David Grinspan

Significant response of oral aphthosis to thalidomide treatment

The results are reported of the treatment of forty patients who had aphthous manifestations with the administration of thalidomide in daily doses ranging between 100 and 300 mg, over a period of 1 to 3 months. The study comprised nineteen patients with severe aphthosis, 17 with mild aphthosis, three with bipolar manifestations, and one with Sutton and Suttons periadenitis mucosa necrotica recurrens. The results obtained were judged as remissions (35%) and marked improvements (40%). It is felt that thalidomide constitutes the most effective therapeutic approach so far available for oral aphthae, not only because it rapidly controls their manifestation but also because it controls recurrences.

Treatment of aphthae with thalidomide

We report our experience in the treatment of major and minor aphthae with thalidomide. With doses of 100 to 300 mg daily for 3 months, a cure was obtained in 34% of cases, and marked improvement was evident in the rest. The follow-up period varied from 1 to 8 years. Two patients experienced dysesthesias, which disappeared when the medication was stopped. Thalidomide cannot be prescribed to women of childbearing potential because of its teratogenic potential.

Angina bullosa hemorrhagica

Background In 1967, Badham used the term angina bullosa hemorrhagica (ABH) to describe an entity we already knew as traumatic oral hemophlyctenosis (TOH) (1933) and later renamed recurrent oral hemophlyctenosis (ROH) (1971).

Melanoma on dysplastic nevus spilus

Background Nevus spilus is found with relative frequency. It is observed as a tan to brown macule serving as base to a speckle of smaller and darker maculo‐papular elements. On rare occasions it turns into a malignant melanoma.

Metastatic involvement of four eyelids

CASE REPORT A 58-year-old woman had a right radical mastectomy in 1973 and several courses of chemotherapy. Five years later progressive eyelid inflammation, induration, and narrowing of the palpebral fissures occurred. Peritoneal involvement was noted. Both eyes showed palpebral overlapping, swelling, red discoloration, and woody induration that precluded the assessment of the eyeballs (Fig. 1). 1 A biopsy specimen of the left lower eyelid showed epidermal atrophy and edema associated with blood and lymph vessel enlargement in the papillary dermis. The reticular dennis was hypertrophic, and confluent cords of cuboid cells with a pale cytoplasm and a hyperchromatic nucleus invaded the connective tissue (Fig. 2). No inflammatory infiltrate was present. The adnexa were atrophic. A diagnosis of skin metastasis from breast carcinoma was made. A specimen from the right lower eyelid had similar features. Roentgenograms demonstrated spine and peritoneal metastases. The patient received 3000 rads to each eye, but died 4 months later.

Ectopic Geographic Tongue and AIDS

A 23–year‐old man with AIDS developed a lesion with the clinical characteristics of an ectopic geographic tongue in the lower lip, near the right commissure.