DOCSLIB.ORG

Jemds.Com Original Research Article

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Jemds.Com Original Research Article Jemds.com Original Research Article ORAL ULCERS- A CLINICOPATHOLOGICAL PROFILE... Manjunath K1, Smitha V. Manjunath2 1Assistant Professor, Department of ENT, Basaveshwara Medical College and Hospital & Research Centre, Chitradurga. 2Postgraduate Student, Department of Oral Pathology & Microbiology, Bapuji Dental College and Hospital, Davangere. ABSTRACT BACKGROUND Oral ulcers have been an everyday problem and routinely patients with oral ulcers are treated symptomatically without even coming to a definitive conclusion of their own disease. The objectives of this study are to identify various aetiological factors in ulcers of oral cavity and to study the benign and malignant nature of these lesions and outcome of its management. MATERIALS AND METHODS Study included patients attending ENT Outpatient Department for 12 months at our Hospital, wherein 68 cases were studied. RESULTS Out of 68 cases, 55 cases (80.8%) were non-malignant ulcers and 13 cases (19.1%) were malignant (including 3 cases of Leukoplakia). There were proper 10 cases of malignant ulcers (14.7%), M: F : 4: 6, commonest age group between 3rd to 4th decade. Histopathologically, all the malignant ulcers were Squamous Cell Carcinoma. CONCLUSION Oral ulcers are common disease for which patient seeks medical advice. Clinical examination and histopathological examinations are mandatory investigations done for early diagnosis and treatment. KEYWORDS Histopathological Examination, Tobacco Chewers, Smoking, Betel Quid Chewers, Oral Cavity Lesions, Pre-Malignant Lesions (Leukoplakia), Malignant Lesions, Wedge Biopsy, Cancer Screening. HOW TO CITE THIS ARTICLE: Manjunath K, Manjunath SV. Oral ulcers- a clinicopathological profile... J. Evolution Med. Dent. Sci. 2017;6(69):4938-4941, DOI: 10.14260/Jemds/2017/1071 BACKGROUND and erythroplakia. Furthermore, lichen planus and oral Oral ulcers have been an everyday clinical condition to many submucous fibrosis are on rise. It was only in 1967 when an otolaryngologists, physicians and dental surgeons. Many a international reference centre for the study of oral pre- times, patients with oral ulcers are treated symptomatically cancerous lesion was established by the WHO. The incidence without even coming to a definitive conclusion of their of oral cancer among patients who had tobacco smoking was malady. Among them many lesions are benign, pre-malignant 8.4-fold higher than that among patients who did not. and malignant with various aetiological factors. Membranous patch is an inflammatory condition, in Most of the oral cavity lesions are asymptomatic. The which the cells of mucous membrane surface are eroded, an association between ill-fitting dentures and tobacco chewing, exudate is laid down on the surface and the whole necrotic where most of them are inflammatory like aphthous ulcers, layer is bound by fibrosis to the underlying tissue to form a oral candidiasis, oral submucous fibrosis, mucoceles and false membrane classically seen in diphtheritic membrane. nevus. No significant advancement in the treatment of oral Oral cavity ulcer may be an early sign of drug reaction or lesions was found in recent years. malignant transformation due to nutritional disorder and World Health Organisation (WHO) workshop end in 2005, immunocompromised state. So, early diagnosis may help in terminology, definitions and classification of oral lesions with better treatment and reduction of morbidity and mortality. predisposing factors of malignant transformation has been discussed. The conditions considered as pre-malignant are Objectives of the Study leukoplakia, lichen planus, oral submucous fibrosis and To identify clinical behaviour and various aetiological erythroplakia. The pre-malignant conditions of the oral cavity factors associated with ulcerative and membranous are those which have potentiality to turn malignant in its due conditions in oral cavity and oropharynx. course if left untreated. In these treaties, tension was given to To know the significance in clinical morbidity and to leukoplakia determine the malignant potential in these lesions. Financial or Other, Competing Interest: None. Submission 08-07-2017, Peer Review 03-08-2017, MATERIALS AND METHODS Acceptance 08-08-2017, Published 28-08-2017. • This study is a descriptive study from March 2016 Corresponding Author: Dr. Smitha V. Manjunath, to February 2017 for 12 months. The data was Postgraduate Student, collected from the patients after taking history, Bapuji Dental College and Hospital, Davangere. detailed clinical examination and relevant E-mail: [email protected] investigations. DOI: 10.14260/jemds/2017/1071 J. Evolution Med. Dent. Sci./eISSN- 2278-4802, pISSN- 2278-4748/ Vol. 6/ Issue 69/ Aug. 28, 2017 Page 4938 Jemds.com Original Research Article • Clinical diagnosis was confirmed by throat swabs fibrosis, 6 had abusive history of smoking and gutka chewing for culture, blood tests and biopsy for and 3 had history of alcohol, betel nuts and pan chewing. histopathological examination (HPE) wherever In our study, various investigations have been done for 56 necessary. Patients were treated appropriately and cases (82.3%). Routine haematological tests were done. Out regular followup of the cases was done. of these Random blood sugar 15 cases were elevated, HIV and HBsAg were positive in 3 cases, ESR levels were raised in 2 Data was analysed by using descriptive statistics (mean, cases and 12 cases were anaemic with Hb < 10 gm%. proportions, percentage) and presented in the form of tables, For 30 cases, Wedge biopsy was done and sent for bar diagram, cone diagram and pie diagrams. histopathological examination. Out of these, 10 cases were diagnosed to have squamous cell carcinoma, 3 cases were RESULTS pre-malignant lesions (leukoplakia), 4 cases were oral In our study of aetiopathology of ulcers and membranous submucous fibrosis, 2 cases were lichen planus, 2 cases were lesions of oral cavity and oropharynx of the 68 cases, out of pemphigus vulgaris and 9 cases were aphthous ulcers. which 56 patients were above 40 years of age and 12 were In our study, benign ulcers were 54 cases (79.4%), pre- below that age. P-value was 0.001. Out of 68, males were 46 malignant lesions (leukoplakia) were 4 cases (5.8%) and cases (67.6%) and females were 22 cases (32.3%). The ratio malignant lesions were 10 cases (14.7%). of Male: Female was 2: 1 with male predominance. Among the study group various benign lesions were aphthous ulcers 25 cases (36.7%), oral submucous fibrosis 12 Sex No. of Patients Percentage P value cases (17.6%), oral candidiasis 6 cases (8.8%), dental ulcers 2 Male 46 66% cases (2.9%), pemphigus vulgaris 2 cases (2.9%), traumatic Female 22 34% 0.05 ulcers 2 cases (2.9%), lichen planus 2 cases (2.9%) and Total 68 100% follicular tonsillitis 3 cases (4.4%). Table 1. Sex Distribution The present study shows various lesions presented as ulcers and membranous lesions, among them patients came Among the study group, 52 cases (76.4%) presented as with ulcers were 23 cases of aphthous ulcers, 8 cases of oral ulcer and 16 cases (23.5%) as membrane like lesions. submucous fibrosis, 10 cases of malignant lesions, 2 cases of In the study, the anatomical distribution of various ulcers dental ulcers, pemphigus vulgaris, traumatic ulcers, and membranous lesions were buccal mucosa 41 cases leukoplakia and lichen planus respectively. Cases presented (60.2%), tongue 11 cases (16.1%), lips 6 cases (8.8%), as membrane like lesions were 2 cases of aphthous ulcers, 4 gingiva 3 cases (4.4%), hard palate 3 cases (4.4%), anterior cases of oral submucous fibrosis, 6 cases of oral candidiasis, 3 tonsillar pillar 2 cases (2.9%) and soft palate 2 cases (2.9%). of follicular tonsillitis and 2 of leukoplakia. In our present study, patients having abuse/ habits were In our study, among various types of lesions 35 cases 45 cases (66.1%). Various combined abuse/ habits found in (51%) were acute ulcers (less than 3 weeks), among them 20 these patients were smoking in 20 cases (29.4%), alcohol in were (29.4%) aphthous ulcers (sporadic), 3 were (4.4%) oral 18 cases (26.4%), tobacco chewing in 23 cases (33.8%), betel submucous fibrosis, 4 were (5.8%) oral candidiasis, 2 were nuts in 22 cases (32.3%), pan chewing in 20 cases (29.4%) (2.9%) leukoplakia and traumatic ulcers respectively, 1 was and gutka in 14 cases (20.5%). In the study, duration of (1.4%) dental ulcer, pemphigus vulgaris, lichen planus and abuse/ habits were smoking for 25-30 yrs. of 27 cases follicular tonsillitis respectively. In chronic ulcers (more than (61.3%), alcohol for 12 – 15 yrs. of 8 cases (18.1%), Gutka 3 weeks) there were 33 cases (49%), among them 5 were chewing for 12 – 15 yrs. of 4 cases (9%), tobacco chewing for (7.3%) aphthous ulcers (recurrent), 9 were (13.2%) oral 8 - 10 yrs. of 3 cases (6.8%) and betel nuts and pan chewing submucous fibrosis, 10 were (14.7%) malignant lesions, 2 for 8 – 10 yrs. of 3 cases (6.8%). were (2.9%) oral candidiasis, leukoplakia and follicular Among the study group, 45 cases (66.1%) had habits/ tonsillitis respectively, 1 was (1.4%) dental ulcer, pemphigus abuse and 23 cases (33.8%) did not have any habits. Out of vulgaris and lichen planus respectively. patients who had habits, 29 (42.6%) were males and 16 (23.5%) were females. DISCUSSION • In our study, commonest benign ulcers constituting Habits/ No. of Per- 80.8% (n= 55) of all cases. Majority of them were Sl. No. P-value Abuse Patients centage Aphthous ulcers in buccal mucosa and lateral Patients having border of tongue. Other benign ulcers were oral 1. 45 66.1% habits submucous fibrosis 20.5% (n= 14) and oral 0.008 Patients not candidiasis 8.8% (n= 6). Next commonest benign 2. 23 33.8% ulcers were Dental ulcers 4.4% (n= 3), Pemphigus having habits vulgaris 4.4% (n= 3), Traumatic ulcers 2.9% (n= 2) Table 2.
Load more

Recommended publications
  • The Use of Biologic Agents in the Treatment of Oral Lesions Due to Pemphigus and Behçet's Disease: a Systematic Review
    Davis GE, Sarandev G, Vaughan AT, Al-Eryani K, Enciso R. The Use of Biologic Agents in the Treatment of Oral Lesions due to Pemphigus and Behçet’s Disease: A Systematic Review. J Anesthesiol & Pain Therapy. 2020;1(1):14-23 Systematic Review Open Access The Use of Biologic Agents in the Treatment of Oral Lesions due to Pemphigus and Behçet’s Disease: A Systematic Review Gerald E. Davis II1,2, George Sarandev1, Alexander T. Vaughan1, Kamal Al-Eryani3, Reyes Enciso4* 1Advanced graduate, Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA 2Assistant Dean of Academic Affairs, Assistant Professor, Restorative Dentistry, Meharry Medical College, School of Dentistry, Nashville, Tennessee, USA 3Assistant Professor of Clinical Dentistry, Division of Periodontology, Dental Hygiene & Diagnostic Sciences, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA 4Associate Professor (Instructional), Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA Article Info Abstract Article Notes Background: Current treatments for pemphigus and Behçet’s disease, such Received: : March 11, 2019 as corticosteroids, have long-term serious adverse effects. Accepted: : April 29, 2020 Objective: The objective of this systematic review was to evaluate the *Correspondence: efficacy of biologic agents (biopharmaceuticals manufactured via a biological *Dr. Reyes Enciso, Associate Professor (Instructional), Division source) on the treatment of intraoral lesions associated with pemphigus and of Dental Public Health and Pediatric Dentistry, Herman Ostrow Behçet’s disease compared to glucocorticoids or placebo. School of Dentistry of USC, Los Angeles, California, USA; Email: [email protected].
    [Show full text]
  • Glossary for Narrative Writing
    Periodontal Assessment and Treatment Planning Gingival description Color: o pink o erythematous o cyanotic o racial pigmentation o metallic pigmentation o uniformity Contour: o recession o clefts o enlarged papillae o cratered papillae o blunted papillae o highly rolled o bulbous o knife-edged o scalloped o stippled Consistency: o firm o edematous o hyperplastic o fibrotic Band of gingiva: o amount o quality o location o treatability Bleeding tendency: o sulcus base, lining o gingival margins Suppuration Sinus tract formation Pocket depths Pseudopockets Frena Pain Other pathology Dental Description Defective restorations: o overhangs o open contacts o poor contours Fractured cusps 1 ww.links2success.biz [email protected] 914-303-6464 Caries Deposits: o Type . plaque . calculus . stain . matera alba o Location . supragingival . subgingival o Severity . mild . moderate . severe Wear facets Percussion sensitivity Tooth vitality Attrition, erosion, abrasion Occlusal plane level Occlusion findings Furcations Mobility Fremitus Radiographic findings Film dates Crown:root ratio Amount of bone loss o horizontal; vertical o localized; generalized Root length and shape Overhangs Bulbous crowns Fenestrations Dehiscences Tooth resorption Retained root tips Impacted teeth Root proximities Tilted teeth Radiolucencies/opacities Etiologic factors Local: o plaque o calculus o overhangs 2 ww.links2success.biz [email protected] 914-303-6464 o orthodontic apparatus o open margins o open contacts o improper
    [Show full text]
  • Rebamipide to Manage Stomatopyrosis in Oral Submucous Fibrosis 1Joanna Baptist, 2Shrijana Shakya, 3Ravikiran Ongole
    JCDP Rebamipide to Manage Stomatopyrosis10.5005/jp-journals-10024-1972 in Oral Submucous Fibrosis ORIGINAL RESEARCH Rebamipide to Manage Stomatopyrosis in Oral Submucous Fibrosis 1Joanna Baptist, 2Shrijana Shakya, 3Ravikiran Ongole ABSTRACT Source of support: Nil Introduction: Oral submucous fibrosis (OSF) causes progres- Conflict of interest: None sive debilitating symptoms, such as oral burning sensation (sto- matopyrosis) and limited mouth opening. The standard of care INTRODUCTION (SOC) protocol includes habit cessation, intralesional steroid and hyaluronidase injections, and mouth opening exercises. The Oral submucous fibrosis (OSF) is commonly seen in objective of the study was to evaluate efficacy of rebamipide the Indian subcontinent affecting individuals of all age in alleviating burning sensation of the oral mucosa in OSF in groups. It is a potentially malignant disorder caused comparison with SOC intralesional steroid injections. almost exclusively by the use of smokeless form of Materials and methods: Twenty OSF patients were divided into tobacco products. The malignant transformation rates two groups [rebamipide (100 mg TID for 21 days) and betametha- vary from 3 to 19%.1,2 sone (4 mg/mL biweekly for 4 weeks)] of 10 each by random Oral submucous fibrosis causes progressive debilitat- sampling. Burning sensation was assessed every week for 1 month. Burning sensation scores were analyzed using repeated ing symptoms affecting the oral cavity, such as burning measures analysis of variance (ANOVA) and paired t-test. sensation, loss of cheek elasticity, restricted tongue move- Results: Change in burning sensation score was significant ments, and limited mouth opening. Oral submucous (p < 0.05) in the first four visits. However, score between the fibrosis is an irreversible condition and the management 4th and 5th visit was not statistically significant (p > 0.05).
    [Show full text]
  • Zeroing in on the Cause of Your Patient's Facial Pain
    Feras Ghazal, DDS; Mohammed Ahmad, Zeroing in on the cause MD; Hussein Elrawy, DDS; Tamer Said, MD Department of Oral Health of your patient's facial pain (Drs. Ghazal and Elrawy) and Department of Family Medicine/Geriatrics (Drs. Ahmad and Said), The overlapping characteristics of facial pain can make it MetroHealth Medical Center, Cleveland, Ohio difficult to pinpoint the cause. This article, with a handy at-a-glance table, can help. [email protected] The authors reported no potential conflict of interest relevant to this article. acial pain is a common complaint: Up to 22% of adults PracticE in the United States experience orofacial pain during recommendationS F any 6-month period.1 Yet this type of pain can be dif- › Advise patients who have a ficult to diagnose due to the many structures of the face and temporomandibular mouth, pain referral patterns, and insufficient diagnostic tools. disorder that in addition to Specifically, extraoral facial pain can be the result of tem- taking their medication as poromandibular disorders, neuropathic disorders, vascular prescribed, they should limit disorders, or atypical causes, whereas facial pain stemming activities that require moving their jaw, modify their diet, from inside the mouth can have a dental or nondental cause and minimize stress; they (FIGURE). Overlapping characteristics can make it difficult to may require physical therapy distinguish these disorders. To help you to better diagnose and and therapeutic exercises. C manage facial pain, we describe the most common causes and underlying pathological processes. › Consider prescribing a tricyclic antidepressant for patients with persistent idiopathic facial pain. C Extraoral facial pain Extraoral pain refers to the pain that occurs on the face out- 2-15 Strength of recommendation (SoR) side of the oral cavity.
    [Show full text]
  • Study of Oropharyngeal Ulcers with Their Commonest Anatomical Sites of Presentation Correlated with Histopathological Diagnosis Among the North Bengal Population
    Panacea Journal of Medical Sciences 2020;10(3):258–263 Content available at: https://www.ipinnovative.com/open-access-journals Panacea Journal of Medical Sciences Journal homepage: www.ipinnovative.com Original Research Article Study of oropharyngeal ulcers with their commonest anatomical sites of presentation correlated with histopathological diagnosis among the north Bengal population Tanwi Ghosal (Sen)1, Pallab Kr Saha2,*, Sauris Sen3 1Dept. of Anatomy, North Bengal Medical College, Sushrutanagar, West Bengal, India 2Dept. of Anatomy, NRS Medical College, Kolkata, West Bengal, India 3Dept. of ENT, Jalpaiguri District Hospital, Jalpaiguri, West Bengal, India ARTICLEINFO ABSTRACT Article history: Introduction: Oropharyngeal ulcers are very common in North East part of India due to bad oral habits like Received 31-07-2020 chewing of tobacco etc. A study was performed at North Bengal Medical College and Hospital among the Accepted 06-10-2020 patients attending otorhinolaryngology outdoor to explore the relationship of different types and proportion Available online 29-12-2020 of oropharyngeal ulcers with their commonest anatomical sites and to elicit the relationship with bad oral habits. Aims: • To elicit the different types and proportions of oropharyngeal ulcers. • To explore the relationship Keywords: of different histopathological types with anatomical sites. • To identify the relationship with addiction. Ulcer Material and Methods: This is a Cross-sectional Observational Hospital based study, conducted in the Oral Cavity Otorhinolaryngology outdoor of North Bengal Medical College and Hospital twice a week. 102 patients Oropharynx were selected as study population after maintaining inclusion and exclusion criteria. Anatomical sites Results: The study shows that the most common type of ulcer is aphthous (25.49%) and the least common types are erythroplakia and autoimmune ulcers (1.96%).
    [Show full text]
  • 2017 Oregon Dental Conference® Course Handout
    2017 Oregon Dental Conference® Course Handout Nasser Said-Al-Naief, DDS, MS Course 8125: “The Mouth as The Body’s Mirror: Oral, Maxillofacial, and Head and Neck Manifestations of Systemic Disease” Thursday, April 6 2 pm - 3:30 pm 2/28/2017 The Mouth as The Body’s Mirror Oral Maxillofacial and Head and Neck Manifestation of Ulcerative Conditions of Allergic & Immunological Systemic Disease the Oro-Maxillofacial Diseases Region Nasser Said-Al-Naief, DDS, MS Professor & Chair, Oral Pathology and Radiology Director, OMFP Laboratory Oral manifestations of Office 503-494-8904// Direct: 503-494-0041 systemic diseases Oral Manifestations of Fax: 503-494-8905 Dermatological Diseases Cell: 1-205-215-5699 Common Oral [email protected] Conditions [email protected] OHSU School of Dentistry OHSU School of Medicine 2730 SW Moody Ave, CLSB 5N008 Portland, Oregon 97201 Recurrent aphthous stomatitis (RAS) Recurrent aphthous stomatitis (RAS) • Aphthous" comes from the Greek word "aphtha”- • Recurrence of one or more painful oral ulcers, in periods of days months. = ulcer • Usually begins in childhood or adolescence, • The most common oral mucosal disease in North • May decrease in frequency and severity by age America. (30+). • Affect 5% to 66% of the North American • Ulcers are confined to the lining (non-keratinized) population. mucosa: • * 60% of those affected are members of the • Buccal/labial mucosa, lateral/ventral tongue/floor of professional class. the mouth, soft palate/oropharyngeal mucosa • Etiopathogenesis: 1 2/28/2017 Etiology of RAU Recurrent Aphthous Stomatitis (RAS): Types: Minor; small size, shallow, regular, preceeded by prodrome, heal in 7-10 days Bacteria ( S.
    [Show full text]
  • Oral Manifestations of Systemic Disease Their Clinical Practice
    ARTICLE Oral manifestations of systemic disease ©corbac40/iStock/Getty Plus Images S. R. Porter,1 V. Mercadente2 and S. Fedele3 provide a succinct review of oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease. While the majority of disorders of the mouth are centred upon the focus of therapy; and/or 3) the dominant cause of a lessening of the direct action of plaque, the oral tissues can be subject to change affected person’s quality of life. The oral features that an oral healthcare or damage as a consequence of disease that predominantly affects provider may witness will often be dependent upon the nature of other body systems. Such oral manifestations of systemic disease their clinical practice. For example, specialists of paediatric dentistry can be highly variable in both frequency and presentation. As and orthodontics are likely to encounter the oral features of patients lifespan increases and medical care becomes ever more complex with congenital disease while those specialties allied to disease of and effective it is likely that the numbers of individuals with adulthood may see manifestations of infectious, immunologically- oral manifestations of systemic disease will continue to rise. mediated or malignant disease. The present article aims to provide This article provides a succinct review of oral manifestations a succinct review of the oral manifestations of systemic disease of of systemic disease. It focuses upon oral mucosal and salivary patients likely to attend oral medicine services. The review will focus gland disorders that may arise as a consequence of systemic upon disorders affecting the oral mucosa and salivary glands – as disease.
    [Show full text]
  • Download Download
    628 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 Tongue Lesions - A Review N.Anitha1, Dharini Jayachandran2 1Reader, Department of Oral Pathology and Microbiology,2Undergraduate Student, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research Abstract Tongue is a vital organ within the oral cavity that has varied function,and it may act as an index for the underlying systemic diseases.The investigation of the tongue diseases may begin with mere clinical examination .This review is to highlight the signs and symptoms of the various lesions that affects the tongue and especially to talk in brief about the benign and malignant tumours that affect the tongue along with other inherited and congenital abnormalities.Tongue lesions are categorized as tumours,infections, reactionary,congenital,developmental,acquired,autoimmune and potentially malignant disorders for easy understanding and to arrive at appropriate diagnosis.Tongue playing an important role in maintaining the harmony in the oral environment,it should be treated from diseases. Keywords: Tongue lesions,benign tumours,malignant tumours,diseases of tongue. CLASSIFICATION OF LESIONS ● Pyogenic granuloma AFFECTING THE TONGUE. ● Frictional keratosis BENIGN TUMOURS OF THE TONGUE INFECTIOUS LESIONS OF TONGUE ● Capillary hemangioma ● Oral squamous papilloma ● Fibroma ● Oral hairy leukoplakia ● Cavernous hemangioma ● Candidiasiis ● Giant cell granuloma ● Median rhomboid glossitis ● Lipoma ● Sublingual abcess ● Lymphangioma INHERITED,CONGENITAL,DEVELOPMENT ● Schwannoma AND ACQUIRED ABNORMALITIES OF TONGUE MALIGNANT TUMOURS OF TONGUE ● White sponge nevus ● Squamous cell carcinoma ● Foliate papillitis ● Veruccous carcinoma ● Angina bullosa hemorrhagica ● Non-Hodgkin’s lymphoma ● Geographic tongue TRAUMATIC/REACTIONARY LESIONS OF ● Fissured tongue THE TONGUE ● Median rhomboid glossitis ● Fibrous reactive hyperplasia ● Bifurcated/tetrafurcated tongue ● Traumatic ulcer Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol.
    [Show full text]
  • Tobacco Induced Oral Keratosis. Oral Sub-Mucous Fibrosis. Nicotine Stomatitis
    Tobacco induced oral keratosis. Oral sub-mucous fibrosis. Nicotine stomatitis. Actinic keratosis. Actinic cheilitis Assoc. prof. Zornitsa Mihaylova, DDS, PhD Dept. of Dental, oral and maxillofacial surgery, Faculty of Dental medicine, Medical Universtity- Sofia Precancerous lesions are morphologically altered tissues that possess greater than normal tissues risk of malignant transformation. The term “potentially malignant disorders” (PMD) is broadly accepted in order to avoid terminological confusion. In significant number of cases the oral cancer is preceded by a premalignancy. On the other hand PMD may not undergo malignant transformation (especially when the bad habits are ceased and proper treatment with long-term follow up have been conducted). The following risk factors may play a significant role in the development of PMD and cancer: tobacco smoking, smokeless tobacco, betel quid, alcohol consumption (the combination of smoking and alcohol significantly increases the risk of malignant transformation), oral HPV infection, radiation, vitamin deficiency, bacterial infections, immunosuppression and immunodeficiency, drugs, poor oral hygiene, chronic trauma. It is well established that the effects of the etiologic factors may vary depending on the geographic region, the lifestyle and the habits of the population. Tobacco induced oral keratosis There are three types of smokeless tobacco: dry snuff, moist snuff and chewing tobacco. Smokeless tobacco is mainly used by young males. The long-term/chronic smokeless tobacco use causes local alterations of the oral structures due to the significant nicotine absorption. Some of the most common oral changes related to smokeless tobacco are oral mucosa lesions, periodontal disease and dental caries. Clinically asymptomatic white lesions of the oral mucosa are identified.
    [Show full text]
  • Paraneoplastic Pemphigus with Clinical Features of Lichen Planus Associated with Low-Grade B Cell Lymphoma
    Report Paraneoplastic pemphigus with clinical features of lichen planus associated with low-grade B cell lymphoma Sónia Coelho, MD, José Pedro Reis, MD, Oscar Tellechea, MD, PhD, Américo Figueiredo, MD, PhD, and Martin Black, MD, PhD From the Department of Dermatology, Abstract University Hospital, Coimbra, Portugal, St Background Neoplasia-induced lichen planus is described as a cell-mediated reaction to John’s Institute of Dermatology, St Thomas’ unknown epithelial antigens. Paraneoplastic pemphigus (PNP), characterized by the presence Hospital, London, UK of a specific array of autoantibodies, probably represents a different form of presentation of the Correspondence same autoimmune syndrome where the mucocutaneous expression depends on the dominant Sónia Coelho pathologic mechanism. Clínica de Dermatologia, Hospital da Methods The authors report a case of PNP with predominant lichen planus-like lesions and Universidade review the relevant literature. We observed a 74-year-old female with vesico-bullous, erosive, P.3000–075 Coimbra target-shaped and flat papular lichenoid lesions on the lower legs, palms and soles, evolving for Portugal E-mail: [email protected] 3 weeks. Histopathology revealed a lichenoid dermatitis. Direct immunofluorescence showed C3 deposition around keratinocytes and epidermal IgG intranuclear deposition. Indirect immunofluorescence revealed circulating IgG with intercellular staining on rat bladder substrate. Immunoblotting demonstrated bands of 130, 190, 210 and 250 kDa antigens. A pararenal B cell lymphoma was found. Results Oral corticotherapy with 40 mg prednisolone daily was initiated with a good cutaneous response. Four months later, cyclophosphamide (50 mg/day) was introduced because of a discrete enlargement of the pararenal mass. The patient died on the seventh month of follow up as a result of respiratory insufficiency.
    [Show full text]
  • Cardiovascular Drugs-Induced Oral Toxicities: a Murky Area to Be Revisited and Illuminated
    Pharmacological Research 102 (2015) 81–89 Contents lists available at ScienceDirect Pharmacological Research j ournal homepage: www.elsevier.com/locate/yphrs Review Cardiovascular drugs-induced oral toxicities: A murky area to be revisited and illuminated a, b b Pitchai Balakumar ∗, Muthu Kavitha , Suresh Nanditha a Pharmacology Unit, Faculty of Pharmacy, AIMST University, Semeling, 08100 Bedong, Malaysia b Faculty of Dentistry, AIMST University, 08100 Bedong, Malaysia a r t i c l e i n f o a b s t r a c t Article history: Oral health is an imperative part of overall human health. Oral disorders are often unreported, but are Received 20 July 2015 highly troublesome to human health in a long-standing situation. A strong association exists between Received in revised form 22 August 2015 cardiovascular drugs and oral adverse effects. Indeed, several cardiovascular drugs employed clinically Accepted 8 September 2015 have been reported to cause oral adverse effects such as xerostomia, oral lichen planus, angioedema, Available online 25 September 2015 aphthae, dysgeusia, gingival enlargement, scalded mouth syndrome, cheilitis, glossitis and so forth. Oral complications might in turn worsen the cardiovascular disease condition as some reports suggest an Keywords: adverse correlation between periodontal oral disease pathogenesis and cardiovascular disease. These are Cardiovascular drugs certainly important to be understood for a better use of cardiovascular medicines and control of associated Oral adverse effects oral adverse effects. This review sheds lights on the oral adverse effects pertaining to the clinical use of Dry mouth Angioedema cardiovascular drugs. Above and beyond, an adverse correlation between oral disease and cardiovascular Dysgeusia disease has been discussed.
    [Show full text]
  • PRACTICAL CLINICAL COURSES V3969 Common Frustrating Oral
    PRACTICAL CLINICAL COURSES A Service of the Gordon J. Christensen Career Development Program V3969 Common Frustrating Oral Diseases – Diagnosis & Treatment John A. Svirsky, DDS, MEd Gordon J. Christensen, DDS, MSD, PhD Materials Included C.E. Instruction Sheet Products List Clinician Responsible Goals & Objectives Overview References AGD Post-Test Non-SLS Toothpastes Therapy – Treatments 1 Gordon J. Christensen PRACTICAL CLINICAL COURSES PROCEDURE FOR RECEIVING ACADEMY OF GENERAL DENTISTRY AND STATE CREDIT FOR DVDS 1. Complete the enclosed Post-Test.* For each CE Video Purchased, one test is included. If additional tests are needed, the following fees will apply: $25 per test for 1 additional dentist; $10 per test for each auxiliary (dental assistants, hygienists, lab technicians - no limit on auxiliary tests). Fees can be paid either by check or credit card when tests are submitted to Practical Clinical Courses. 2. Complete the demographic information located at the end of the test. Type of Credit: a. If the applicant selects “State,” PCC will send a certificate of verification to the applicant. The applicant must then submit this certificate to his/her state board to obtain credit. b. If the applicant selects “AGD,” PCC will submit credit information to the Academy of General Dentistry and confirmation to the applicant that it has been submitted. (The applicant may check their AGD transcript for verification – please allow 30 days.) c. If the applicant selects “Both,” PCC will complete a. & b. above. 3. Return the Post-Test portion via mail, fax, or email. Our contact information is as follows: Practical Clinical Courses 3707 N Canyon Road Suite 3D Provo, UT 84604 Fax: (801) 226-8637 [email protected] 4.
    [Show full text]