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Chemical burns of the oral mucosa caused by Policresulen: report of a case

Policresulen 오용에 의한 구강 궤양의 발병 증례 및 화학화상에 대한 고찰

  • Jung, Jung-Woo (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Byun, Jin-Seok (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Jung, Jae-Kwang (Department of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Choi, Jae-Kap (Department of Oral Medicine, School of Dentistry, Kyungpook National University)
  • 정정우 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 변진석 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 정재광 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 최재갑 (경북대학교 치의학전문대학원 구강내과학교실)
  • Received : 2013.05.11
  • Accepted : 2013.05.31
  • Published : 2013.06.30

Abstract

Chemical burn on the oral mucosa is caused by contact with various chemical products and manifests with localized mucositis, keratotic white lesions, bleeding, and painful tissue surface due to the coagulation of the tissue. Policresulen ($Albothyl^{(R)}$) is a topical antiseptic, commonly used over-the-counter drug for vaginitis, thrush and stomatitis. This drug is highly acidic with pH 0.6, and can act as a strong corrosive agent to oral mucosa. When inadvertently used in oral cavity, it may cause chemical burns of oral mucosa, resulting necrosis and bleeding surface resembling to erythema multifome. A 56 years old female patient presented with the chief complaints of painful ulcerations on the tongue, the upper and lower lips. On intraoral examination, an erythromatous, erosive or ulcerative surface covered with inflammatory exudates or bleeding crust is observed on the anterior half of the tongue and the upper and lower lips. She has occasionally applied the policresulen solution topically on the tongue to relieve pain from recurrent focal glossitis for about 10 years. In this time she applied it broadly and repeatedly to the tongue, the upper and lower lips for the purpose of pain relief by herself without instruction by physician or dentist. After cessation of policresulen application, the oral mucosa was rapidly recovered with use of topical steroids. In 2 weeks the lesions subsided completely. In summary, inadvertent use of $Albothyl^{(R)}$ on oral mucosa may result in chemical burn, causing mucosal erosion, ulceration and inflammation. It can be recovered by topical use of corticosteroid for 2 weeks after cessation of using $Albothyl^{(R)}$.

구강점막의 화학화상은 다양한 화학제품과의 접촉에 의해 일어날 수 있으며 국소 점막염, 각화성 백색병소, 출혈, 통증성조직 표면 등과 같은 임상적 특징을 나타낸다. Policresulen(알보칠$^{(R)}$)은 산부인과, 피부과, 이비인후과 영역에서 점막이나 피부의 소독 및 지혈 목적으로 사용되는 일반의약품이다. pH 0.6의 강산성을 띠고 있어서 강력한 부식제로 작용할 수 있으며 구강점막에 접촉될 경우 괴사나 화학화상과 같은 부작용을 나타낼 수 있기 때문에 사용상 세심한 주의를 요한다. 56세 여자 환자가 입술의 궤양과 부종 및 염증성 삼출물을 주소로 구강내과에 내원하였다. 이 환자는 약 10년 전부터 혓바늘이 가끔 발생하였으며 그런 경우에 알보칠$^{(R)}$을 종종 사용했었다고 하였다. 최근에는 혀와 입술의 통증 때문에 알보칠$^{(R)}$을 혀와 입술에 광범위하게 여러 차례 도포한 적이 있다고 하였다. 임상검사상 혀의 전방 1/2 부위에서 홍반성 미란 및 염증성 삼출물이 관찰되었고 상, 하순에 출혈성 가피 및 궤양이 형성되어 있었다. 알보칠 사용을 중단하게 한 후 구순부에 스테로이드 연고 도포 및 스테로이드 구강 가글액 사용 후 1주일 만에 병소는 현저히 줄어들었으며 2주 후 완치되었다. 본 증례를 통해서 일반의약품으로 쉽게 접할 수 있는 Policresulen(알보칠$^{(R)}$)의 오용으로 인한 구강점막의 출혈성 궤양의 발생 양상 및 치료과정을 소개하였으며, 구강점막에서 발생하는 화학화상에 대해 고찰하였다.

Keywords

References

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