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Usman, Nur A.
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Dentistry Health Professions

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Identifying oral macula with malignant potential and its etiology: A case report with literature review Rasdayanti, Nur; Usman, Nur A.; Sumintarti, Sumintarti; Harlina, Harlina; Yusran, Ali; Marlina, Erni; Putri, Andi AM.
Journal of Case Reports in Dental Medicine Vol 6, No 3 (2024)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v6i3.247

Abstract

Objective: This article aims to report interesting case of whole mouth pigmentation, including on patient full protheses.Methods: A 79-year old female came to dental clinic with a chief complaint of difficulty in swallowing. The patient felt no pain but is very uncomfortable due to impaired taste and a burning sensation in her mouth.  In addition, the patient's dentures were stained with a diffuse black-and-white coating indicating a long and chronic course event.  This complaint occurred for last 2 months, after a long history of being in and out from the hospital due to several illnesses.  Ongoing treatment of the patient include drug for chronic digestive diseases and hypertension. Results: The patients told to come back in 7 days with strict instructions to bring all hospital-related documents to rule out possible etiologic of the pigmentation.Conclusions: This interesting case concluded with working diagnosis of oral melanocarcinoma due to macula fast and massive spread and distribution. However, black-pigmentation on patient prothesis can lead to a strong suggestion that the trigger of those malignant possible triggered by a long-chronic un-treated candida infection.
Hypercobalaminemia in recalcitrant oral ulcers: A case report and literature review Nisaa, Ihda R.; Putri, Andi AM.; Marlina, Erni; Usman, Nur A.
Journal of Case Reports in Dental Medicine Vol 6, No 3 (2024)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v6i3.245

Abstract

Objective: This article aims to report an interesting rare case of recurrent oral ulceration with a high level of cobalamin.Case report: A 44-year-old female came to dental clinic with chief complaint of recalcitrant oral ulceration since half a year ago. Patients basically had history of periodic oral ulcer for quite long time with short occurrence and only one or two ulcer in one period. However, the ulcer become alarming after she was hospitalized due to extreme fatigue. Patients subsequently instructed for routine blood along with cobalamin and IgE total examination. The test came back with highly decreased level of red blood index indicates that the patients on severe anemic condition. Unexpectedly, the levels of cobalamin in blood increased by 70% from the referral score. Patients urgently refer for hospitalization to recover her Hb level. After blood transfusion, patients discharged from the hospital but under hematologic observation for the exact etiology of her anemia, including the high cobalamin level. After two months observation, patients Hb gained normal level, however the vitamin B12 level remain. Patients reported decreased in number of ulcers.Conclusion:  It is worthy to always check on cobalamin level for patients with recurrent oral ulcers since lower level can directly causing it or the high level can lead to some life-threatening diseases which can also trigger the recalcitrant oral ulcers.
Intra uterine device on the severity of recurrent aphthous stomatitis: A case report Anitasari, Merry; Marlina, Erni; Usman, Nur A.; Putri, Andi AM.; Israyani, Israyani; Yusran, Ali; Rahmi, Rahmi
Journal of Case Reports in Dental Medicine Vol 6, No 3 (2024)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v6i3.246

Abstract

Objectives:  This article aimed to report RAS with severe clinical form due to hormonal fluctuant triggered by Intra Uterine Device.Methods: A 26-year-old female patient came to Hasanuddin University Dental Hospital with complaints of continuous mouth ulcers since 1 year ago. Deep anamnesis revealed that the initial trigger of the unhealed ulcers incidentally happened at the same time after the patient installed an Intra Uterine Device (IUD) which also led to continuous menstruation in the past month leading to self-decision to have her IUD removed. Due to her clinically anemic condition, the patient was referred for routine blood examination with the result of lower red blood cells and hemoglobin which also contributed to the ulcer severity. Since the main cause of hormonal imbalance has been removed, supportive treatment uses vitamins to support the patient’s systemic condition which gives a good response.Conclusion: Recalcitrant and severe intraoral ulceration may be triggered by hormonal imbalance caused by IUD. Removal of these devices can help reduce oral complaints if the patient is on optimum health, otherwise, the background systemic needs to be improved.
Management of recalcitrant ulcer in elderly patients with anemia: A case report Marlina, Erni; Usman, Nur A.; Rahayu, Masita
Journal of Case Reports in Dental Medicine Vol 4, No 3 (2022)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v4i3.212

Abstract

Objective: This case report aimed to answer challenging in the treatment of chronic recalcitrant ulcers in elderly complicated by anemic condition. A 68 years old female patient came to Hasanuddin University Dental Hospital with chief complaint of recalcitrant painful canker sores affecting mouth and throat.Methods: Elder age could contribute in difficulty swallowing due to reduced saliva, slow eating habit, lost or caries teeth which lead to a less efficiency in the absorption of important nutrients such as iron and folic acid. This condition triggers a recalcitrant but chronic ulcer which in the end would add more difficulties for swallowing. A part from the pale conjunctiva of the eye, there was no other abnormality found extra orally. Drug therapy Bcom 150 mg with chlorhexidine gluconate 0.2% mouthwash and systemic corticosteroid.Results: Blood screening results demonstrated lower hemoglobin level with 11.6 and hematocrit 35.6 with referred value of 12 and 37, respectively. Long visit was needed to slowly adapted patient oral environment with local condition, as well as from systemic background improvement. Recalcitrant but chronic ulcers might be challenging in the treatment due to variabilities contributed factors such as age, unhealthy-eating habits, systemic background, and local oral hygiene and condition. One should be careful and be patient in changing the long behavior of the patient.Conclusion: Most importantly, patient been given advice to change her eating behaviors by consume more iron and folic acid food, and avoid irritant food. Local irritant of element 45 also been grinded.
Intra uterine device on the severity of recurrent aphthous stomatitis: A case report Anitasari, Merry; Usman, Nur A.; Marlina, Erni; Putri, Andi AM.; Israyani, Israyani; Yusran, Ali; Rahmi, Rahmi
Journal of Case Reports in Dental Medicine Vol 7, No 1 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i1.265

Abstract

Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases characterized by recalcitrant and painful ulcerations in the oral cavity. The pathogenesis remains uncovered, but several factors are thought to contribute, such as a hormonal imbalance due to puberty, a disease, contraceptive devices including Intra Uterine Device (IUD) for birth control, and un-coping stress.Objectives:  This article aimed to report RAS with severe clinical form due to hormonal fluctuant triggered by Intra Uterine Device.Case report: A 26-year-old female patient came to Hasanuddin University Dental Hospital with complaints of continuous mouth ulcers since 1 year ago. Deep anamnesis revealed that the initial trigger of the unhealed ulcers incidentally happened at the same time after the patient installed an Intra Uterine Device (IUD) which also led to continuous menstruation in the past month leading to self-decision to have her IUD removed. Due to her clinically anemic condition, the patient was referred for routine blood examination with the result of lower red blood cells and hemoglobin which also contributed to the ulcer severity. Since the main cause of hormonal imbalance has been removed, supportive treatment uses vitamins to support the patient’s systemic condition which gives a good response.Conclusion: Recalcitrant and severe intraoral ulceration may be triggered by hormonal imbalance caused by IUD. Removal of these devices can help reduce oral complaints if the patient is on optimum health, otherwise, the background systemic needs to be improved.
Early detection, better prognosis in oral squamous cell carcinoma: A case report Nisaa, Ihda R.; Usman, Nur A.; Putri, Andi AM.; Marlina, Erni; Israyani, Israyani; Yusran, Ali
Journal of Case Reports in Dental Medicine Vol 7, No 3 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i3.253

Abstract

Introduction: Misdiagnosed oral lesions can lead to delayed diagnosis and progression to malignancy, significantly impacting patient outcomes. Early detection of oral squamous cell carcinoma (OSCC) remains a significant challenge in clinical practice, particularly in cases with atypical presentation. We aim to highlight the importance of vigilance and early detection in improving prognose for patients with OSCC.Case Report: This case report discusses good progression of OSCC treatment in 43-year-old male who presented with a persistent ulcer on the ventrolateral tongue, initially attributed to trauma and misdiagnosed as a traumatic ulcer. Over nine months, the lesion progressively enlarged, with associated pain and induration, despite symptomatic treatment. The patient had a history of systemic conditions, along with previous tobacco use, which are recognized as risk factors for OSCC. Histopathological examination revealed keratinizing squamous cell carcinoma. Patient then treated with chemotherapy and showed significant progression on his tongue.Discussion: Early recognition of warning signs, such as non-healing ulcers with indurated borders, could have facilitated timely diagnosis and intervention. This case emphasizes the critical role of clinicians in identifying high-risk lesions, particularly in patients with systemic comorbidities or lifestyle-related risk factors. Regular oral health examinations, prompt biopsies, and multidisciplinary approaches are essential in reducing delays in diagnosing potentially malignant oral conditions.Conclusion: Clinicians must prioritize early evaluation and adopt a proactive approach in managing suspicious oral lesions to reduce the burden of advanced malignancies in oral health.
A rare case of recurrent aphthous ulcer associated with calcium channel blocker Ishak, Andi AQM.; Marlina, Erni; Usman, Nur A.; Putri, Andi AM.; Israyani, Israyani; Yusran, Ali; Nisaa, Ihda R.
Journal of Case Reports in Dental Medicine Vol 7, No 3 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i3.251

Abstract

Introduction: The most commonly used hypertension medications are calcium channel blockers (CCB). Their oral impact is well recognized for gingival enlargement, yet is very limited to another oral manifestations. Here, we reported a rare case of recurrent aphthous ulcer in a patient under CCB medication.Case Report: A 59-year-old male patient came to Hasanuddin University Dental Hospital with a chief complaint of recalcitrant ulcers on his mouth three weeks ago, which started to occur continuously for a year after the regular consumption of amlodipine. Intraoral examination demonstrated painful solitary white ulcer on the right ventral of the tongue and on the left buccal mucosa. The working diagnosis of recurrent aphthous ulcer et causa CCB was made. Management includes dexamethasone gargle, triamcinolone acetonide gel, and chlorhexidine gluconate, which improved significantly. The patient was suggested to do a consultation with his internist regarding drug substitution.Discussion: The incidence of oral ulcers induced by CCB is predicted to be related to immunological mechanisms. Any drug component triggers an exaggerated immune reaction directed at the surface of the epithelium, resulting in ulcer. The potential for such response depends on the drug's immunogenicity, exposure frequency, and administration route.Conclusion: Practitioners should consider the possibility of oral ulceration triggered by a specific drug, especially if any therapy does not exhibit improvement. Moreover, dental literature must explore the association between CCB and oral ulcers more since this issue has limited explanations.
A common drug of paracetamol contributes to oral hypersensitivity: A case report Abnas, Rizqi J.; Marlina, Erni; Usman, Nur A.; Putri, Andi AM.; Israyani, Israyani; Harlina, Harlina
Journal of Case Reports in Dental Medicine Vol 7, No 2 (2025)
Publisher : Hasanuddin University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/jcrdm.v7i2.252

Abstract

Introduction: Paracetamol is the most commonly used analgesic drug in the general population, but it can cause hypersensitivity reactions in certain individuals. This case report describes the diagnosis of erythema multiforme due to hypersensitivity to paracetamol.Case Report: An 11-year-old girl presented to her parents with chief complaints of peeling, bleeding lips, erosive lesions, and pain on the lip commissure. Anamnesis revealed that the complaints had occurred for 5 days. The patient had no history of drug or food allergies. Clinical examination showed red erosion lesions, irregular diffuse border, rough texture, pain on the vermilion of both lips, and fissured lesions, irregular, with bleeding, on the commissure of labium extra. The clinical appearance was characterized as erythema multiforme and treated with triamcinolone acetonide, which gave a good response.Discussion: Reactions to paracetamol may be due to the paracetamol-specific IgE or T cells. Some cases have been reported of hypersensitivity to paracetamol, which causes similar symptoms and can be more severe, like Steven Johnson Syndrome (SJS). An allergy panel is needed to determine the exact hypersensitivity experienced by the patient to support recovery and prevent recurrence.Conclusion: Cases of Erythema multiforme due to paracetamol ingestion are rare. However, it is important to remember that adverse drug reactions may occur in certain individuals. Clinicians should be aware of such occurrences to take appropriate action.Keywords: Erythema Multiforme, Hypersensitivity, Paracetamol, Triamcinolone Acetonide
Co-Authors Abnas, Rizqi J. Ali Yusran, Ali Anitasari, Merry Erni Marlina, Erni Harlina Harlina Ishak, Andi AQM. Israyani, Israyani Nisaa, Ihda R. Putri, Andi AM. Rahayu, Masita Rahmi Rahmi Rasdayanti, Nur Sumintarti Sumintarti, Sumintarti