[Drug-induced oral ulcerations].
Different side effects of drugs have been described in the oral cavity, including oral ulcerations. Direct contact between drugs and oral mucosa may induce chemical burn or local hypersensitivity. Less frequently, these drug-induced oral ulcerations are part of a complex reaction with cutaneous or systemic manifestations. Sometimes, one or more oral ulcerations appear as the main side-effect of a drug, or exceptionally as solitary lesions. Solitary oral ulcerations usually appear after few weeks of treatment. In most of cases, these lesions resist to conventional treatments, with a rapid healing following the suppression of the responsible drug. This diagnosis is usually difficult, particularly with patients receiving multiple drug therapy. Besides, special attention must be paid to new drugs. Oral ulcerations following symptoms of burning mouth, metallic taste, dysgueusia or agueusia are strongly suggestive of a pharmacological origin. Most of the molecules able to induce solitary oral ulcerations are commonly prescribed in a) rheumatology: NSAI (diclofenac, flurbiprofen, indomethacin, naproxen), long-term rheumatoid arthritis therapy (azathioprine, methotrexate, penicillamine, gold compounds, tiopronin); b) cardiology: angiotensin-converting-enzyme inhibitors (captopril, enalapril), angiotensin 2-receptor antagonist (losartan), anti-angorous (nicorandil), c) psychiatry: antidepressants (fluoxetine, lithium), d) AIDS therapy (foscarnet, zalcitabine).
UFR d'Odontologie, Université de Nice-Sophia Antipolis, 24, avenue des Diables-Bleus, 06357 Nice Cedex 4.
I
I
Madinier
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N
Berry
R M
RM
Chichmanian
D000779:Anesthetics, Local / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D019380:Anti-HIV Agents / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects; D018501:Antirheumatic Agents / Q000009:adverse effects; D003937:Diagnosis, Differential; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D009910:Oral Hygiene / Q000379:methods; D019226:Oral Ulcer / Q000139:chemically induced* / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D013256:Steroids; D014945:Wound Healing
D000779:Anesthetics, Local; D000806:Angiotensin-Converting Enzyme Inhibitors; D019380:Anti-HIV Agents; D000893:Anti-Inflammatory Agents; D000928:Antidepressive Agents; D018501:Antirheumatic Agents; D013256:Steroids; D008012:Lidocaine