Contact allergies to potential allergens in patients with oral lichen lesions

Objective

The aim of the present controlled study was to investigate a possible relationship between contact allergies to potential allergens and oral lichen lesions.

Methods

Eighty-three patients with oral lichen lesions (OLL) and control groups of age- and gender-matched dermatitis patients (DP, n?=?83) and patch-tested dermatitis patients randomly selected from files (PSFF, n?=?319) were included in the study. OLL and DP groups were patch-tested epicutaneously and examined intraorally.

Results

The frequencies of contact allergy to mercury and carvone were statistically higher in the OLL group than in the DP group. Surfaces of amalgam and composite restorations were statistically more frequent in the OLL group compared to the DP group. Contact allergy to nickel and colophony, the latter with a statistically significant difference, was more common in the DP group. The numerical difference found for nickel allergy was, however, not significant comparing the OLL and PSFF groups.

Conclusion

Contact allergy to mercury was overrepresented in patients with OLL and has been reported in previous studies, but the present finding of an overrepresentation of contact allergy to carvone in patients with oral lichen lesions has not been reported previously.

Clinical relevance

Carvone, in addition to mercury and gold, as previously suggested, can be one of the causative or maintenant factors for oral lichen lesions. Carvone-hypersensitive patients with oral lichen lesions should therefore avoid carvone-containing products for oral use.     

Histologic and Micro–Computed Tomographic Analyses of Replanted Teeth Stored in Different Kind of Media

Introduction

Coconut water (CW) and soy milk (SM) have been proposed as storage media for avulsed teeth because of their nutrients that preserve cell viability. The present study investigated the periodontal healing process of dog teeth replanted after storage in CW, SM, and whole milk (WM) using micro–computed tomographic (μCT) and histologic analyses compared with immediate tooth replantation.

Methods

Forty roots of 10 adult beagle dogs were extracted and subjected to the following protocols: immediate replantation after extraction (control), stored in CW with an adjusted pH, and SM and WM for 50 minutes before replantation. The animals were euthanized 28 days postoperatively, and the obtained specimens were scanned using a μCT scanner and subjected to routine processing for histometric analyses under an optical microscope.

Results

CW and SM performed similarly to WM; however, SM showed significantly higher ankylosis than the control group.

Conclusions

Additionally, this study showed that the combined use of histologic analysis and μCT is a promising method to better identify tooth resorption and the repair process and to evaluate the total extension of the periodontium. CW as a storage medium is a promising transport media for avulsed teeth.     

Learning strategies of general practitioners striving to achieve point-of-care ultrasound competence: a qualitative study

BackgroundPoint-of-care ultrasonography (POCUS) is increasingly used in general practice despite the lack of official educational programmes or guidelines for general practitioners (GPs).AimTo explore how GPs have learnt to use POCUS and which barriers they have encountered in their learning process.Design and settingQualitative study conducted in office-based general practice in Denmark.MethodsSemi-structured interviews were conducted with 13 GPs who had implemented POCUS without supporting guidelines or regulations. Analysis was carried out using systematic text condensation. The interview data for this study were collected along with data used in a previous study.ResultsThe participating GPs described having composed their own ultrasound education following a continuous learning process. Basic POCUS competences were achieved through formalized training sessions at hospital departments or courses. The GPs further developed and expanded their scanning skills through additional courses and continuous self-study practice on patients often while consulting internet sources, textbooks or colleagues. Lack of available ultrasound courses, supervision, and clinical guidelines together with time constraints and financial aspects were mentioned as barriers to their ultrasound training.ConclusionThis study showed how GPs had composed their own ultrasound education individually and differently, guided by their own experiences and beliefs about good clinical practice. Formalized ultrasound training was considered a prerequisite for achieving basic ultrasound competences while continuous practice was considered paramount to develop and maintain scanning skills. There were several obstacles to overcome in the learning process including lack of supervision, guidance, and opportunity for practicing skills.

Key points

• Little is known about the educational needs of general practitioners striving to achieve ultrasound competences.
• General practitioners described using formalized training to achieve basic scanning competences and continuous self-study and practice to further develop their skills.
• Lack of time, supervision, clinical guidelines and ultrasound courses were considered barriers in the learning process together with financial aspects.

     

A peculiar adverse reaction to blue pigment tattoo

The practice of tattooing dates back to 5000 years ago and is currently constantly growing. The most common pigment associated with tattoo complications is the red one. Another pigment, which could be associated with adverse reactions, even if less frequently than red, is blue. Traditionally, blue pigment contains cobalt, which causes allergic reactions. Here, we report a case of blue pigment granulomatous reaction in a 37‐year‐old male patient.     

Atypical koebner phenomenon on a tattoo

Tattooing is more and more popular in developed countries in recent years and many side effects are associated with this practice, including psoriatic lesions and Koebner phenomenon. We report the case of a lichenoid reaction to red pigment in a patient affected by psoriasis.