Noma-like lesion in a patient with acute promyelocytic leukemia

Santos, Paulo Sérgio da Silva; Neri, Nathalia Bigelli Del; Chiattone, Carlos S.

doi:10.5581/1516-8484.20110087

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…Cases of noma reported in HIV patients are shown in Table 1 . Noma was also reported in patients with cyclic neutropenia ( Erbagci, 2003 ), leukemia ( Santos, Neri, & Chiattone, 2011 ), Down's syndrome ( Lembo, De Leonibus, Francia, Lembo, & Ayala, 2011 ), Burkett's disease ( Millogo, Konsem, Ouedraogo, Ouoba, & Zwetyenga, 2012 ) and herpetic stomatitis ( Fasola, Obiechina, & Arotiba, 2003 ).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 96%

A Review on Noma: A Recent Update

Ashok¹,

Tarakji²,

Darwish³

et al. 2015

GJHS

109

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Noma is a gangrenous infection primarily affecting under developed countries. The aim of this paper was to review all recent articles on noma from January 2003 to August 2014 and briefly update the latest information related to the topic. A literature search was done on PUBMED using the keywords “noma / cancrum oris”. Noma is commonly seen in malnourished children. There has been an increased incidence of noma in HIV patients. Apart from these, noma has also been reported in association with cyclic neutropenia, herpetic stomatitis, leukemia, Down's syndrome and Burkett's disease. Treatment of acute noma includes transfusion of blood and intravenous fluids, administration of antibiotics, putting the patient on a high protein diet and debridement of necrotic areas. Surgical phase is usually initiated 6 to 18 months after a period of quiescence. Although, the mortality rate associated with noma has reduced significantly with the advent of modern generation antibiotics, the functional, cosmetic and psychological challenges associated with the destruction of soft or hard tissues still remains a huge challenge. Adequate steps must be implemented by the government or medical professionals to prevent the disease and provide an early intervention.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 96%

A Review on Noma: A Recent Update

Ashok¹,

Tarakji²,

Darwish³

et al. 2015

GJHS

109

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“…Patients with leukemia are more likely to develop noma during chemotherapy inasmuch as this can induce agranulocytosis (Brady-West et al, 1998). There are only five cases reported concerning noma or noma-like lesions in patients with hematologic malignancies in PubMED (Brady et al, 1998;Santos et al, 2011). Finally, some authors support that intraoral MS involves patients with the subtype of granulocytic origin (Xie et al, 2007).…”

Section: Oral Manifestations Of Amlmentioning

confidence: 99%

“…The oral lesions reported in this review are summarized in Table 1 along with different managements mentioned in the scientific literature and based on our clinical experience (Katz and Peretz, 2002;Arvanitidou et al, 2011;Santos et al, 2011;Pai et al, 2012;Reenesh et al 2012;Sepúlveda et al, 2012;Guan and Firth;Hasan et al, 2015;Zimmermann et al, 2015).…”

Section: Management Of Leukemic Oral Manifestationsmentioning

confidence: 99%

Leukemic Oral Manifestations and their Management

Francisconi¹,

Caldas²,

Martins³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Leukemia is the most common neoplastic disease of the white blood cells which is important as a pediatric malignancy. Oral manifestations occur frequently in leukemic patients and may present as initial evidence of the disease or its relapse. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections. Oral lesions arise in both acute and chronic forms of all types of leukemia. These oral manifestations either may be the result of direct infiltration of leukemic cells (primary) or secondary to underlying thrombocytopenia, neutropenia, or impaired granulocyte function. Despite the fact that leukemia has long been known to be associated with oral lesions, the available literature on this topic consists mostly of case reports, without data summarizing the main oral changes for each type of leukemia. Therefore, the present review aimed at describing oral manifestations of all leukemia types and their dental management. This might be useful in early diagnosis, improving patient outcomes.

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“…Noma‐like lesions are very rare in AML and are characterised by rapid progress of an ulceration with necrotic characteristics that can infiltrate both hard and soft tissues; however, its development is not as aggressive as the classic noma lesions. They are very unusual manifestations of AML; only six cases were reported worldwide until 2011. In the current case, the necrotising tissue was isolated in the right‐side mandibular buccal sulcus without any further evident diffusion into the hard tissues.…”

Section: Discussionmentioning

confidence: 64%

Intra‐oral noma‐like lesion associated with acute myeloid leukaemia: a case report

Chatzipantelis

Atkin

2018

Oral Surgery

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Acute myeloid leukaemia is a malignancy of the white blood cells that can develop in both children and adults with rapid development and possible intra‐oral manifestations. This report describes a case involving a 50‐year‐old patient who was referred to the Emergency Department of a University Dental Hospital complaining of severe intra‐oral ulceration, spontaneous intra‐oral bleeding and generalised fatigue and malaise. Examination revealed the existence of an erythematous intra‐oral necrotising, noma‐like, ulceration in the posterior area of the right buccal mucosa. The patient was diagnosed with acute myeloid leukaemia. Acute myeloid leukaemia develops rapidly and the initial symptoms may be non‐specific. Patients may demonstrate intra‐oral manifestations; most common symptoms include spontaneous gingival bleeding, gingival enlargement and acute ulceration. Ulceration with necrotising (noma‐like) characteristics is a rare oral manifestation of acute myeloid leukaemia, the cause of which is yet unknown. Fewer than 10 cases have been reported in the international literature. Intra‐oral pathology can be an early indicator of significant medical pathology. A dental practitioner is likely to be the first point of contact for patients with acute myeloid leukaemia due to the unusual or painful nature of the intra‐oral pathology; identification of suspicious signs and symptoms can lead to early detection and treatment. Clinical relevance Leukaemia may present initially to dental practitioners because of a high incidence of early intra‐oral signs and symptoms. A high index of suspicion for underlying systemic disease will lead to prompt onward referral for specialist investigations. Oral presentations may include spontaneous gingival bleeding and gingival enlargement. A rare oral presentation of acute myeloid leukaemia is deep and severe oral ulceration presenting as a noma‐like lesion, which we present here.

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Noma-like lesion in a patient with acute promyelocytic leukemia

Cited by 6 publications

References 6 publications

A Review on Noma: A Recent Update

A Review on Noma: A Recent Update

Leukemic Oral Manifestations and their Management

Intra‐oral noma‐like lesion associated with acute myeloid leukaemia: a case report

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