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Bi oMe d Central Page 1 of 4 (page number not for citation purposes) Journal of Medical Case Reports Open Access Case report Ulceration of the oral mucosa induced by antidepressant medication: a case report Fern and a Ber tin i 1 , Nív ea Cr is ti na Sena Costa 1 , Adria na Aig otti Haberbeck Bra ndã o 2 , Ana Sueli Rodri gue s Cavalcante 3 and Janete Dias Al meida* 3  Address: 1 Postgraduate Program in Biopathology and Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil, 2 Discipline of General Pathology, Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil and 3 Discipline of Stomatology, Department of Biosciences and Oral Diagnosis, São José dos Campos Dental School, São José dos Campos, São Paulo, Brazil Email: Fernand a Bertin i- bertini fe@uol .com.br ; Nívea Cristin a Sena Costa - niveasen [email protected] om.br ; Adrian a Aigotti Haberbec k Brandão - aigott i@fosjc .unesp .br; Ana Sueli Rodrig ues Cavalcante - sueli@fo sjc.unes p.br; Jane te Dias Alme ida* - janete@f osjc .unesp.br * Corresponding author Abstract Introduction: Ulcers are frequent lesions of the oral mucosa. Generally, they are circumscribed round or elliptical lesions surrounded by an erythematous halo and covered with an inflammatory exudate in their central portion, and are accompanied by painful symptoms. Oral ulcers affect 20% of the population, especially adolescents and young adults. The etiopathogenesis includes immunological alterations, infections, nutritional deficiency, trauma, food and contact allergies, autoimmune diseases, neoplasms, and psychosomatic, genetic and environmental factors. Case presentation: A 78-year-old Caucasian woman was referred by her dentist to our outpatient clinic with a 4-week history of an oral ulceration after using an antidepressant (sertraline hydrochloride). On the basis of the clinical findings and anamnesis, the occurrence of the lesion was attributed to the use of the drug. Exfoliative cytology was performed, to reassure the patient that it was not oral cancer, which revealed the presence of a nonspecific inflammatory reaction. The drug was replaced and resolution of symptoms was observed. Conclusion: Exfoliative cytology should be the complementary examination of choice in cases of oral ulcers with a suspicion of drug interaction. Although this is a rare event in dental practice, dentists should be aware of the diagnostic possibility of drug-induced ulcers and should cooperate with the clinician to adjust the prescribed medication to resolve the symptoms. Introduction Oral ulcers are inflammatory lesions of the oral mucosa that affect approximately 20% of the population [1].  These ulcers are accompanied by painful symptoms and are generally characterized by shallow oval circumscribed lesions surrounded by an erythematous halo and covered  with a fibrinous exudate in their central portion. Oral Published: 3 November 2009  Journal of Medical Case R eports 2009, 3:98 doi :10 .11 86/ 175 2-1 947 -3- 98 Received: 30 April 2008 Accepted: 3 November 2009 This article is available from: http://www.jmedicalcasereports.com/content/3/1/9 8 © 2009 Bertini et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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