Noma management in a child with systemic lupus erythematosus

Irna Sufiawati, Asri Arum Sari, Budi Setiabudiawan, Rahmat Gunadi
2010 Dental Journal: Majalah Kedokteran Gigi  
N��a, als� kn���n as cancr�� �ris, is an �r��acial gangrene, ���ic� d�ring its ��l�inating stage ca�ses �r�gressive and ��tilating destr�cti�n �� t�e in�ected tiss�es. ��e disease �cc�rs �ainly in c�ildren ��it� �aln�triti�n, ���r �ral �ygiene and de�ilitating c�nc�rrent illness. Purpose: ��e ai� �� t�is �a�er ��as t� re��rt a �niq�e case �� n��a ass�ciated ��it� syste�ic l���s eryt�e�at�s�s in an 8-year-�ld ��y. Case: An 8-year-�ld ��y re�erred t� Oral �edicine De�art�ent c���laining a���t an
more » ... ��laining a���t an �lcer at t�e le�t c�rner �� �is ���t� ��r 1 ��nt�, �ain��l and di��ic�lty in ��ening t�e ���t�. ��e �atient ��as diagn�sed syste�ic l���s eryt�e�at�s�s since 14 ��nt�s �e��re and �ad �een given i���n�s���ressive t�era�y. ��e �atient ��as als� diagn�sed severe �aln�triti�n. Hae�at�l�gic investigati�ns revealed ane�ia. Case management: Pan�ra�ic radi�gra��y ��as �er��r�ed t� c�eck ��r dental �r �eri�d�ntal ��ci �� in�ecti�n, ��t n� a�n�r�alities ��ere �resent. ��e �icr��i�l�gy e�a�inati�n revelaed F�s��acteri�� necr����r��, Sta��yl�c�cc�s a�re�s, and Kla�siella. ��e �atient �as �een treated ��it� �ral irrigati�n �sing �ydr�gen �er��ide, saline and 0.2% c�l�r�e�idine, t��s �el�ed t� sl��g� t�e necr�tic tiss�e. Oral anti�i�tics and analgesics ��ere �rescri�ed. ��e �atient ��as ad�itted t� ��s�ital �nder t�e care �� a �ediatrician, allergy and i���n�l�gy s�ecialist, and a n�triti�nist. ��e res�lt �� t�e c���re�ensive disease �anage�ent s����ed t�at t�e lesi�n �ealed c���letely, ��t leaving a scar �n �is c�rner �� t�e ���t�. �ts ��ysical e��ects are �er�anent and �ay req�ire rec�nstr�ctive s�rgery t� �e re�aired �y �ral s�rge�n. Conclusion: N��a is n�t a �ri�ary disease, t�ere are vari��s �redis��sing �act�rs �s�ally �recede its �cc�rrence. ��e �anage�ent �� n��a req�ires a ��ltidisci�linary a��r�ac�.
doi:10.20473/j.djmkg.v43.i1.p6-10 fatcat:lwrekbmgkjhvrdpk2o3e2yrale