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Melkersson-Rosenthal syndrome

Melkersson-Rosenthal syndrome is a rare neurological disorder characterized by recurring facial paralysis, swelling of the face and lips (usually the upper lip), and the development of folds and furrows in the tongue. Onset is in childhood or early adolescence. After recurrent attacks (ranging from days to years in between), swelling may persist and increase, eventually becoming permanent. The lip may become hard, cracked, and fissured with a reddish-brown discoloration. The cause of Melkersson-Rosenthal syndrome is unknown, but there may be a genetic predisposition. It can be symptomatic of Crohn's disease or sarcoidosis. more...

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Treatment

Treatment is symptomatic and may include medication therapies with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to reduce swelling, as well as antibiotics and immunosuppressants. Surgery may be recommended to relieve pressure on the facial nerves and to reduce swollen tissue, but its effectiveness has not been established. Massage and electrical stimulation may also be prescribed.

Prognosis

Melkersson-Rosenthal syndrome may recur intermittently after its first appearance. It can become a chronic disorder. Follow-up care should exclude the development of Crohn's disease or sarcoidosis.

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Dermatology
From OB/GYN News, 1/1/01 by Sally Koch Kubetin

Dermatitis in a Jar?

Women who routinely use night cream, moisturizer, and foundation makeup have a 13-fold higher risk of developing perioral dermatitis than those who don't use such cosmetics, said Dr. Rita Malik and Dr. Christopher Quirk of Royal Perth (Australia) Hospital.

They assessed the use of facial cosmetics and topical corticosteroids in 133 women with perioral dermatitis and 99 women of similar age who served as controls. Thirty-two percent of the case group used three cosmetics (moisturizer, foundation, night cream) vs. 5% of controls. Twenty-six percent with perioral dermatitis commonly used moisturizer plus foundation, compared with 19% of controls.

The risk of developing perioral dermatitis was threefold higher in women who used moisturizer plus foundation and 13-fold higher in women who used night cream in addition to the two other products, compared with women who didn't use any of the cosmetics (Australas. J. Dermatol. 41[1]:34-38, 2000).

"Our study supports the theory that cosmetic agents may play a major role in the development of perioral dermatitis, probably through an occlusive mechanism. We therefore recommend that foundation be excluded from the cosmetic regimen not only at initial onset of perioral dermatitis but also to prevent recurrences," they said.

A Good Tongue Brushing

The tongue can be the site of a number of dermatologic conditions that are very troubling for patients, but most are either easy to treat or require no treatment at all, Dr. Roy S. Rogers III said at a meeting of the Alabama Dermatology Society held in Sandestin, Fla.

* Furred tongue. Fever, smoking, mouth breathing, a diet low in fiber, and poorly fitting dentures that cause patients to adhere to a soft-food diet can contribute to its development, said Dr. Rogers of the Mayo Medical School in Rochester, Minn.

Treatment is simple. It involves brushing the surface of the tongue with 5-15 strokes using a simple dentifrice.

* Black hairy tongue. Overproduction of pigment causes this troubling condition. In some cases hyperplasia of the filiform papillae can occur, causing a hairy appearance. These "hairs" on the tongue can sometimes extend long enough to tickle the uvula; snipping them corrects this problem. Treatment otherwise involves brushing with a dilute hydrogen peroxide solution to bleach the pigmentation, and brushing the tongue with a dentifrice, 5-15 strokes, he said.

* Fissured tongue. Deep fissures and folds in the tongue characterize this condition, which is more common in older people and in those with developmental defects. It is often seen in those with Down syndrome and Melkersson-Rosenthal syndrome, and it occurs in about one in six people over age 70.

COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group

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