Drug-Induced Oral Ulcerations: Case Report

Abstract

SUMMARY -A 70-year-old patient was admitted to the Department of Oral Medicine for multiple oral ulcerations on the left buccal mucosa, around 0.5 cm in diameter, as well as on the gingiva. Otherwise, the patient suff ered from chronic lymphocytic leukemia, hypogammaglobulinemia, chronic renal insuffi ciency, with complete afunction of the right kidney, asthma, hypertension, gastritis and prostate hyperplasia. Diff erential diagnosis of oral ulcerations included drug induced oral ulcerations, paraneoplastic pemphigus, viral ulcerations (cytomegalovirus, herpes simplex viruses), fungal ulcerations (candidiasis, aspergillosis, histoplasmosis, cryptococcosis) and bacterial ulcerations, as well as neutropenic ulcers. One of the possible explanations was that the lesions were due to the use of drugs, the more so as oral lesions evolved when the doses of allopurinol and chlorambucil were increased, and subsided when the doses of both drugs were decreased. However, we could not establish for sure whether the lesions were due to allopurinol or chlorambucil. According to literature data, allopurinol is one of the most frequent drugs known to induce skin adverse reactions, therefore we assumed that it was the culprit drug. Unfortunately, several weeks later the patient died from sepsis, pneumonia with respiratory insuffi ciency and multiorgan failure.

Combined treatment of dexamethasone mouthwash and low‐level laser therapy in the management of aphthous‐like ulcers caused by nonsteroidal anti‐inflammatory drugs: A case report

“…Adverse drug reactions in the oral cavity are common with varied presentations and are sometimes difficult to diagnose. Diagnosis is usually based on the medical history and clinical findings 14 . The severity of oral adverse reactions to drugs depends on the drug structure and composition, and duration of exposure to medication 6 .…”

“…Diagnosis is usually based on the medical history and clinical findings. 14 The severity of oral adverse reactions to drugs depends on the drug structure and composition, and duration of exposure to medication. 6 After a few weeks of therapy, solitary oral ulcerations typically develop.…”