Algeffari Metab, Alsharidah Mansour
Department of Family and Community Medicine, College of Medicine, Qassim University, Saudi Arabia.
Department of Physiology, College of Medicine, Qassim University, Saudi Arabia.
Case Rep Dent. 2022 Mar 29;2022:7960513. doi: 10.1155/2022/7960513. eCollection 2022.
The benefits of prescribing statins are well published in the treatment of hypercholesterolemia. With such widespread usage of statins, physicians may be ignoring or misdiagnosing the association of oral side effects with these medications. A 54-year-old man presented with a painful ulceration on the dorsum of his tongue that had been recurring for 10 months. Originally, he experienced a burning sensation on his tongue, and as the lesion advanced, the pain became more intense specially when consuming spicy or acidic foods. He is on rosuvastatin for the treatment of hypercholesterolemia for over five years. Several months prior to the lesion forming, his physician increased his daily dosage of rosuvastatin from 10 mg to 20 mg. Four weeks later at a follow-up appointment, all workup did not show any significant findings, the examination revealed a new ulcer on the dorsum of the tongue, and he reported no improvement after antifungal lozenges, nor when administered a short one-week treatment with oral steroids. After eight weeks of statin discontinued, the patient showed improvement with no episodes of ulceration.
Physicians do note that statins affect multiple immunological pathways, which could explain some adverse cutaneous reactions. More research is needed in discovering the link of statins and oral disorders.
他汀类药物在治疗高胆固醇血症方面的益处已得到充分报道。随着他汀类药物的广泛使用,医生可能会忽视或误诊这些药物与口腔副作用之间的关联。一名54岁男性患者舌背出现疼痛性溃疡,已反复出现10个月。最初,他的舌头有烧灼感,随着病变进展,疼痛变得更加剧烈,尤其是在食用辛辣或酸性食物时。他服用瑞舒伐他汀治疗高胆固醇血症已有五年多。在病变形成前几个月,他的医生将瑞舒伐他汀的每日剂量从10毫克增加到20毫克。四周后的随访预约中,所有检查均未发现任何显著异常,检查发现舌背有一个新溃疡,他报告使用抗真菌含片后没有改善,口服类固醇进行为期一周的短期治疗后也没有改善。停用他汀类药物八周后,患者病情好转,未再出现溃疡发作。
医生确实注意到他汀类药物会影响多种免疫途径,这可以解释一些皮肤不良反应。在发现他汀类药物与口腔疾病之间的联系方面,还需要更多的研究。