Color Atlas of Oral Diseases George Laskaris, D. D. S. , M. D. Foreword by Gerald Shklar Second edition, revised and expanded 555 illustrations 1994 Georg Thieme Verlag Thieme Medical Publishers, Inc. Stuttgart . New York New York ﺧﺪﻣﺎت ﻋﻠﻤﯽ ﺑﺎران اوﻟﯿﻦ وﺗﻨﻬﺎ ﺗﻮﻟﯿﺪ ﮐﻨﻨﺪ ﮐﺘﺐ اﻟﮑﺘﺮوﻧﯿﮏ اﯾﻦ ﮐﺘﺎب در ﺷﺮﮐﺖ ﺧﺪﻣﺎت ﻋﻠﻤﯽ ﺑﺎران ﺑﺼﻮرت اﻟﮑﺘﺮوﻧﯿﮏ (e-book) ﺗﻬﯿﻪ ﺷﺪه اﺳﺖ و ﺗﻤﺎم ﺣﻘﻮق اﯾﻦ اﺛﺮ در اﻧﺤﺼﺎر اﯾﻦ ﺷﺮﮐﺖ ﻣﯽ ﺑﺎﺷﺪ . ﺷﺮﮐﺖ ﺑﺎران ﮐﺎﻣﻼ ﻣﺴﺘﻘﻞ ﺑﻮده و ﺑﻪ ﻫﯿﭻ ﻣﻮﺳﺴﻪ وﯾﺎ ﺷﺮﮐﺘﯽ واﺑﺴﺘﻪ ﻧﻤﯽ ﺑﺎﺷﺪ. ﻫﺮﮔﻮﻧﻪ ﮐﭙﯽ ﺑﺮداری و ﯾﺎ ﺗﮑﺜﯿﺮ از اﯾﻦ ژورﻧﺎل ﻏﯿﺮ ﻗﺎﻧﻮﻧﯽ ﺑﻮده و ﻣﺘﺨﻠﻔﯿﻦ ﺷﺪﯾﺪا ﻣﻮرد ﭘﯿﮕﯿﺮی و ﻣﺸﻤﻮل ﻗﻮاﻧﯿﻦ ﮐﺸﻮر اﯾﺮان ﻣﯽ ﺷﻮﻧﺪ. ﺑﺮای درﯾﺎﻓﺖ ﻟﯿﺴﺖ ﮐﺘﺐ و ﻣﺠﻼت و ﺧﺮﯾﺪ ﻣﺴﺘﻘﯿﻢ ﺑﺎ ﻣﺎ ﺗﻤﺎس ﺑﮕﯿﺮﯾﺪ. ﺗﻬﺮان ص پ 765-14515 ﺗﻠﻔﻦ 4311689 iv George Laskaris, D.D.S., M.D. Associate Professor in Oral Medicine and Pathology, Dental School, University of Athens. Consultant in Oral Medicine, Dept. of Dermatology, <<A. Syngros» Hospital, University of Athens. 20-22 Ipsilandou St. 10676 Athens, Greece Library of Congress Cataloging-in-Publication Data Important Note: Medicine is an ever-changing science. Research and clinical experience are continually broad- Laskaris, George. ening our knowledge, in particular our knowledge of [Enchromos atlas stomatologias. English] proper treatment and drug therapy. Insofar as this book Color atlas of oral diseases / George Laskaris ; foreword mentions any dosage or application, readers may rest by Gerald Shklar. -- 2nd ed., rev. and expanded. assured that the authors, editors and publishers have p. cm. made every effort to ensure that such references are Includes bibliographical references and index. strictly in accordance with the state of knowledge at the ISBN 3-13-717002-8 (G. Thieme Verlag). -- time of production of the book. Nevertheless, every ISBN 0-86577-537-0 (Thieme Medical Publishers) user is requested to carefully examine the manufac- 1. Mouth--Diseases--Atlases. §. Title. turers leaflets accompanying each drug to check on his [DNLM: 1. Mouth Diseases--atlases. WU 17 L345e own responsibility whether the dosage schedules recom- 1994] mended therein or the contraindications stated by the RC815.L3713 1994 manufacturers differ from the statements made in the 617.5'22'0222--dc20 present book. Such examination is particularly impor- DNLM/DLC tant with drugs which are either rarely used or have for Library of Congress 94-9767 been newly released on the market. CIP This atlas is based on the Greek edition: Cover drawing: Renate Stockinger Enchromos Atlas Stomatologias- Color Atlas of Stomatology Copyright © 1986 by George Laskaris, Athens, Greece. Published by Litsas Medical Publications, ist Italian edition 1991 Athens, Greece 1st French edition 1989 Some of the product names, patents and registered ©1988,1994 Georg Thieme Verlag, RudigerstraBe 14, designs referred to in this book are in fact registered 70469 Stuttgart, Germany trademarks or proprietary names even though specific Thieme Medical Publishers, Inc., reference to this fact is not always made in the text. 381 Park Avenue South, New York, N. Y. 10016 Therefore, the appearance of a name without designa- tion as proprietary is not to be construed as a repre- Typesetting by Druckhaus Gotz GmbH, sentation by the publishers that it is in the public 71636 Ludwigsburg domain. (System 5, Linotron 202) This book, including all parts thereof, is legally protect- Printed in Germany by K. Grammlich, GmbH ed by copyright. Any use, exploitation or commercial- ization outside the narrow limits set by copyright legisla- tion, without the publisher's consent, is illegal and liable ISBN 3-13-717002-8 (Georg Thieme Verlag, Stuttgart) to prosecution. This applies in particular to photostat ISBN 0-86577-537-0 (Thieme Medical Publishers, Inc., reproduction, copying, mimeographing or duplication New York) of any kind, translating, preparation of microfilms, and electronic data processing and storage. 1 2 3 4 5 6 V Foreword It is a distinct pleasure to see Dr. George Laskaris' original Greek, by the excellence of the color excellent Atlas of Oral Diseases come out in an illustrations and the broad range of diseases English edition. Dr. Laskaris' knowledge, back- covered. The English text now offers a brief but ground, and wealth of experience in the disci- authoritative discussion of each condition. plines of oral medicine and oral pathology have been well known to those of us in the field. His highly respected research on autoimmune diseases GERALD SHKLAB, D.D.S., M.S. of the mouth has appeared in many English lan- Charles A. Brackett Professor of Oral Pathology guage journals, and it is fitting that his extensive and Head of the Department of Oral Medicine experience with oral diseases is now made avail- and Oral Pathology, able to the English-speaking world. This Atlas has Harvard School of Dental Medicine, impressed even those of us who could not read the Boston, Massachusetts VI Preface to the Second Edition The second edition of the Color Atlas of Oral Twenty-three illustrations have been replaced Diseases is enlarged and revised to keep pace with by new, higher quality, more representative ones. current concepts and changes in the field of Oral Three hundred and eighty-eight references Medicine. New chapters and illustrations have have been added. been included and the text of the first edition has I hope that the revised and enlarged second been modified on several occasions. edition of the Atlas is an improvement, and that it Two new chapters on HIV infections and AIDS will be as useful as the first edition to all of those and renal diseases have been added. who are involved in the field of oral medicine. Sixty-four illustrations of lesions and clinical entities affecting the oral cavity, not published in the first edition, are now included. Nineteen new illustrations of diseases pub- lished in the first edition have been added to broaden the spectrum of clinical presentation of these entities. Athens, 1994 GEORGE LASKARIS, D.D.S., M.D. VII Preface to the First Edition Oral medicine is a rapidly growing clinical spe- oral pathologist and surgeon, the dermatologist, cialty encompassing the diagnosis and treatment and otorhinolaryngologist to solve the diagnostic of patients with a wide spectrum of disorders problems posed by oral diseases. It can also be involving the oral cavity. valuable to dental and medical students, general To achieve the optimum goals, oral medical internists, pediatricians, and other medical clinicians have to broaden their knowledge bases specialists. and practice their clinical skills. This book is not a complete reference work of When 1 first started to work in this field 20 oral medicine and should be used in conjunction years ago, I could not imagine the variety of with current textbooks and articles regarding disorders that affect the oral cavity, including recommendations on treatment and new diagnos- genetic diseases, infections, cancers, blood dis- tic techniques that are beyond its scope. eases, skin diseases, endocrine and metabolic dis- The material of the Atlas is divided into 33 orders, autoimmune and rheumatologic diseases, chapters. Each entity is accompanied by color local lesions, to name a few. Fortunately, the oral plates and a description of the clinical features, cavity is accessible to visual examination, and I differential diagnosis, helpful laboratory tests, and have attempted to record oral lesions in color a brief statement on treatment. slides. During my career as a stomatologist, I have Selective bibliography and index are included. collected more than 25,000 clinical color slides I hope that the Atlas will serve as a comprehen- that encompass a broad spectrum of common and sive pictorial guide for diagnostic problems in the rare oral diseases. The most representative and mouth and it will find its way in the places where educationally useful illustrations have been used the battle against oral diseases is waged daily, that in this Atlas. Almost all color slides have been is dental schools, hospitals, and private practice taken by me with a Nikon-Medical camera. offices. This book is the distillation of my clinical ex- perience and is intended to aid primarily the prac- ticing dentist, the specialist in oral medicine, the Athens, 1988 GEORGE LASKARIS, D.D.S., M.D. VIII Acknowledgements My deep appreciation is due to my patients, who tal Medicine, United States, both of whom read taught me so much, and to all of the Greek the manuscript of the first edition. Their sugges- dentists and physicians who have contributed by tions and criticisms have been gratefully received referring their patients to me through the years. and indeed improved the text considerably. My gratitude is extended to the late Professor Finally, I wish to thank my colleagues at the of Dermatology, John Capetanakis, and the cur- Department of Oral Medicine and Pathology of rent Professor of Dermatology and Head of the the Dental School, University of Athens, with Department of Dermatology, University of whom I have worked closely for more than 25 Athens, "A. Syngros" Hospital, John Stratigos, years. In particular I wish to thank Dr. Alexandra for their constant encouragement in my en- Sklavounou, Dr. Panagiota Economopoulou, and deavors. Dr. Eleana Stufi for their assistance in the prepa- I am also indebted to Associate Professor of ration of the first edition of the Atlas. Dermatology Antony Vareltzidis, who has greatly I am especially indebted to Dr. Stathis S. helped me to broaden my knowledge in the field Papavasiliou and Professor Crispian Scully for of dermatology. their critical review of the text of second edition. My sincere thanks are extended to the scientific I thank the following colleagues for permission staff of "A.Syngros" Hospital, Department of to use their color plates: Dr. Robert Gorlin Dermatology, University of Athens, for their wil- (USA) for Figure 46, Dr.