International Journal of Experimental Dental Science

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VOLUME 7 , ISSUE 1 ( January-June, 2018 ) > List of Articles


Management of Oral Manifestations in a Case of Cushing's Habitus

Mohinder Panwar, Jacqueline J Dias

Keywords : Cushing's habitus, Immunomodulator, Recurrent oral ulcers, Thalidomide

Citation Information : Panwar M, Dias JJ. Management of Oral Manifestations in a Case of Cushing's Habitus. Int J Experiment Dent Sci 2018; 7 (1):35-38.

DOI: 10.5005/jp-journals-10029-1172

License: CC BY-SA 3.0

Published Online: 01-03-2010

Copyright Statement:  Copyright © 2018; The Author(s).


Background: Cushing's syndrome is a debilitating endocrine disorder comprising signs and symptoms due to prolonged exposure to cortisol. It is characterized by excessive cortisol levels in the blood, which may be the result of various causes, such as tumors of pituitary glands, tumors arising elsewhere in the body (ectopic adrenocorticotropic hormone-producing tumors), or exogenous causes, such as prolonged intake of steroids (known as Cushing's habitus). Aim: This article is a case report on the management of a patient with Cushing's habitus, presenting with recurrent oral ulcers as one of the manifestations. Case report: A 25-year-old patient diagnosed with Cushing's habitus came to the department with complaint of recurrent ulcers on the tongue and lips since 6 months. These ulcers were unresponsive toward conventional therapies, such as amlexanox and steroids. Conclusion: Due to the unique history presented by the patient and the persistence of recalcitrant ulcers, an immunomodulator was prescribed. This drug prevented the recurrence of the oral ulcers. Clinical significance: Various manifestations of Cushing's disease include metabolic, cardiovascular, and endocrinal abnormalities, to mention a few. Prevalence of dental manifestations is rare, oral ulcers being among the few. These oral ulcers require special consideration since the underlying pathogenesis of the ulcers is very different. This article describes the management of such ulcers in Cushing's habitus using an immunomodulator.

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  1. Shulman JD, Beach MM, Rivera-Hidalgo F. The prevalence of oral mucosal lesions in U.S. adults: data from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Dent Assoc 2004 Sep;135(9):1279-1286.
  2. Nieman LK, Biller BM, Findling JW, Murad MH, Newell-Price J, Savage MO, Tabarin A. Treatment of Cushing's syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2015 Aug;100(8):2807-2831.
  3. Long RG, Hlousek L, Doyle JL. Oral manifestations of systemic diseases. Mt Sinai J Med 1998 Oct-Nov;65(5-6):309-315.
  4. Buno IJ, Huff JC, Weston WL, Cook DT, Brice SL. Elevated levels of interferon gamma, tumor necrosis factor alpha, interleukins 2, 4, and 5, but not interleukin 10, are present in recurrent aphthous stomatitis. Arch Dermatol 1998 Jul;134(7):827-831.
  5. Kose O, Stewart J, Waseem A, Lalli A, Fortune F. Expression of cytokeratins, adhesion and activation molecules in oral ulcers of Behcet's disease. Clin Exp Dermatol 2008 Jan;33(1):62-69.
  6. Altenburg A, Abdel-Naser MB, Seeber H, Abdallah M, Zouboulis CC. Practical aspects of management of recurrent aphthous stomatitis. J Eur Acad Dermatol Venereol 2007 Sep;21(8):1019-1026.
  7. Shivhare P, Shankarnarayan L, Singh A, Patil ST, Yadav M. Role of immunomodulators in oral diseases. Int J Oral Health Med Res 2015;2(3):73-80.
  8. Elad S, Epstein JB, Yarom N, Drucker S, Tzach R, von Bultzingslowen I. Topical immunomodulators for management of oral mucosal conditions, a systematic review. Part I: Calcineurin inhibitors. Expert Opin Emerg Drugs 2010 Dec;15(4):713-726.
  9. Carlos Fabue L, Soriano YJ, Sarrion Perez MG. Dental management of patients with endocrine disorders. J Clin Exp Dent 2010;2(4):e196-e203.
  10. Bascones-Martinez A, Mattila R, Gomez-Font R, Meurman JH. Immunomodulatory drugs: oral and systemic adverse effects. Med Oral Patol Oral Cir Bucal 2014 Jan;19(1):e24-e31.
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