Tongue ulcers

Lockhart SP, Baron JH. Tongue ulceration after lingual buprenorphine. BMJ (Chn Res Ed) 1984 288 1346. 

A 22-year-old man developed double vision and difficulty in focusing after using 2% viscous lidocaine for a painful tongue ulcer. He used viscous 2% lidocaine 10 ml hourly and developed symptoms when the daily dose exceeded 240 ml (4800 mg of lidocaine hydrochloride) after 10 days of use. At that time his serum lidocaine concentration was 6.7 pg/ml. His symptoms persisted when the serum concentration of lidocaine fell to below toxic concentrations, implying that metabolites of lidocaine had contributed. 

Yamashita S, Sato S, Kakiuchi Y, Miyabe M, Yamaguchi H. Lidocaine toxicity during frequent viscous hdocaine use for painful tongue ulcer. J Pain Symptom Manage 2002 24(5) 543-5. 

Gingivitis Glossitis Sialorrhea Stomatitis Tongue black Tongue ulceration Xerostomia (84%)... 

McEvoy GK, Am Hosp Formulary Service Drug Info 392 Tongue pigmentation (1991) Tadini G +, Arch Dermatol 127, 267 (1991) Tal A+, Cutis 48, 153 Tongue ulceration... 

Main signs symptoms Vexatious heat in the heart and chest, thirst, red face, thirst with a desire for chilled drinks, reddish, astringent, inhibited urination, possible oral and tongue ulceration, a red tongue, and rapid pulse... 

Signs and Symptoms Easily confused with foot-and-mouth disease (C18-A017). Symptoms include fever, ulcers and erosions of the oral mucosa, sloughing of the epithelium of the tongue, and lesions at the mucocutaneous junctions of the lips, chewing movements and drooling (ptyalism), crusting lesions of the muzzle. Blisters, ulcers, and erosion of the coronary bands, and teats. 

Ulcers at the base of the tongue, initially edematous and hyperemic... 

In foods vitamin B2 occurs free or combined both as FAD and FMN and complexed with proteins. Riboflavin is widely distributed in foodstnffs, but there are very few rich sources. Only yeast and liver contain more than 2mg/100g. Other good sources are milk, the white of eggs, fish roe, kidney, and leafy vegetables. Since riboflavin is continuously excreted in the urine, deficiency is qnite common when dietary intake is insufficient. The symptoms of deficiency are cracked and red lips, inflammation of the lining of the month and tongue, mouth ulcers, cracks at the comer of the mouth, and sore throat. Overdose of oral intake present low toxicity, probably explained by the limited capacity of the intestinal absorption mechanism [417]. 

Signs and symptoms of superinfections, including anal or genital pruritus, black hairy tongue, vomiting, diarrhea, fever, sore throat, and ulceration or changes of... 

Assess the patient for signs and symptoms of superinfection, such as anal orgenital pruritus, black hairy tongue, oral ulceration orpain, diarrhea, increased fever, sore throat, and vomiting... 

Vitamin deficiency is seldom seen, and its symptoms of leg ulceration (cheilosis), skin symptoms, a purplish tongue, eye disturbances, and photophobia are vague. 

This formula is able to clear heat in the Upper-Jiao, the Heart, the Lung and the diaphragm. It is used in the syndrome in which heat-toxin affects these organs and regions. The symptoms are fever, restlessness, dry mouth and throat, thirst, swollen and sore throat, ulcers in the mouth or on the tongue, red face and red eyes, scanty urine and constipation, a red border on the tongue, which is particularly dry in the middle and has a yellow coating, and a rapid and forceful pulse. 

Four herbs form the deputy group. Huang Qin and Zhi Zi clear the heat from the Upper-Jiao. Zhi Zi and Bo He disperse the heat from the Upper-Jiao and treat restlessness, dry mouth and ulcers on the tongue. In addition, Zhi Zi and Dan Zhu Ye can clear the heat from the Heart by increasing urination. 

The Heart opens into the tongue, thus ulcers on the tongue indicate heat in the Heart. 

This formula can drain and treat smoldering fire in the Spleen which is caused by dampness accumulation. The disorder results in mouth ulcers with foul breath, frequent thirst and hunger, and a dry mouth and lips. Patients may have a red tongue with a yellow and sticky coating and a rapid pulse. 

This formula is devised for treating Heart-Yin and Kidney-Yin deficiency with empty-heat in these organs. The disorder is manifested as anxiousness, irritability, palpitations, difficulty in falling asleep, forgetfulness, nocturnal emissions and tiredness. The dryness due to Yin deficiency and fire consumption causes constipation, a dry mouth and ulcers on the tongue. The red tongue without coating and the rapid, restless and thready pulse indicate Yin deficiency with empty-heat. 

This formula can nourish the Yin of the Heart and calm the mind. It is used for treating restlessness and insomnia due to Heart-Yin and Kidney-Yin deficiency and empty-fire. Besides restlessness and insomnia, symptoms such as palpitations, forgetfulness, mental tiredness, constipation and ulcers in the mouth occur. A red tongue without coating and a thready, rapid pulse are also present. 

A 47-year-old woman weighing 59 kg took acarbose 50 mg tds. Her blood glucose improved but she lost about 1 kg/month. She had a sore tongue without oral ulcers and no evidence of malabsorption. Later she developed general weakness and iron deficiency anemia but no other evidence of malabsorption. After she had lost 7 kg in 5 months, acarbose was withdrawn. Her complaints disappeared, her weight normalized, and she had no signs of iron deficiency anemia, even without iron therapy. 

Gastrointestinal signs and symptoms of vitamin B12 deficiency occur in 26% of cases. These include sore tongue, stomatitis, mucosal ulceration, appetite loss, flatulence, and constipation or diarrhea. Appetite loss, excess gas, and diarrhea are probably related to the underlying gastric disorder (i.e., gastric atrophy) in pernicious anemia. Gastrointestinal symptoms may occur in the absence of symptomatic anemia or macrocytosis. 

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