Tongue ulcer in a child: Riga‐Fede disease

Abstract

1357mucosal lesions have been reported on the mouth, labia majora, and oesophagus. In addition, verrucoid papules infrequently occur, 2 which, when on the genital areas, may resemble warts. Langenbery et al. 2 reviewed the literature and concluded that all verrucoid genital lesions with the histological features of HHD may represent familial benign chronic pemphigus (HHD). The authors thought that this rare clinical entity, verrucoid HHD, was not associated with HPV infection. In our patient, however, verrucoid papules were found on the surface of the erythematous patch clinically, and HPV type 6 DNA was detected in the verrucoid lesions. These findings therefore differ from Langenbery's conclusion. The argument that our patient had condyloma on the genital skin, which happened to have a subclinical anatholytic process of HHD, is unjustified because the base of the verrucoid papules was an erythematous, erosive patch, representing an active lesion of HHD. It seems more likely that our patient had a newly developed HHD lesion superimposed with HPV type 6 infection on the genitalia.The role of infection in inducing lesions of HHD is controversial. 3,4 Herpes virus hominis has been reported to cause a severe exacerbation of HHD. 5 Candidal or bacterial infection may or may not initiate lesions but the subsequent inflammation certainly potentiates acantholysis. 3 On the other hand, some investigators consider that such microbes are secondary invaders rather than primary aetiological agents. 4 In our case, we surmise a possible role of HPV infection in the provocation or induction of skin lesions of HHD. Therefore, biopsy and detection of HPV genome are necessary when verrucoid papules on genital lesions of HHD are encountered.

Traumatic lingual ulcer in a child: Riga-Fede disease

“…Any mucosal surface can be affected in the oral mucosa; however, the tongue is the most common location in reported cases. Oral lesions usually appear as ulcerations on the ventral surface of the tongue in the midline 5–8 . This clinical picture is more familiar to oral pathologists and dentists, but there have been some reported cases in the dermatological literature 1,4–6 …”

“…As it often mimics many oral malignant and benign disorders, the differential diagnosis is important 2–4 . The disease is extremely rare; we found only four cases when we reviewed the dermatological literature 1,4–6 …”

A importância da interação entre odontopediatrias e pediatrias no manejo de dentes natais e neonatais

“…A ulceração tende a crescer de acordo com o trauma de repetição, podendo provocar uma fibrose local do tecido, com aparência de úlcera granulomatosa. Esta complicação dificulta a sucção e a alimentação do bebê, podendo causar deficiências nutricionais (37)(38)(39)(40) . A anomalia pode ainda causar lacerações ao seio materno (12,15) ; entretanto, Hals (24) , Zhu e King (5) e Walter et al (32) relataram não existir relação entre o ferimento no seio mater-no e a presença destes dentes, visto que, durante a sucção, a língua se interpõe entre o dente e o seio, ocorrendo somente uma lesão na base da língua do bebê.…”

Natal teeth associated with Riga-Fede ulcer: case report

“…There is the formation of a layer of soft tissue above the alveolar ridge, occasionally covered by mucous membrane, having exacerbated mobility and may be swallowed or aspirated in most cases [12][13] . Normally, the presence of natal teeth in the oral cavity baby is followed by some complications, one of which Riga-Fede ulcer [14][15] . Riga-Fede ulcer is a rare entity seen in children and is characterized by persistent lingual ulceration due to repetitive mucosal trauma 3 , interfering with the infant sucking and feeding capacity and can lead it to irritability, lack of appetite and the risk of nutritional deficiencies [15][16] .…”