Nickel - Induced Oral Pemphigus Vulgaris -Like Lesions

U literaturi je zabilježen samo jedan slučaj oralnog pemfigusa za koji se kao uzrok navodi nikal. U ovom prikazu opisali smo deskvamativni gingivitis kod 49-godišnjeg muškarca. Lezija se nalazila u prednjoj regiji mandibule koja je bila u kontaktu s keramičkim krunicama i mostovima. Osim tog oštećenja pronađene su i opsežne ulceracije u području lijeve i desne obrazne sluznice. Nakon godine dana liječenja lezije se nisu povukle. Uklanjanjem krunica i mostova te jakim topikalnim kortikosteroidima postignut je zadovoljavajući rezultat. Dentalna legura ispitivala se nakon toga metalurgijskim tehnikama. Rezultati su pokazali da je njezin glavni sastojak nikal. Patohistološki test i test imunofluorescencije potvrdili su dijagnozu pemphigus vulgaris. To nas je navelo na zaključak da pacijent boluje od lezija nalik na pemphigus vulgaris izazvanih niklom.So far, only a single case of nickel-induced pemphigus has been reported in the literature. We present a case of a 49-year-old male who had experienced a desquamative gingivitis on the anterior mandibular region which was in contact with porcelain crowns and bridges and severe ulcerations on the right and left buccal mucosa. The lesions did not respond to any medications for a year. After removal of those crowns and bridges with the treatment of potent topical steroids, the lesions responded dramatically. The dental alloy used as the core of crowns and bridges was further investigated using metallurgy techniques. The results showed that the dental alloy mainly contained nickel. Histopathologic and direct immunofluorescence evaluations confirmed a diagnosis of pemphigus vulgaris. We concluded that the patient had experienced nickel-induced pemphigus vulgaris-like lesions on the oral mucosa

Maximal Points of Head's Zone in Fixed Drug Eruption

The principles determining the primary localization of lesions in fixed drug eruption (FDE) are still unknown. Studies investigating the predilection areas in FDE have indicated drug-related, trauma-related, or inflammation-related specific site involvement, as well as visceracutaneous reflex-related specific site involvement. The importance of viscerocutaneous reflexes for the location of dermatoses was first recognized in the 1960s. Head's zones are viscerocutaneous reflex projection fields on the skin that extend over certain dermatomes and possess a reflex-associated maximal point. Recently, in a Turkish collective of patients, three women with the primary location of FDE lesions on the maximal points of Head's zones were presented. We also experienced 3 cases with FDE where the lesions were located at specific sites (buttocks), the so-called maximal points of Head's zones, which are known to be the most active dermatomal areas of an underlying visceral pathology. An underlying internal disturbance (ureter stone, pyelonephritis and chronic pelvic inflammatory disease) was found in all 3 patients, corresponding to the organ-related maximal point of Head's zones in each case. In conclusion, the primary location of FDE lesions on the maximal points of Head's zones revealed relevant organ disorders with corresponding projection fields