salicylates and Leukoplakia--Oral

Pachyonychia congenita is a rare genetic disorder characterized mainly by hypertrophy of the nails and hyperkeratosis of the skin and mucosae. Fifty percent of all patients have oral leukokeratosis, which is often painful. The case reported here is of a 41-year-old patient who had white lesions in the form of irregular plaques; these affected multiple regions of the oral mucosa and were sensitive to touch. Histological examination revealed acanthosis, parakeratosis and ballooning of the epithelial cells, consistent with oral leukokeratosis. After therapy including topical steroids and prosthetic rehabilitation, the symptoms resolved.

Topics: Adult; Anti-Inflammatory Agents; Dexamethasone; Female; Humans; Leukoplakia, Oral; Malocclusion; Mouth Mucosa; Pachyonychia Congenita; Salicylates; Urea

A 23-year-old white female with a history of psychological instability presented with burning, adhesive, white plaques of the buccal mucosa. She had been unsuccessfully treated for 1.5 years with topical retinoids as well as topical and systemic corticosteroids. The differential diagnoses included leukoplakia, cheek biting and lichen planus. Clinical and histopathological examinations suggested the diagnosis of severe oral leukoedema. Careful history and clandestine surveillance of the patient finally revealed the lesions to be due to a caustic (over-the-counter product for the treatment of corns), which the patient regularly applied to her buccal mucosa.

Topics: Adult; Diagnosis, Differential; Drug Combinations; Edema; Factitious Disorders; Female; Humans; Lactates; Lactic Acid; Leukoplakia, Oral; Mouth Mucosa; Mouth Neoplasms; Salicylates