M. Jusri
Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga

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Erythema multiforme as the result of taking carbamazepine Maharani Laillyza Apriasari; M. Jusri
Dental Journal (Majalah Kedokteran Gigi) Vol. 43 No. 2 (2010): June 2010
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (428.69 KB) | DOI: 10.20473/j.djmkg.v43.i2.p49-53

Abstract

Background: Erythema multiforme is an acute mucocutaneus disease which is caused by the hypersensitivity reaction. It is characterized by target lesions on the skin or ulcerative oral lesion. Etiology of the disease is unknown, it is currently considered as immunologic disease. The triggering factors is the use of certain type of drugs like antibiotics, anticonvulsant, and NSAID. Most of the dentists do not know about it is mechanism, so a lot of people consider it as a malpractice. Purpose: This paper reported a case of a man, 46 years old which had ulcerative oral mucous, peeled and pain lips after taking carbamazepine drugs. Case: The clinical diagnosis of this case was erythema multiforme because of the hypersensitivity reaction as the result of taking carbamazepine. Case management: The final diagnosis based on anamnesis history of taking systemic drugs and clinical manifestation of erythema multiforme in the oral cavity. The drugs therapy that had been given were antihistamine, oral corticosteroid, gargle liquid contained of topical anesthetic, corticosteroid, and antibiotic. Conclusion: In this case, it can be concluded that erythema multiforme appeared was triggered by taking carbamazepine as the drug of choice for trigeminal neuralgia therapy. These drugs can cause type III hypersensitivity reaction. The final diagnosis based on anamnesis history of taking carbamazepine before lesions erupted and the characterized clinical manifestation.Latar belakang: Erythema multiforme adalah penyakit mukokutaneus akut yang menyerang kulit dan mukosa sebagai akibat dari reaksi hipersensitivitas. Secara karakteristik ditandai oleh lesi target pada kulit atau lesi ulserasi pada mukosa rongga mulut. Etiologi penyakit ini belum jelas, diduga karena adanya reaksi imunologi. Pencetusnya dikarenakan adanya pemakaian obat-obatan tertentu seperti antibiotik, antikonvulsan dan NSAID. Banyak dokter gigi kurang memahami mekanisme timbulnya penyakit ini, sehingga oleh masyarakat dianggap sebagai malpraktek. Tujuan: Tulisan ini melaporkan kasus pasien pria berusia 46 tahun dengan keluhan sariawan dan bibir terkelupas dan sakit setelah sehari meminum obat karbamazepin. Kasus: Diagnosis klinis kasus ini adalah erythema multifome karena reaksi hipersensitivitas terhadap pemakaian obat karbamazepin. Tatalaksana kasus: Diagnosis ditegakkan berdasarkan anamnesis riwayat pemakaian obat sistemik dan manifestasi klinis dari erythema multiforme pada rongga mulut. Pengobatan yang diberikan adalah antihistamin, kortikosteroid oral, obat kumur dengan anastesi topikal, kortikosteroid topikal dan antibiotik topikal. Kesimpulan: Dapat disimpulkan bahwa erythema multiforme yang timbul pada kasus ini dipicu oleh pemakaian obat karbamazepin yang merupakan obat pilihan untuk terapi trigeminal neuralgia. Obat ini menimbulkan efek samping reaksi hipersensitivitas tipe III. Diagnosis ditegakkan berdasarkan anamnesa riwayat pemakaian obat karbamazepin sebelum timbulnya lesi dan pemeriksaan klinis pada pasien.
Treatment of recurrent aphthous stomatitis major with metronidazole and ciprofloxacin M. Jusri; Nurdiana Nurdiana
Dental Journal (Majalah Kedokteran Gigi) Vol. 42 No. 3 (2009): September 2009
Publisher : Faculty of Dental Medicine, Universitas Airlangga https://fkg.unair.ac.id/en

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (470.007 KB) | DOI: 10.20473/j.djmkg.v42.i3.p109-113

Abstract

Background: Recurrent aphthous stomatitis (RAS) are painful oral ulcerations that recur from days to months or even years. It represents the most common lesion of the oral mucosa with prevalence ranging from 15% to 30%. Although the clinical characteristics of RAS are well defined, the precise etiopathogenesis of RAS remains unclear. Since the etiology of RAS remains unknown, there is no definitive treatment. RAS responds quite well to the use of topical or systemic antiinflammatory drugs, particularly corticosteroids. Purpose: The objective of this paper is to discuss the treatment of RAS with secondary infection. Case: This paper reported a case of 22-year-old man with multiple oral ulcers that did not heal for 7 months. Case Management: These ulcers were diagnosed as RAS major with secondary infection that caused by normal oral flora (aerobic and anaerobic bacteria) and treated with metronidazole (topical and oral) and ciprofloxacin (oral). These lesions healed in 3 weeks with scars. Conclusion: Large ulcer without signs of malignancy that contaminated with normal oral flora will delayed in healing, but with rational treatment RAS mayor with secondary infection has good prognosis.