Self-inflicted intraoral ulcer in children: Cases report
Georgios NTAGIANTIS, Danai-Anna PAPAVASILEIOU, Adamantia VLACHAKI, Ioannis PAPADIOCHOS, Nikolaos NIKITAKIS, Nadia THEOLOGIE-LYGIDAKIS
Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor C. Perisanidis), Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor N. Nikitakis)
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 2, 33-42
SUMMARY: Single ulcers of the oral mucosa are usually of traumatic origin, but they can also hide a malignancy or systematic disease. In case of a chronic ulcer that shows non-specific character, consistent with a traumatic origin, the possibility of self-inflicted injury should be considered. There has been a staging of self-harm into three distinguished stages, and it may present with intraoral manifestation. The final diagnosis is dependent on the medical history, and more specifically on a history of injury in the specific location, and of course on the biopsy and the histopathological examination.
Cases presentation: Two children, a 12 years old boy and a 10 years old girl, presented with a buccal abscess, accompanied by a persistent, large ulcer in the buccal mucosa. Repeated biting and self-injury with the fingernails respectively, were determined. The third case was about an infant, that presented an ulcer at the tongue. The diagnostic and treatment procedures are being presented. In the first two cases, consultation with a Child Psychologist or Psychiatrist was needed.
Conclusions: Self-injury in children is not a common con- dition. Clinicians must be sensitive and well-informed concerning the identification of conditions of psychological nature and discreet management.
KEY WORDS: Eosinophilic, ulcer, traumatic, self-injury, TUGSE
REFERENCES
Αναστασόπουλος Γ: Νεογνικά δόντια και Riga Fede. Ελληνική Νοσοκομειακή Οδοντιατρική 10: 55-58, 2017
Λάσκαρης Χ. Γιώργος: Κλινική Στοματολογία, Διάγνωση-Θεραπεία. Έκδοση 3η, Εκδόσεις Λίτσας, Αθήνα 2012.
Akhavan A, Mosavi Α, Jarrahi Μ, Navabii Η: Eosinophilic ulcer of the tongue in an 80-year-old Iranian woman after a psychologically stressful event. BMJ Case Rep Volume 2013
Alobeid B, Pan LX, Milligan L, Budel L, Frizzera G: Eosinophil-rich CD30 lymphoproliferative disorder of the oral mucosa. A form of “trau- matic eosinophilic granuloma.” Am J Clin Pathol 121(1):43-50, 2004
Boffano P, Gallesio C, Campisi P, Roccia F: Traumatic ulcerative gran- uloma with stromal eosinophilia of the retromolar region. J Cran- iofac Surg 20: 2150-52, 2009
Briere J, Gil E: Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. The American Journal of Orthopsychiatry. 68:609-20, 1998
Cannavale R, Itro A, Campisi G, Compilato D, Colella G: Oral self-in- juries: Clinical findings in a series of 19 patients. Med Oral Patol Oral Cir Bucal. Mar 1;20 (2): e123-9, 2015
Chatzistamou I, Doussis-Anagnostopoulou I, Georgiou G, Gkilas H, Prodromidis G, Andrikopoulou M, Sklavounou A: Traumatic ul- cerative granuloma with stromal eosinophilia: report of a case and literature review. J Oral Maxillofac Surg. 70(2):349-53, 2012
Chavan SS, Reddy P: Traumatic ulcerative eosinophillic granuloma with stromal eosinophilia of tongue. South Asian Journal of Cancer. 2:144, 2013
Chen JY, Wang WC, Chen YK, Lin LM: A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan. J Appl Oral Sci. 18(1):5-9, 2010
Compilato D, Corsello G, Campisi G: Un unusual traumatic ulceration of the tongue. J Paediatr Child Health. 48(12):1104-5, 2012
Εl-Mofty SK, Swanson PE, Wick MR, Miller AS: Eosinophilic ulcer of the oral mucosa. Report of 38 new cases with immunohistochem- ical observations. Oral Surg Oral Med Oral Pathol 75(6): 716,1993
Favazza AR: Bodies under siege: self-mutilation and body modification in culture and psychiatry. 2nd ed. Armando R. Favazza ed, Balti- more, MD, London: Johns Hopkins University 1996, pp. 1-325
Ficarra G, Prignano F, Romagnoli P: Traumatic eosinophilic granuloma of the oral mucosa: A CD30(Ki-1) lymphoproliferative disorder? Oral Oncol 33:375, 1997
Fitzpatrick S, Cohen D, Clark A: Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head and Neck Pathology, Special Issue: Colors and Textures, A Review of Oral Mucosal Entities, 2019
Hirshberg A, Amariglio N, Akrish S, et al.: Traumatic ulcerative granu- loma with stromal eosinophilia. A reactive lesion of the oral mu- cosa. Am J Clin Pathol 126:522-529, 2006
Il KJ, Woo Kim H, Nam W, Kim HJ: Traumatic ulcerative granuloma misjudged as oral squamous cell carcinoma (SCC) on the buccal cheek: Case report. J Korean Assoc Oral Maxillofac Surg 36:217– 20, 2010
McManus S, Gunnell D, Cooper C, Bebbington P, Howard L, Brugha T, Jenkins R, Hassiotis A, Weich S, Appleby L: Prevalence of non- suicidal self-harm and service contact in England, 2000–14: re- peated cross-sectional surveys of the general population. Lancet Psychiatry 6: 573–81, 2019
Morgan C, Webb R, Carr M, Kontopantelis E, Green J, Chew Graham C, Kapur N, Ashcroft D: Incidence, clinical risk and mortality risk following self harm among children and adolescents: cohort study in primary care. BMJ 359: j4351, 2017
Mortazavi H, Safi Y, Baharvand M, Rahmani S: Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. Int J Dent. 2016: 7278925, 2016
Pattison EM, Kahan J: The deliberate self-harm syndrome. Am J Psy- chiatry. 140: 867-72, 1983
Regezi JA et al: Oral traumatic granuloma. Characterization of the cel- lular infiltrate. Oral Surg Oral Med Oral Pathol 75:723, 1993 Sarangarajan R, Vaishnavi Vedam VK, Sivadas G, Sarangarajan A, Meera
S: Traumatic ulcerative granuloma with stromal eosinophilia – Mystery of pathogenesis revisited. J Pharm Bioallied Sci. 7(Suppl 2): S420–S423, 2015
Shapiro L, Juhlin EA: Eosinophilic ulcer of the tongue. Report of two cases and review of the literature. Dermatologica. 140(4):242-50, 1970
Simeon D, Hollander E: Self-injurious behaviors: assessment and treat- ment. Washington D.C: American Psychiatric Press 2001, pp. 1-28 Ystgaard M, Arensman E, Hawton K, Madge N, van Heeringen K, He- witt A, de Wilde EJ, De Leo D, Fekete S: Deliberate self-harm in adolescents: comparison between those who receive help following self-harm and those who do not. J Adolesc 32(4) :875-91, 2009
Van der Meij EH, de Vries TW, Eggink HF, de Visscher JG: Traumatic lingual ulceration in a newborn: Riga-Fede disease. Ital J Pediatr. 38: 20, 2012
Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor C. Perisanidis), Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor N. Nikitakis)
Hellenic Archives of Oral & Maxillofacial Surgery (2020) 2, 33-42
SUMMARY: Single ulcers of the oral mucosa are usually of traumatic origin, but they can also hide a malignancy or systematic disease. In case of a chronic ulcer that shows non-specific character, consistent with a traumatic origin, the possibility of self-inflicted injury should be considered. There has been a staging of self-harm into three distinguished stages, and it may present with intraoral manifestation. The final diagnosis is dependent on the medical history, and more specifically on a history of injury in the specific location, and of course on the biopsy and the histopathological examination.
Cases presentation: Two children, a 12 years old boy and a 10 years old girl, presented with a buccal abscess, accompanied by a persistent, large ulcer in the buccal mucosa. Repeated biting and self-injury with the fingernails respectively, were determined. The third case was about an infant, that presented an ulcer at the tongue. The diagnostic and treatment procedures are being presented. In the first two cases, consultation with a Child Psychologist or Psychiatrist was needed.
Conclusions: Self-injury in children is not a common con- dition. Clinicians must be sensitive and well-informed concerning the identification of conditions of psychological nature and discreet management.
KEY WORDS: Eosinophilic, ulcer, traumatic, self-injury, TUGSE
REFERENCES
Αναστασόπουλος Γ: Νεογνικά δόντια και Riga Fede. Ελληνική Νοσοκομειακή Οδοντιατρική 10: 55-58, 2017
Λάσκαρης Χ. Γιώργος: Κλινική Στοματολογία, Διάγνωση-Θεραπεία. Έκδοση 3η, Εκδόσεις Λίτσας, Αθήνα 2012.
Akhavan A, Mosavi Α, Jarrahi Μ, Navabii Η: Eosinophilic ulcer of the tongue in an 80-year-old Iranian woman after a psychologically stressful event. BMJ Case Rep Volume 2013
Alobeid B, Pan LX, Milligan L, Budel L, Frizzera G: Eosinophil-rich CD30 lymphoproliferative disorder of the oral mucosa. A form of “trau- matic eosinophilic granuloma.” Am J Clin Pathol 121(1):43-50, 2004
Boffano P, Gallesio C, Campisi P, Roccia F: Traumatic ulcerative gran- uloma with stromal eosinophilia of the retromolar region. J Cran- iofac Surg 20: 2150-52, 2009
Briere J, Gil E: Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. The American Journal of Orthopsychiatry. 68:609-20, 1998
Cannavale R, Itro A, Campisi G, Compilato D, Colella G: Oral self-in- juries: Clinical findings in a series of 19 patients. Med Oral Patol Oral Cir Bucal. Mar 1;20 (2): e123-9, 2015
Chatzistamou I, Doussis-Anagnostopoulou I, Georgiou G, Gkilas H, Prodromidis G, Andrikopoulou M, Sklavounou A: Traumatic ul- cerative granuloma with stromal eosinophilia: report of a case and literature review. J Oral Maxillofac Surg. 70(2):349-53, 2012
Chavan SS, Reddy P: Traumatic ulcerative eosinophillic granuloma with stromal eosinophilia of tongue. South Asian Journal of Cancer. 2:144, 2013
Chen JY, Wang WC, Chen YK, Lin LM: A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan. J Appl Oral Sci. 18(1):5-9, 2010
Compilato D, Corsello G, Campisi G: Un unusual traumatic ulceration of the tongue. J Paediatr Child Health. 48(12):1104-5, 2012
Εl-Mofty SK, Swanson PE, Wick MR, Miller AS: Eosinophilic ulcer of the oral mucosa. Report of 38 new cases with immunohistochem- ical observations. Oral Surg Oral Med Oral Pathol 75(6): 716,1993
Favazza AR: Bodies under siege: self-mutilation and body modification in culture and psychiatry. 2nd ed. Armando R. Favazza ed, Balti- more, MD, London: Johns Hopkins University 1996, pp. 1-325
Ficarra G, Prignano F, Romagnoli P: Traumatic eosinophilic granuloma of the oral mucosa: A CD30(Ki-1) lymphoproliferative disorder? Oral Oncol 33:375, 1997
Fitzpatrick S, Cohen D, Clark A: Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head and Neck Pathology, Special Issue: Colors and Textures, A Review of Oral Mucosal Entities, 2019
Hirshberg A, Amariglio N, Akrish S, et al.: Traumatic ulcerative granu- loma with stromal eosinophilia. A reactive lesion of the oral mu- cosa. Am J Clin Pathol 126:522-529, 2006
Il KJ, Woo Kim H, Nam W, Kim HJ: Traumatic ulcerative granuloma misjudged as oral squamous cell carcinoma (SCC) on the buccal cheek: Case report. J Korean Assoc Oral Maxillofac Surg 36:217– 20, 2010
McManus S, Gunnell D, Cooper C, Bebbington P, Howard L, Brugha T, Jenkins R, Hassiotis A, Weich S, Appleby L: Prevalence of non- suicidal self-harm and service contact in England, 2000–14: re- peated cross-sectional surveys of the general population. Lancet Psychiatry 6: 573–81, 2019
Morgan C, Webb R, Carr M, Kontopantelis E, Green J, Chew Graham C, Kapur N, Ashcroft D: Incidence, clinical risk and mortality risk following self harm among children and adolescents: cohort study in primary care. BMJ 359: j4351, 2017
Mortazavi H, Safi Y, Baharvand M, Rahmani S: Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. Int J Dent. 2016: 7278925, 2016
Pattison EM, Kahan J: The deliberate self-harm syndrome. Am J Psy- chiatry. 140: 867-72, 1983
Regezi JA et al: Oral traumatic granuloma. Characterization of the cel- lular infiltrate. Oral Surg Oral Med Oral Pathol 75:723, 1993 Sarangarajan R, Vaishnavi Vedam VK, Sivadas G, Sarangarajan A, Meera
S: Traumatic ulcerative granuloma with stromal eosinophilia – Mystery of pathogenesis revisited. J Pharm Bioallied Sci. 7(Suppl 2): S420–S423, 2015
Shapiro L, Juhlin EA: Eosinophilic ulcer of the tongue. Report of two cases and review of the literature. Dermatologica. 140(4):242-50, 1970
Simeon D, Hollander E: Self-injurious behaviors: assessment and treat- ment. Washington D.C: American Psychiatric Press 2001, pp. 1-28 Ystgaard M, Arensman E, Hawton K, Madge N, van Heeringen K, He- witt A, de Wilde EJ, De Leo D, Fekete S: Deliberate self-harm in adolescents: comparison between those who receive help following self-harm and those who do not. J Adolesc 32(4) :875-91, 2009
Van der Meij EH, de Vries TW, Eggink HF, de Visscher JG: Traumatic lingual ulceration in a newborn: Riga-Fede disease. Ital J Pediatr. 38: 20, 2012
|
How to cite this article:
|
| ||
|
View the full-text PDF:
|
| ||