Ulceration of the oral mucosa induced by antidepressant medication: a case report.
BACKGROUND
Ulcers are frequent lesions of the oral mucosa. Generally, they are circumscribed round or elliptical lesions surrounded by an erythematous halo and covered with an inflammatory exudate in their central portion, and are accompanied by painful symptoms. Oral ulcers affect 20% of the population, especially adolescents and young adults. The etiopathogenesis includes immunological alterations, infections, nutritional deficiency, trauma, food and contact allergies, autoimmune diseases, neoplasms, and psychosomatic, genetic and environmental factors.


METHODS
A 78-year-old Caucasian woman was referred by her dentist to our outpatient clinic with a 4-week history of an oral ulceration after using an antidepressant (sertraline hydrochloride). On the basis of the clinical findings and anamnesis, the occurrence of the lesion was attributed to the use of the drug. Exfoliative cytology was performed, to reassure the patient that it was not oral cancer, which revealed the presence of a nonspecific inflammatory reaction. The drug was replaced and resolution of symptoms was observed.


CONCLUSIONS
Exfoliative cytology should be the complementary examination of choice in cases of oral ulcers with a suspicion of drug interaction. Although this is a rare event in dental practice, dentists should be aware of the diagnostic possibility of drug-induced ulcers and should cooperate with the clinician to adjust the prescribed medication to resolve the symptoms.
Bertini
Fernanda
F
Postgraduate Program in Biopathology and Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil.
Costa
Nívea Cristina Sena
NC
Brandão
Adriana Aigotti Haberbeck
AA
Cavalcante
Ana Sueli Rodrigues
AS
Almeida
Janete Dias
JD