should suspect CUS in chronic steroid-unresponsive erosive/ulcerative stomatitis. In these cases, to diagnose CUS, the presence of stratified epithelium-specific antinuclear antibodies (SES-ANA) should be investigated through immunofluorescence. Once diagnosed, CUS can be treated with antimalarials, which are an effective treatment contrarily to corticosteroids.