trimethoprim--sulfamethoxazole-drug-combination and Stomatitis--Aphthous

Little is known about the characteristic features of oral mucosal fixed drug eruption (FDE).. To present the clinical highlights and the differential diagnosis of oral mucosal FDE in a relatively large group of patients from Turkey.. This was a methodological, retrospective, cross-sectional study of 61 patients with oral mucosal FDE. The causative drug was established mainly by oral provocation test.. The age range of 61 patients (38 females, 23 males) was 7 to 62 years. Naproxen and cotrimoxazole were the main inducers. Fourteen patients (23%) had a solitary oral lesion predominantly located on the dorsum of the tongue, or on the hard palate, the former statistically significantly associated with cotrimoxazole. Bullous/erosive (n = 47), aphthous (n = 12), and erythematous (n = 2) morphology were observed. A considerable number of patients were referred with a prior clinical diagnosis of herpes simplex and Behçet's disease; some of them were already receiving long-term treatment with acyclovir and colchicine, respectively.. The main limitation of the present study resides in its retrospective design.. Isolated oral lesions, aphthous lesions, severe bullous/erosive lesions, and the absence of residual pigmentation are the main features that may cause difficulties in the differential diagnosis. It is important to differentiate dysmenorrhea-related monthly attacks of oral FDE in female patients caused by nonsteroidal anti-inflammatory drugs from menstruation-triggered attacks of herpes simplex infection, and isolated orogenital aphthous FDE from Behçet's disease, especially in countries with a high frequency of the disease in order to prevent irrelevant therapies.

Topics: Adolescent; Adult; Age Distribution; Behcet Syndrome; Child; Cross-Sectional Studies; Diagnosis, Differential; Drug Eruptions; Drug-Related Side Effects and Adverse Reactions; Female; Follow-Up Studies; Herpes Simplex; Humans; Incidence; Male; Middle Aged; Mouth Mucosa; Naproxen; Retrospective Studies; Risk Assessment; Severity of Illness Index; Sex Distribution; Stomatitis, Aphthous; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult

Topics: Adolescent; Adrenal Cortex Hormones; Anti-Infective Agents; Arthralgia; Cyclophosphamide; Diagnosis, Differential; Fatigue; Female; Fever; Glomerulonephritis; Granulomatosis with Polyangiitis; Humans; Immunosuppressive Agents; Muscle Weakness; Pallor; Renal Dialysis; Stomatitis, Aphthous; Trimethoprim, Sulfamethoxazole Drug Combination

We report a 24-year-old man with a known Behcet's disease who was lost to follow-up for a year. The patient was admitted for the association of scrotal ulceration and inguinal folliculitis, suggesting a Behcet's disease flare-up. Necrotizing course of the folliculitis led to the diagnosis of skin infection caused by a community-acquired methicillin-resistant Staphylococcus aureus strain, carrying Panton-Valentine leukocidin genes. Bacteriological analysis should be mandatory in the absence of specific criteria for the diagnosis of Behcet's disease.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Anti-Infective Agents, Local; Bacterial Toxins; Behcet Syndrome; Chlorhexidine; Colchicine; Community-Acquired Infections; Diagnosis, Differential; Drug Therapy, Combination; Exotoxins; Folliculitis; Follow-Up Studies; Groin; Humans; Leg Ulcer; Leukocidins; Male; Methicillin-Resistant Staphylococcus aureus; Necrosis; Ofloxacin; Phenindione; Scrotum; Staphylococcal Skin Infections; Stomatitis, Aphthous; Time Factors; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult