Pilocarpine hydrochloride (Salagen^®) is a therapeutic drug used to treat xerostomia caused by Sjögren's syndrome (SS), whose effectiveness has been confirmed. However, some patients treated with this agent develop polyhidrosis, nausea, and increased micturition. These side effects can reduce compliance with regimens containing this medicine. In this retrospective study, we examined the effects of an herbal medicine (Byakkokaninjinto^®) on the development of polyhidrosis in SS patients treated with Salagen^® for xerostomia. Sixteen SS subjects were given 15mg of pilocarpine per day for the first four weeks, after which we initiated treatment with a combination of herbal medicines (Byakkokaninjinto^®) in eight cases and in others were given 15mg of pilocarpine hydrochloride alone per day. Consequently all cases involve a polyhidrosis symptoms; this regimen was continued for twelve weeks. A reduction in polyhidrosis symptoms was observed in six patients (75.0%). These results suggest that polyhidrosis caused by pilocarpine hydrochloride can be reduced with treatment with herbal medicine (Byakkokaninjinto^®). In this study, the promotion of salivation induced by pilocarpine hydrochloride was maintained.

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Squamous papilloma is benign epithelial tumor with granular surface, which originate from skin or mucosal epithelium. Chronic stimulus and human papilloma virus (HPV) are considered to be etiological factors. Favorite site of squamous papilloma are tongue, palate, lip and buccal mucosa, but the occurrence at uvula is very rare. 86-year-old female visited our hospital with a chief complaint of strangeness at pharyngeal region. Pedunculated tumor mass was presented at the tip of uvula. She underwent surgical resection under local anesthesia. Histopathological diagnosis was squamous papilloma. Infection of human papilloma virus (HPV) was not found.

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We report a case of perioral dermatitis due to gold in dental metal. A 67-year-old woman had a dental prosthesis attached by a family dentist six months before visiting our hospital for first medical examination. A few days later, she had erythema around the lips. Patch testing of metal series and lymphocyte stimulation test showed positive results to gold chloride. Her condition resolved three months after removal of the dental prosthesis containing gold. The clinical course and the results of tests suggest the cause of this case is the allergy to gold in a newly attached dental prosthesis. We discuss possible mechanisms of perioral dermatitis due to dental metal with reference to the literature, although the pathomechanism was still unclear.

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