Pyogenic granuloma (PG) is a benign nonneoplastic mucocutaneous lesion. It occurs as a result of chronic irritation or due to hormonal changes. The most favorable site for this fairly common lesion is gingiva, but rarely, it can occur outside the oral cavity, later often difficult to diagnose, as a diverse group of the pathologic process can produce such lesions outside the oral cavity. The diagnosis is also challenging as the lesions appear as smooth or lobulated red nodules with easy bleeding, occasionally ulcerated mimicking malignancies. The purpose of this article is to report a rare case of extragingival PG of the lower lip simulating as a vascular lesion in young male of 30 years old diagnosed by ultrasound followed by histopathological examination.
Recurrent aphthous stomatitis (RAS) is an oral condition characterized by painful oral ulcerations. While the clinical features of this disease are easily defined, the etiology remains unclear. Thus, existing treatments are still unsatisfactory in reducing the severity, healing, and recurrence rate; however, there is no permanent and definitive treatment. Effective treatment for aphthous stomatitis is not available, and those treatments available mainly focus on suppressing its symptoms. We are reporting a case of a 17-year-old boy who presented with a 3-year history of multiple recurrent major ulcers in the oral cavity. Levamisole with steroids has been used in many clinical trials to treat aphthous ulcers, showing an improvement in pain, discomfort, healing time, and reduction in the number of ulcers. The same method was used to treat our patient, who showed promising results, with no recurrence for one year. Levamisole is a safe, easily tolerable and promising drug for the treatment of RAS.
Papillon-Lefévre syndrome (PLS) is an autosomal recessive disorder that is characterised by severe generalized early-onset periodontitis and palmoplantar hyperkeratosis. Besides these cardinal features some patients rarely exhibits recurrent pyogenic infections of skin, hair follicle infection (frunculosis), multiple abscess of skin, hyperhidrosis. This article represents a rare case of 17 year old young male patient with cardinal features of PLS along with history of recurrent pyogenic abscess of facial skin followed by scarring since childhood. There are multiple etiological factors like genetic, immunological, and microbial factors, consanguineous marriage and reduced host defense mechanism. Patients with PLS have increased susceptibility to infections. Over 300 cases have been reported till now in dental and medical literature with most of the cases discovered amongst Africans, Arabs and, Indians with 25% patients showing recurrent pyogenic infections. Management of the disorder primarily involves conventional periodontal treatment; oral hygiene instructions, antiseptic mouth rinses; and systemic antibiotic. Skin lesions are usually treated with topical application of emollients, keratolytic agents, steroids, and oral retinoid.
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