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Laser Photobiomodulation for a Complex Patient with Severe Hydroxyurea-Induced Oral Ulcerations

View Article: PubMed Central - PubMed

ABSTRACT

Patients affected by polycythemia vera (PV), a myeloproliferative neoplasm characterized by an elevated red blood cell mass, are at high risk of vascular and thrombotic complications. Conventional therapeutic options aim at reducing vascular and thrombotic risk; low-dose aspirin and phlebotomy are first-line recommendations, for patients at low risk of thrombotic events, whereas cytoreductive therapy, usually hydroxyurea (HU) or interferon alpha, is recommended for high-risk patients. In the present study, we report the case of a patient with persistent oral ulcerations, possibly related to long-lasting HU treatment, firstly treated with topic and systemic corticosteroids and then more effectively with the addition of low-level laser therapy. Laser photobiomodulation has achieved pain control and has contributed to the healing of oral ulcers without any adverse effect; this has permitted a reduction in the dose of systemic corticosteroids and the suspension of the use of the topic ones, due to the long-term stability of oral health, even after the interruption of low-level laser therapy sessions.

No MeSH data available.


Erosive lesions presented in (a) and (b) lateral border of the tongue.
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fig1: Erosive lesions presented in (a) and (b) lateral border of the tongue.

Mentions: A 72-year-old male (diagnosed with PV in 1994 and treated with HU since 1995) was referred to the Oral Medicine Section of the Turin University in March 2014 because of severe tongue and lips pain and difficulty in feeding and speaking. At the time being, HU dosage consisted of three 500 mg tablets daily. At physical examination, extensive ulcerations on the tongue and lips were observed (Figure 1). Based on the clinical appearance and the topography of the lesions, a differential diagnosis between HU related ulcers and erosive lichen was posed. However, advice against the execution of the oral biopsy came directly from the oncologist, due to the very high level of platelets (more than 1.000.000/μL) detected in the patient's blood.


Laser Photobiomodulation for a Complex Patient with Severe Hydroxyurea-Induced Oral Ulcerations
Erosive lesions presented in (a) and (b) lateral border of the tongue.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121453&req=5

fig1: Erosive lesions presented in (a) and (b) lateral border of the tongue.
Mentions: A 72-year-old male (diagnosed with PV in 1994 and treated with HU since 1995) was referred to the Oral Medicine Section of the Turin University in March 2014 because of severe tongue and lips pain and difficulty in feeding and speaking. At the time being, HU dosage consisted of three 500 mg tablets daily. At physical examination, extensive ulcerations on the tongue and lips were observed (Figure 1). Based on the clinical appearance and the topography of the lesions, a differential diagnosis between HU related ulcers and erosive lichen was posed. However, advice against the execution of the oral biopsy came directly from the oncologist, due to the very high level of platelets (more than 1.000.000/μL) detected in the patient's blood.

View Article: PubMed Central - PubMed

ABSTRACT

Patients affected by polycythemia vera (PV), a myeloproliferative neoplasm characterized by an elevated red blood cell mass, are at high risk of vascular and thrombotic complications. Conventional therapeutic options aim at reducing vascular and thrombotic risk; low-dose aspirin and phlebotomy are first-line recommendations, for patients at low risk of thrombotic events, whereas cytoreductive therapy, usually hydroxyurea (HU) or interferon alpha, is recommended for high-risk patients. In the present study, we report the case of a patient with persistent oral ulcerations, possibly related to long-lasting HU treatment, firstly treated with topic and systemic corticosteroids and then more effectively with the addition of low-level laser therapy. Laser photobiomodulation has achieved pain control and has contributed to the healing of oral ulcers without any adverse effect; this has permitted a reduction in the dose of systemic corticosteroids and the suspension of the use of the topic ones, due to the long-term stability of oral health, even after the interruption of low-level laser therapy sessions.

No MeSH data available.