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Maglia DR, Souza BDAF, Visioli F. Efficacy of ozone therapy for oral mucosa wound healing: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:490. [PMID: 39153027 DOI: 10.1007/s00784-024-05873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis to assess the effectiveness of ozone therapy in oral ulcers healing when compared to placebo or active treatments. MATERIALS AND METHODS The search was carried out using PubMed, EMBASE, Scopus, and Lilacs databases. Clinical trials involving human participants were included. The Risk Ratio (RR) and the standardized mean difference (SMD) with 95%CI (confidence interval) were calculated. The ROBINS-I (risk of bias in non-randomized studies of interventions) and RoB2 (risk of bias tool for randomized trials) assessment tool was used to detect bias. RESULTS After the selection process, 12 studies were included. The meta-analysis showed that ozone therapy helps to reduce the size of the traumatic and autoimmune ulcers (RR=-0.44; 95% CI -0.71,-0.17; I2=0%) in comparison to placebo. Regarding pain reduction, ozone was superior to placebo (RR = 1.29, 95% CI -1.6 to -0.95); I2=0%), and equivalent to topical corticosteroid and laser photobiomodulation (RR = 0.26, 95% CI -0.27,0.78, p = 0.34). CONCLUSION Ozone therapy is an alternative for accelerating healing and reducing pain for both traumatic and autoimmune ulcers. However, the quality of evidence is limited. CLINICAL RELEVANCE Oral ulcerations are usually painful and impact quality of life requiring different approaches to boost wound healing and reduce symptoms. For this purpose, ozone therapy is a promising strategy.
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Affiliation(s)
- Deisi Romitti Maglia
- Oral Pathology and Oral Medicine Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2492, room 503, Porto Alegre, RS, 90035-003, Brazil
| | - Bruna do Amaral Ferreira Souza
- Oral Pathology and Oral Medicine Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2492, room 503, Porto Alegre, RS, 90035-003, Brazil
| | - Fernanda Visioli
- Oral Pathology and Oral Medicine Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2492, room 503, Porto Alegre, RS, 90035-003, Brazil.
- Experimental Center Research, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos St 2350, Porto Alegre, RS, Brazil.
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2
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Susanto H, Ratu Mas Saraswati A, Patera Nugraha A, Wicaksono S, Nur'aeny N, Savitri Ernawati D. Topical Adipose Mesenchymal Stem cell metabolites regulate the expression of MMP-1, MMP-9, EGF, TGF-β in oral mucosa ulcer rat model. Saudi Dent J 2024; 36:932-939. [PMID: 38883902 PMCID: PMC11178951 DOI: 10.1016/j.sdentj.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/27/2024] [Accepted: 03/31/2024] [Indexed: 06/18/2024] Open
Abstract
Objective Matrix metalloproteinase (MMP-1 and -9), Epidermal Growth Factor (EGF), and Transforming Growth factor (TGF)-β are expressed in the oral ulcer wound-healing process. The Adipose mesenchymal stem cell metabolites (AdMSCMs) may accelerate wound-healing. This study aimed to investigate the expression of MMP-1, MMP-9, EGF, and TGF-β in the oral mucosa ulcer rat model treated with topical AdMSCMs. Materials and Methods Oral ulcer models were created in twenty healthy male Wistar rats (Rattus novergicus) divided into AdMSCMs and control groups. The oral ulcer model was treated topically using AdMSCMs oral gel three times daily for 3 and 7 days. The expression of MMP-1, MMP-9, EGF, TGF-β was evaluated through histological examination using the immunohistochemistry method. Independent t-test was used to compare the mean of expression of MMP-1, MMP-9, EGF, TGF-β between control and treatment groups (AdMSCMs), and paired t-test was used to analyze the mean between day 3 and day 7 of each group. Results A lower expression of MMP-1, MMP-9 in AdMSCMs group and higher expression EGF and TGF-β in AdMSCMs group compared to the control group in day 3 and day 7. Independent t-test results showed a significant difference in the expression of MMP-1, MMP-9, EGF between the control and AdMSCMs group in day 3 and day 7. Only TGF-β expression mean difference between day 3 and day 7 showed a significant difference compared to the control groups (p < 0.05). Conclusions AdMSCMs oral gel may accelerate oral ulcer healing models by reducing the expression MMP-1, MMP-9, and increasing EGF and TGF-β expressions during the wound-healing process.
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Affiliation(s)
- Hendri Susanto
- Departement of Oral Medicine, Faculty of Dentistry, Universitas Gadjah Mada, Indonesia
| | - Ade Ratu Mas Saraswati
- Clinical Dentistry, Magister Study Program, Faculty of Dentistry, Universitas Gadjah Mada, Indonesia
| | | | - Satutya Wicaksono
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Indonesia
| | - Nanan Nur'aeny
- Departement of Oral Medicine, Faculty of Dentistry, Universitas Padjajaran, Indonesia
| | - Diah Savitri Ernawati
- Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Indonesia
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3
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Mehrmal S, Mojica R, Guo AM, Missall TA. Diagnostic Methods and Management Strategies of Herpes Simplex and Herpes Zoster Infections. Clin Geriatr Med 2024; 40:147-175. [PMID: 38000858 DOI: 10.1016/j.cger.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Herpesviruses are medium-sized double-stranded DNA viruses. Of more than 80 herpesviruses identified, only 9 human herpesviruses have been found to cause infection in humans. These include herpes simplex viruses 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), human cyto-megalovirus (HCMV), Epstein-Barr virus (EBV), and human herpesvirus (HHV-6A, HHV-6B, HHV-7, HHV-8). HSV-1, HSV-2, and VZV can be problematic given their characteristic neurotropism which is the ability to invade via fusion of its plasma membrane and reside within neural tissue. HSV and VZV primarily infect mucocutaneous surfaces and remain latent in the dorsal root ganglia for a host's entire life. Reactivation causes either asymptomatic shedding of virus or clinical manifestation of vesicular lesions. The clinical presentation is influenced by the portal of entry, the immune status of the host, and whether the infection is primary or recurrent. Affecting 60% to 95% of adults, herpesvirus-associated infections include gingivostomatitis, orofacial and genital herpes,and primary varicella and herpes zoster. Symptomatology, treatment, and potential complications vary based on primary and recurrent infections as well as the patient's immune status.
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Affiliation(s)
- Sino Mehrmal
- Department of Dermatology, Saint Louis University School of Medicine, 1225 South Grand Boulevard, Saint Louis, MO 63104, USA
| | - Rafael Mojica
- Department of Dermatology, University of Florida College of Medicine, 4037 Northwest 86th Terrace, Gainesville, FL 32606, USA
| | - Aibing Mary Guo
- Department of Dermatology, Saint Louis University School of Medicine, 1225 South Grand Boulevard, Saint Louis, MO 63104, USA
| | - Tricia A Missall
- Department of Dermatology, University of Florida College of Medicine, 4037 Northwest 86th Terrace, Gainesville, FL 32606, USA.
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Elbatreek MH, Fathi AM, Mahdi I, Abdelfattah MAO, Mahmoud MF, Sobeh M. Thymus satureioides Coss. combats oral ulcer via inhibition of inflammation, proteolysis, and apoptosis. Inflammopharmacology 2023; 31:2557-2570. [PMID: 37477794 DOI: 10.1007/s10787-023-01285-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023]
Abstract
Oral ulcer is a frequent condition that commonly affects the tongue and in which 75% of the patients experience pain, and 25% report taste changes. The available therapies are not sufficiently effective for rapid and complete healing of tongue ulcers. We previously annotated the metabolites of Thymus satureioides (TS) aerial parts and reported their antioxidant, dermacosmeceutical and hepatoprotective properties. In this study, we performed in silico analysis, by applying network pharmacology and molecular docking, followed by experimental validation of the effect of local application of T. satureioides (TS) gel at two different concentrations on the healing of acetic-acid-induced tongue ulcer in rats. Salvianolic acid A, phloretic acid caffeate, rosmarinic acid, apigenin, and luteolin were the top bioactive ingredients of TS extract. Network pharmacology showed that the most relevant targets of these active constituents were TLR4, COX-2, MMP-9, TNF-α, and Caspase-3. Molecular docking showed that rosmarinic acid and salvianolic acid had a relatively strong binding affinity, compared to the other compounds, toward all the target proteins. Experimental validation in tongue ulcer model in rats and immunohistochemistry experiments showed that application of a gel containing TS extract (5 and 10%) was effective in healing the tongue ulcer via downregulation of COX-2, TNF-α, MMP-9, and Caspase-3. This study suggests that T. satureioides extract could act as a topical treatment for tongue ulcers by combating inflammation, apoptosis, and proteolysis. The possible treatment potential of some constituents including rosmarinic acid and salvianolic acid in oral ulcerations awaits further investigations to confirm their potency.
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Affiliation(s)
- Mahmoud H Elbatreek
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Ayman M Fathi
- Department of Pharmaceutics, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Ismail Mahdi
- AgroBioSciences Department, College for Sustainable Agriculture and Environmental Science, Mohammed VI Polytechnic University, 43150, Ben Guerir, Morocco
| | - Mohamed A O Abdelfattah
- College of Engineering and Technology, American University of the Middle East, Egaila, 54200, Kuwait
| | - Mona F Mahmoud
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Mansour Sobeh
- AgroBioSciences Department, College for Sustainable Agriculture and Environmental Science, Mohammed VI Polytechnic University, 43150, Ben Guerir, Morocco.
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5
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Conejero Del Mazo R, García Forcén L, Navarro Aguilar ME. [Recurrent aphthous stomatitis]. Med Clin (Barc) 2023; 161:251-259. [PMID: 37357066 DOI: 10.1016/j.medcli.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/27/2023]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common clinical disease of the oral mucosa. Its prevalence in the general population varies between 5 and 25%, with its peak appearance in the second decade of life. So far, the etiopathogenesis is not clear. In genetically predisposed patients, the effect of certain triggering factors would initiate the proinflammatory cytokine cascade directed against certain regions of the oral mucosa. Ulcers are round or oval with well-defined erythematous margins and a shallow ulcerated center covered with a gray or yellowish fibrinous pseudomembrane. The ulcers may reappear at intervals of a few days and months. Given the appearance of periodic thrush in the oral mucosa, the first thing to do is to make a correct differential diagnosis, rule out associated systemic diseases and assess treatable causes before reaching the diagnosis of RAS. At present, there is no curative treatment.
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Affiliation(s)
| | - Laura García Forcén
- Centro de Salud Ejea de los Caballeros, Ejea de los Caballeros, Zaragoza, España
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6
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Iwamuro M, Hamada K, Kawano S, Kawahara Y, Otsuka M. Review of oral and pharyngolaryngeal benign lesions detected during esophagogastroduodenoscopy. World J Gastrointest Endosc 2023; 15:496-509. [PMID: 37547241 PMCID: PMC10401409 DOI: 10.4253/wjge.v15.i7.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/30/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
Recent advancements in endoscopy equipment have facilitated endoscopists’ detection of neoplasms in the oral cavity and pharyngolaryngeal regions. In particular, image-enhanced endoscopy using narrow band imaging or blue laser imaging play an integral role in the endoscopic diagnosis of oral and pharyngolaryngeal cancers. Despite these advancements, limited studies have focused on benign lesions that can be observed during esophagogastroduodenoscopy in the oral and pharyngolaryngeal regions. Therefore, this mini-review aimed to provide essential information on such benign lesions, along with representative endoscopic images of dental caries, cleft palate, palatal torus, bifid uvula, compression by cervical osteophytes, tonsil hyperplasia, black hairy tongue, oral candidiasis, oral and pharyngolaryngeal ulcers, pharyngeal melanosis, oral tattoos associated with dental alloys, retention cysts, papilloma, radiation-induced changes, skin flaps, vocal cord paresis, and vocal fold leukoplakia. Whilst it is imperative to seek consultation from otolaryngologists or dentists in instances where the diagnosis cannot be definitively ascertained by endoscopists, the merits of attaining foundational expertise pertaining to oral and pharyngolaryngeal lesions are unequivocal. This article will be a valuable resource for endoscopists seeking to enhance their understanding of oral and pharyngolaryngeal lesions.
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Affiliation(s)
- Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Kenta Hamada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yoshiro Kawahara
- Department of Practical Gastrointestinal Endoscopy, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Motoyuki Otsuka
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama 700-8558, Japan
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7
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Soto AP, Meyer SL. Oral Implications of Polypharmacy in Older Adults. Clin Geriatr Med 2023; 39:273-293. [PMID: 37045533 DOI: 10.1016/j.cger.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Over the next several decades, rates of aged populations will increase rapidly. These populations are susceptible to multimorbidities and polypharmacy (concurrently, prescribed 5 or more medications). Many medications have side effects that manifest orally. Therefore, it essential to possess current pharmacologic knowledge to diagnose and treat oral implications of commonly prescribed medications. This article details common medication-induced oral lesions and patient assessment of risk factors for polypharmacy and provides a template to integrate medication reconciliation into dental clinical practice.
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Affiliation(s)
- Annetty P Soto
- Division of General Dentistry, Department of Restorative Dental Sciences, University of Florida College of Dentistry, 1395 Center Drive, PO Box 100415, Gainesville, FL 32610-0415, USA.
| | - Sarah L Meyer
- University of Florida Health Science Center Libraries, 1600 Southwest Archer Road, PO Box 100206, Gainesville, FL 32610, USA
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8
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Gao Q, Shang Y, Zhou W, Deng S, Peng C. Marine collagen peptides: A novel biomaterial for the healing of oral mucosal ulcers. Dent Mater J 2022; 41:850-859. [PMID: 35934799 DOI: 10.4012/dmj.2021-323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to analyze the therapeutic effects of marine collagen peptides (MCPs) from tilapia skin on oral mucosal ulcers in a rat model. CCK-8 and wound healing assays were performed in vitro to evaluate proliferation and migration of L929 cells after treatment with MCPs. The effects of MCPs on the healing of oral mucosal ulcers in a rat model were macroscopically and microscopically analyzed in vivo. Results showed that MCPs promoted proliferation and migration of L929 cells. Moreover, 75%MCPs enhanced the ulcer healing process, suppressed inflammatory response and up-regulated the expression levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF). MCPs are potentially used as a new therapeutic strategy for oral mucosal ulceration.
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Affiliation(s)
- Qiuying Gao
- Department of Stomatology, The Second Hospital of Tianjin Medical University
| | - Yuli Shang
- Department of Stomatology, The Second Hospital of Tianjin Medical University
| | - Weiwei Zhou
- Department of Stomatology, The Second Hospital of Tianjin Medical University
| | - Shu Deng
- Henry M Goldman School of Dental Medicine, Boston University
| | - Cheng Peng
- Department of Stomatology, The Second Hospital of Tianjin Medical University
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9
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Abstract
The prevalence of oral ulcers in children is reported to be 9%, however diagnosis of oral lesions can be challenging, being an unspecific symptom of several diseases. Differential diagnosis can range from classic infectious disease of childhood (e.g. herpangina, hand-foot-and-mouth-disease) over nutritional deficiencies, gastrointestinal disorders, inflammations (e.g. pemphigus vulgaris, lichen planus, mucous membrane pemphigoid) to side effects of medications (Stevens-Johnson Syndrome) or chronic dieseases (e.g. sarcoidosis, systemic Lupus erythematodes, familial Mediterrenean fever). Therefore, children with oral ulcers are treated by many different specialists such as dentists, family doctors, paediatricians, rheumatologists, haematologists, gastroenterologists and otorhinolaryngologists.A systematic literature search and a narrative literature review about the potential 48 diseases connected to oral ulcers were performed. According to the duration of symptoms and size of the lesions, a tabular overview was created to support the clinician in making a correct diagnosis, additionally different treatment options are presented.
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Affiliation(s)
- Corinne Légeret
- University Children’s Hospital of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- University Children’s Hospital Basel, Spitalstrasse 31, 4055 Basel, Switzerland
| | - Raoul Furlano
- University Children’s Hospital of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- University Children’s Hospital Basel, Spitalstrasse 31, 4055 Basel, Switzerland
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10
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Abstract
Over the next several decades, rates of aged populations will increase rapidly. These populations are susceptible to multimorbidities and polypharmacy (concurrently, prescribed 5 or more medications). Many medications have side effects that manifest orally. Therefore, it essential to possess current pharmacologic knowledge to diagnose and treat oral implications of commonly prescribed medications. This article details common medication-induced oral lesions and patient assessment of risk factors for polypharmacy and provides a template to integrate medication reconciliation into dental clinical practice.
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11
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Wang Z, Cao H, Xiong J, Lu Y, Deng Y, Nan H, Zheng S, Ye H, Cao Z. Recent advances in the aetiology of recurrent aphthous stomatitis (RAS). Postgrad Med J 2021; 98:57-66. [PMID: 33574180 DOI: 10.1136/postgradmedj-2020-139421] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/04/2022]
Abstract
Recurrent aphthous stomatitis (RAS) is the most common disease of oral mucosa, which almost attacks each individual once in their lifespan. Although plenty of factors have been suggested to play a role in the pathogenesis of RAS, the aetiology of RAS is still controversial, which might lead to limited clinical therapies in accordance with each RAS patient. This review mainly illustrates recent advances in potential causes associated with RAS in detail. Deeper comprehension of the aetiology of RAS will support doctors and researchers to make a better management of RAS patients and to discover new treatments. The aetiology of RAS is complicated, hence we should take a comprehensive view into its aetiology, with multiple potential factors being considered. Sample collection of RAS patients have greatly limited the progress in the aetiology of RAS. A research model of multiagency cooperation can help achieve perfect sample collection of year-round and multiposition.
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Affiliation(s)
- Zihan Wang
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Haibo Cao
- Clinical Medicine School, Hebei University of Engineering, Handan, China
| | - Jianqi Xiong
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yilong Lu
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Yixiao Deng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Han Nan
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Shutian Zheng
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Hui Ye
- Department of Biochemistry, School of Basic Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhensheng Cao
- School of Stomatology, Wenzhou Medical University, Wenzhou, China
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12
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Ahmad MF, Ahmad FA, Ashraf SA, Saad HH, Wahab S, Khan MI, Ali M, Mohan S, Hakeem KR, Athar MT. An updated knowledge of Black seed ( Nigella sativa Linn.): Review of phytochemical constituents and pharmacological properties. J Herb Med 2021; 25:100404. [PMID: 32983848 PMCID: PMC7501064 DOI: 10.1016/j.hermed.2020.100404] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 10/08/2019] [Accepted: 09/09/2020] [Indexed: 02/06/2023]
Abstract
N. sativa (N. sativa) has been used since ancient times, when a scientific concept about the use of medicinal plants for the treatment of human illnesses and alleviation of their sufferings was yet to be developed. It has a strong religious significance as it is mentioned in the religious books of Islam and Christianity. In addition to its historical and religious significance, it is also mentioned in ancient medicine. It is widely used in traditional systems of medicine for a number of diseases including asthma, fever, bronchitis, cough, chest congestion, dizziness, paralysis, chronic headache, back pain and inflammation. The importance of this plant led the scientific community to carry out extensive phytochemical and biological investigations on N. sativa. Pharmacological studies on N. sativa have confirmed its antidiabetic, antitussive, anticancer, antioxidant, hepatoprotective, neuro-protective, gastroprotective, immunomodulator, analgesic, antimicrobial, anti-inflammatory, spasmolytic, and bronchodilator activity. The present review is an effort to explore the reported chemical composition and pharmacological activity of this plant. It will help as a reference for scientists, researchers, and other health professionals who are working with this plant and who need up to date knowledge about it.
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Affiliation(s)
- Md Faruque Ahmad
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Saudi Arabia
| | - Fakhruddin Ali Ahmad
- Department of Laboratory Medicine Al-Hada and Taif Military Hospital, Saudi Arabia
| | - Syed Amir Ashraf
- Dept. of Clinical Nutrition, College of Applied Medical Sciences, University of Hail, Saudi Arabia
| | - Hisham H Saad
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Saudi Arabia
| | - Shadma Wahab
- College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Idreesh Khan
- Department of Clinical Nutrition, College of Applied Health Sciences in Arras, Qassim University, Saudi Arabia
| | - M Ali
- College of pharmacy, Dept. of Pharmacognosy, Jazan University, Saudi Arabia
| | - Syam Mohan
- Medical Research Center, Jazan University, Jazan, Saudi Arabia
| | - Khalid Rehman Hakeem
- Department of Biological Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Md Tanwir Athar
- Bioactive Natural Product Laboratory, Hamdard University, India.,Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Asare K, Gatzke CB. Mycophenolate-induced oral ulcers: Case report and literature review. Am J Health Syst Pharm 2020; 77:523-528. [PMID: 32058566 DOI: 10.1093/ajhp/zxz358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE A case of mycophenolate mofetil (MMF)-induced oral ulceration in a kidney transplant recipient is reported. SUMMARY A 54-year-old man who had received a kidney transplant 7 months previously reported to our outpatient clinic with severe oral ulcers with odynophagia and was admitted to the hospital. His maintenance immunosuppressive agents at the time of admission consisted of tacrolimus and mycophenolate. The patient had stable renal function, with all laboratory values within normal ranges. After various alternative etiologies were ruled out, drug-induced oral ulceration was suspected, and the patient's tacrolimus dose was empirically reduced, resulting in reduction of the trough concentration from 10 ng/mL to 3.3 ng/mL without improvement of the ulceration. Mycophenolate-induced oral ulceration was suspected, and MMF was discontinued. Within 5 days of discontinuation, there was a remarkable improvement in both the size and severity of the ulceration, and the patient was discharged from the hospital. During the next clinic visit (a total of 12 days after MMF was discontinued), the patient's mouth and esophageal ulcers had completely healed. Six weeks after complete resolution of the ulcer, MMF at a dosage of 250 mg twice daily was initiated; the dosage was subsequently increased to 500 mg twice daily without a recurrence of ulceration. CONCLUSION A 54-year-old man developed oral ulceration after 7 months of MMF therapy. Discontinuation of therapy resulted in prompt resolution of the patient's ulcers, with no recurrence of ulceration at a lower MMF dose. This is the first case report indicating that mycophenolate-induced ulceration may be dose dependent.
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Affiliation(s)
- Kwame Asare
- Department of Pharmacy, St. Thomas Hospital West, Nashville, TN
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15
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Leite MGM, Freitas EDS, de Vasconcelos Ii AJA, Pinheiro TN. Low-Level Laser Therapy Approach of Bilateral Necrotizing Sialometaplasia of the Hard and Soft Palates. J Lasers Med Sci 2020; 11:348-354. [PMID: 32802297 DOI: 10.34172/jlms.2020.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction: Necrotizing sialometaplasia (NS) is a rare locally destructive inflammatory benign disease that commonly affects the minor salivary glands. It is frequently associated with the glands located in the posterior portion of the hard and soft palates. Low-level laser therapy (LLLT), also called photobiomodulation therapy (PBMT), has been deemed a substantial method for the regenerative wound process. Case Presentation: A 32-year-old male patient was referred with a chief complaint of two asymptomatic crater-like ulcers measuring approximately 1.5 cm wide on the right side of the hard and soft palates, and another measuring 0.3 cm wide on the left side of the hard palate. The lesion had two weeks of evolution followed by a previous infectious "sore throat" event that kept the patient hospitalized for 4 days. A clinical diagnosis of NS was made. LLLT was applied during 2 sessions per week, favoring the total wound healing within 2 weeks. At 3 months of clinical followup, the patient did not present any complication or relapse and was thus released. Conclusion: This is, to our knowledge, the first clinical report of LLLT applied for the management of NS. Large palatal ulcers caused by NS usually have long healing periods. The shortened healing period observed in this case encourages the inclusion of LLLT in any treatment protocol for similar lesions.
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Affiliation(s)
- Milena Gomes Melo Leite
- Undergraduate Student, Superior School of Health Science, Amazonas State University, Av. Carvalho Leal, 1777, Cachoeirinha, Manaus-AM, 69065-001, Brazil
| | - Eliandro de Souza Freitas
- Undergraduate Student, Superior School of Health Science, Amazonas State University, Av. Carvalho Leal, 1777, Cachoeirinha, Manaus-AM, 69065-001, Brazil
| | | | - Tiago Novaes Pinheiro
- DDS, MSc, PhD, Superior School of Health Science, Amazonas State University, Av. Carvalho Leal, 1777, Cachoeirinha, Manaus-AM, 69065-001, Brazil
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Sánchez-Bernal J, Conejero C, Conejero R. Recurrent Aphthous Stomatitis. ACTAS DERMO-SIFILIOGRAFICAS 2020; 111:471-480. [PMID: 32451064 DOI: 10.1016/j.ad.2019.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 08/17/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Recurrent aphthous stomatitis is a chronic inflammatory disease of the oral mucosa. It is characterized by painful mouth ulcers that cannot be explained by an underlying disease. Recurrent oral mucosal ulcers require a proper differential diagnosis to rule out other possible causes before recurrent aphthous stomatitis is diagnosed. The condition is common, with prevalence rates ranging from 5 to 60% in different series. Its pathogenesis is unknown, but multiple factors are considered to play a part. There are no standardized treatments for this condition and none of the treatments are curative. The goal of any treatment should be to alleviate pain, reduce the duration of ulcers, and prevent recurrence.
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Affiliation(s)
- J Sánchez-Bernal
- Servicio de Dermatología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - C Conejero
- Unidad de Dermatología, Centro Médico Millenium, Zaragoza, España
| | - R Conejero
- Departamento de Dermatología, Hospital Royo Villanova, Zaragoza, España.
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17
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Benli M, Batool F, Stutz C, Petit C, Jung S, Huck O. Orofacial manifestations and dental management of systemic lupus erythematosus: A review. Oral Dis 2020; 27:151-167. [PMID: 31886584 DOI: 10.1111/odi.13271] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/14/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease with numerous clinical manifestations. There is no consensus about the ideal oral management for this group of patients to date. This review aimed to describe the broad spectrum of orofacial and clinical manifestations and their therapeutic approaches. Studies concerning orofacial manifestations of SLE and dental treatment modalities were selected by a literature search (1978-2019) using Google Scholar, PubMed/MEDLINE electronic databases. The initial search strategy provided a total of 129 articles, and of these, 30 were included for qualitative synthesis. The reviewed studies revealed that SLE patients are more at risk of compromised oral and dental health exhibiting increased risk of periodontal diseases and temporomandibular joint disorders. The use of systemic drugs especially immunosuppressive and anticoagulants in SLE patients may also influence their oral management. Results emphasize the need to carry out, at an early stage of the disease, an appropriate oral management of these patients to improve oral health-related quality of life and to prevent the need of more invasive therapeutics. A multidisciplinary approach is needed for dental and medical management of such patients.
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Affiliation(s)
- Merve Benli
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Fareeha Batool
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Céline Stutz
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Petit
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sophie Jung
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,CNRS UPR 3572 "Immunologie, Immunopathologie et Chimie Thérapeutique (I2CT)", Institut de Biologie Moléculaire et Cellulaire (IBMC), Strasbourg, France
| | - Olivier Huck
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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18
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Abo-shady AZ, Elkammar H, Elwazzan VS, Nasr M. Formulation and clinical evaluation of mucoadhesive buccal films containing hyaluronic acid for treatment of aphthous ulcer. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2019.101442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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19
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Minhas S, Sajjad A, Kashif M, Taj F, Waddani HA, Khurshid Z. Oral Ulcers Presentation in Systemic Diseases: An Update. Open Access Maced J Med Sci 2019; 7:3341-3347. [PMID: 31949540 PMCID: PMC6953949 DOI: 10.3889/oamjms.2019.689] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Diagnosis of oral ulceration is always challenging and has been the source of difficulty because of the remarkable overlap in their clinical presentations. AIM The objective of this review article is to provide updated knowledge and systemic approach regarding oral ulcers diagnosis depending upon clinical picture while excluding the other causative causes. METHODS For this, specialised databases and search engines involving Science Direct, Medline Plus, Scopus, PubMed and authentic textbooks were used to search topics related to the keywords such as oral ulcer, oral infections, vesiculobullous lesion, traumatic ulcer, systematic disease and stomatitis. Associated articles published from 1995 to 2019 in both dental and medical journals including the case reports, case series, original articles and reviews were considered. RESULTS The compilation of the significant data reveals that ulcers can be classified according to (i) duration of onset, (ii) number of ulcers and (iii) etiological factors. Causation of oral ulcers varies from slight trauma to underlying systemic diseases and malignancies. CONCLUSION Oral manifestations must be acknowledged for precise diagnosis and appropriate treatment.
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Affiliation(s)
- Sadia Minhas
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Aneequa Sajjad
- Department of Oral Pathology, Akhtar Saeed Dental College, Lahore, Pakistan
| | - Muhammad Kashif
- Department of Oral Pathology, Bakhtawar Amin Medical & Dental College, Multan, Pakistan
| | - Farooq Taj
- Department of Prosthetic, Khyber Medical University Institute of Dental Sciences, Kohat, Pakistan
| | - Hamed Al Waddani
- Department of Medicine and Surgery, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa Governorate, Saudi Arabia
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20
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Piacentini M, Borghetti RL, Zancanaro de Figueiredo MA, Cherubini K, Gonçalves Salum F. Doxycycline: An option in the treatment of ulcerated oral lesions? J Clin Pharm Ther 2019; 44:838-843. [PMID: 31400293 DOI: 10.1111/jcpt.13022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/14/2019] [Accepted: 07/17/2019] [Indexed: 12/15/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVES In addition to its antimicrobial effect, doxycycline has potent anti-inflammatory activity. In view of these pharmacological characteristics, its use in the management of inflammatory, autoimmune and granulomatous diseases has been proposed. The objective of this study was to investigate, through a systematic literature review, the effect of doxycycline on pain and healing of ulcerated lesions of the mouth. METHODS An electronic search was performed in accordance with PRISMA guidelines in PubMed, Cochrane Central Register, Web of Science, Bireme/LILACS and Scopus databases. Controlled, randomized clinical trials were selected. The concentration of doxycycline, frequency of application, pain relief and clinical remission of the lesions were analysed. RESULTS AND DISCUSSION According to the inclusion criteria, five articles were selected. In four of these studies, doxycycline was used in the treatment of aphthous stomatitis, and in one study, it was used in the treatment of herpes labialis. In all studies, the drug was used topically, both as a hydrogel and as a crushed tablet (along with a prosthetic adhesive). The groups treated with doxycycline showed faster healing of lesions and lower pain scores compared to placebo. WHAT IS NEW AND CONCLUSION The present study suggests that topical doxycycline has a positive effect on the treatment of recurrent aphthous ulceration and herpes labialis. Experimental animal studies and double-blind randomized clinical trials should be performed on other oral lesions, such as traumatic ulcers and mucositis.
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Affiliation(s)
- Marcello Piacentini
- School of Health Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Brazil
| | - Ruchielli Loureiro Borghetti
- School of Health Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Brazil
| | | | - Karen Cherubini
- School of Health Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Brazil
| | - Fernanda Gonçalves Salum
- School of Health Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul-PUCRS, Porto Alegre, Brazil
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21
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Mahmoud EA, Moneim WA, Shaker OG, Ghalwash DM. Expression of endocan and vascular endothelial growth factor in recurrent minor aphthous ulcers. J Clin Exp Dent 2019; 11:e534-e541. [PMID: 31346373 PMCID: PMC6645254 DOI: 10.4317/jced.55695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/25/2019] [Indexed: 11/28/2022] Open
Abstract
Background Recurrent aphthous ulcers (RAU) are common painful inflammatory lesions of the mucous lining of the mouth. Endocan, previously identified as endothelial cell specific molecule-1, is implicated as a vital player in the regulation of several inflammatory processes. A number of inflammatory cytokines and pro-angiogenic growth factors including VEGF upregulate endothelial cells synthesis and expression of endocan. Material and Methods Clinical scores of pain and ulcer size as well as level of endocan and VEGF were determined in swaps from aphthous ulcer and contra lateral normal mucosa in 30 patients (nine males and twenty one females) with age ranging from 18 to 45 years and mean age is 31.5 years. Results In the early days of ulcer development, ulcer showed statistically significantly higher mean endocan (8.2 ±5.3) and VEGF levels (1220.7 ±294.6) than control healthy mucosal site (1.1 ±0.5) and (518.6 ± 61.7) respectively. An increase in endocan is associated with an increase in pain score and vice versa. A statistically significant positive correlation were also found between endocan and VEGF levels. Conclusions Endocan and VEGF are strongly associated with the destructive phase of minor aphthous ulcers especially Endocan which was positively correlated with pain severity. Key words:Endocan, ESM-1, VEGF, Recurrent Apthous Ulcer.
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Affiliation(s)
- Enji A Mahmoud
- Associate professor in Department of Oral Medicine and Periodontology, Faculty of dentistry, Cairo University
| | - Wesam-Abdel Moneim
- Associate professor in Department of Oral Medicine and Periodontology, Faculty of dentistry, Cairo University
| | - Olfat G Shaker
- Professor in Department of Biochemistry, Faculty of Medicine, Cairo University
| | - Dalia M Ghalwash
- Associate Professor of Oral Medicine and Periodontology, Faculty of dentistry, The British University in Egypt (BUE), Cairo, Egypt
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22
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Kuriyama Y, Shimizu A, Toki S, Endo Y, Yasuda M, Motegi SI, Ishikawa O. Two cases of chronic oral ulcers effectively treated with systemic corticosteroid therapy: Circumorificial plasmacytosis and traumatic ulcerative granuloma with stromal eosinophilia. J Dermatol 2018; 46:48-51. [DOI: 10.1111/1346-8138.14690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/01/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Yuko Kuriyama
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Akira Shimizu
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Sayaka Toki
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Yukie Endo
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Masahito Yasuda
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Sei-ichiro Motegi
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Osamu Ishikawa
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
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23
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Candida is a protractive factor of chronic oral ulcers among usual outpatients. JAPANESE DENTAL SCIENCE REVIEW 2018; 54:52-58. [PMID: 29755615 PMCID: PMC5944075 DOI: 10.1016/j.jdsr.2017.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/17/2017] [Accepted: 12/09/2017] [Indexed: 11/21/2022] Open
Abstract
Although many oral ulcers have similar clinical appearances, their etiologies can range from reactive to neoplastic to oral manifestations of dermatological diseases. In patients with an HIV infection, fungal diseases may cause ulceration in the oral cavity; however, there have been few studies of oral ulcerative lesions associated with Candida in patients without an HIV infection. Nevertheless, we encountered chronic oral ulcer associated with Candida among our frequent outpatients without an HIV infection. The present article reviews the causes of oral ulcers, focusing on Candida as a protractive factor for chronic oral ulcers, and it is recommended that Candida involvement be considered in diagnosis of a certain chronic oral ulcer, that remains of unknown origin even if some examinations have been performed.
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24
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Aphthous stomatitis. Ann Allergy Asthma Immunol 2017; 117:341-343. [PMID: 27742082 DOI: 10.1016/j.anai.2016.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/29/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022]
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25
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Aterido A, Julià A, Carreira P, Blanco R, López-Longo JJ, Venegas JJP, Olivé À, Andreu JL, Aguirre-Zamorano MÁ, Vela P, Nolla JM, Marenco-de la Fuente JL, Zea A, Pego JM, Freire M, Díez E, López-Lasanta M, López-Corbeto M, Palau N, Tortosa R, Gelpí JL, Absher D, Myers RM, Fernández-Nebro A, Marsal S. Genome-wide pathway analysis identifies VEGF pathway association with oral ulceration in systemic lupus erythematosus. Arthritis Res Ther 2017; 19:138. [PMID: 28619073 PMCID: PMC5471877 DOI: 10.1186/s13075-017-1345-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/22/2017] [Indexed: 02/06/2023] Open
Abstract
Background Systemic lupus erythematosus (SLE) is a genetically complex rheumatic disease characterized by heterogeneous clinical manifestations of unknown etiology. Recent studies have suggested the existence of a genetic basis for SLE heterogeneity. The objective of the present study was to identify new genetic variation associated with the clinically relevant phenotypes in SLE. Methods A two-stage pathway-based approach was used to identify the genetic variation associated with the main clinical phenotypes in SLE. In the discovery stage, 482 SLE patients were genotyped using Illumina Human Quad610 microarrays. Association between 798 reference genetic pathways from the Molecular Signatures Database and 11 SLE phenotypes was tested using the set-based method implemented in PLINK software. Pathways significantly associated after multiple test correction were subsequently tested for replication in an independent cohort of 425 SLE patients. Using an in silico approach, we analyzed the functional effects of common SLE therapies on the replicated genetic pathways. The association of known SLE risk variants with the development of the clinical phenotypes was also analyzed. Results In the discovery stage, we found a significant association between the vascular endothelial growth factor (VEGF) pathway and oral ulceration (P value for false discovery rate (PFDR) < 0.05), and between the negative regulation signaling pathway of retinoic acid inducible gene-I/melanoma differentiation associated gene 5 and the production of antinuclear antibodies (PFDR < 0.05). In the replication stage, we validated the association between the VEGF pathway and oral ulceration. Therapies commonly used to treat mucocutaneous phenotypes in SLE were found to strongly influence VEGF pathway gene expression (P = 4.60e-4 to 5.38e-14). Analysis of known SLE risk loci identified a strong association between PTPN22 and the risk of hematologic disorder and with the development of antinuclear antibodies. Conclusions The present study has identified VEGF genetic pathway association with the risk of oral ulceration in SLE. New therapies targeting the VEGF pathway could be more effective in reducing the severity of this phenotype. These findings represent a first step towards the understanding of the genetic basis of phenotype heterogeneity in SLE. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1345-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adrià Aterido
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, 08005, Spain
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain.
| | - Patricia Carreira
- Rheumatology Department, Hospital Universitario 12 de Octubre, Madrid, 28041, Spain
| | - Ricardo Blanco
- Rheumatology Department, Hospital Universitario Marqués de Valdecilla, Santander, 39008, Spain
| | | | | | - Àlex Olivé
- Rheumatology Department, Hospital Universitari Germans Trias i Pujol, Badalona, 08916, Spain
| | - José Luís Andreu
- Rheumatology Department, Hospital Universitario Puerta de Hierro, Madrid, 28222, Spain
| | | | - Paloma Vela
- Rheumatology Department, Hospital General Universitario de Alicante, Alicante, 03010, Spain
| | - Joan M Nolla
- Rheumatology Department, Hospital Universitari de Bellvitge, Barcelona, 08907, Spain
| | | | - Antonio Zea
- Rheumatology Department, Hospital Universitario Ramón y Cajal, 28034, Madrid, Spain
| | - José María Pego
- Instituto de Investigación Biomédica de Vigo, Ourense y Pontevedra, 36204, Spain
| | - Mercedes Freire
- Rheumatology Department, Hospital Universitario A Coruña, A Coruña, 15006, Spain
| | - Elvira Díez
- Rheumatology Department, Hospital Complejo Asistencial Universitario de León, León, 24001, Spain
| | - María López-Lasanta
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain
| | - Mireia López-Corbeto
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain
| | - Núria Palau
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain
| | - Raül Tortosa
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain
| | - Josep Lluís Gelpí
- Life Sciences, Barcelona Supercomputing Centre, Barcelona, 08034, Spain
| | - Devin Absher
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, 35806, USA
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama, 35806, USA
| | - Antonio Fernández-Nebro
- Rheumatology Department, Hospital Regional Universitario de Málaga, Málaga, 29010, Spain. .,Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, 29010, Spain.
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, 08035, Spain
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Kim J, Song MJ, Jeong HJ, Cho SK, Sung YK. A Case of Refractory Oral Aphthous Ulcer Successfully Treated with Adalimumab. JOURNAL OF RHEUMATIC DISEASES 2017. [DOI: 10.4078/jrd.2017.24.3.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jinyeong Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Myung-jin Song
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hye-Jin Jeong
- Department of Rheumatology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Soo-Kyung Cho
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Yoon-Kyoung Sung
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
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Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. Int J Dent 2016; 2016:7278925. [PMID: 27781066 PMCID: PMC5066016 DOI: 10.1155/2016/7278925] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022] Open
Abstract
Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “oral ulcer,” “stomatitis,” and “mouth diseases.” Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression.
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28
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[Chronic or recurrent ulceration of the tongue]. Ann Dermatol Venereol 2016; 143:297-308; quiz 295-6, 309-10. [PMID: 27038855 DOI: 10.1016/j.annder.2016.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 01/31/2016] [Accepted: 02/04/2016] [Indexed: 11/23/2022]
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29
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Plewes K, Maude RJ, Ghose A, Dondorp AM. Severe falciparum malaria complicated by prolonged haemolysis and rhinomaxillary mucormycosis after parasite clearance: a case report. BMC Infect Dis 2015; 15:555. [PMID: 26634340 PMCID: PMC4669602 DOI: 10.1186/s12879-015-1285-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 11/23/2015] [Indexed: 11/13/2022] Open
Abstract
Background Severe falciparum malaria may be complicated by prolonged haemolysis and recurrent fever after parasite clearance. However, their respective etiologies are unclear and challenging to diagnose. We report the first case of severe falciparum malaria followed by prolonged haemolytic anaemia and rhinomaxillary mucormycosis in a previously healthy adult male. Case presentation A 30-year old Bangladeshi man was admitted with severe falciparum malaria complicated by hyperlactataemia and haemoglobinuria. Prior to admission he was treated with intravenous quinine and upon admission received intravenous artesunate and empiric ceftriaxone. Thirty hours later the peripheral parasitaemia cleared with resolution of fever and haemoglobinuria. Despite parasite clearance, on day 3 the patient developed recurrent fever and acute haemolytic anaemia requiring seven blood transfusions over six days with no improvement of his haemoglobin or haemoglobinuria. On day 10, he was treated with high-dose dexamethasone and meropenem with discontinuation of the ceftriaxone. Two days later the haemoglobinuria resolved. Ceftriaxone-induced haemolysis was the suspected final diagnosis. On day 16, the patient had progressively worsening right-sided facial pain and swelling; a necrotic ulceration of the hard palate was observed. Rhinomaxillary mucormycosis was diagnosed supported by microscopy findings. The patient initially responded to treatment with urgent surgical debridement, itraconazole, followed by two weeks of amphotericin B deoxycholate, however was subsequently lost to follow up. Conclusions This case highlights the range of potential alternative aetiologies of acute, prolonged haemolysis and recurrent fever following parasite clearance in severe falciparum malaria. It emphasizes the importance of a high degree of suspicion for alternative causes of haemolysis in order to avoid unnecessary treatments, including blood transfusion and steroids. It is critical to consider and identify common invasive bacterial and rare opportunistic co-infections as a cause of fever in severe malaria patients remaining febrile after parasite clearance to promote antimicrobial stewardship and prompt emergency care.
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Affiliation(s)
- Katherine Plewes
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Richard J Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
| | - Aniruddha Ghose
- Department of Medicine, Chittagong Medical College Hospital, Chittagong, Bangladesh.
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajvithi Road, Rajthevee, Bangkok, 10400, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
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30
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Dmitrieva LA, Nemeryuk DA, Gerasimova EV, Glibina NA. [Possibility of combined system enzyme therapy and antioxidants in treatment of periodontal and oral mucosa diseases]. STOMATOLOGII︠A︡ 2015; 94:69-72. [PMID: 26171550 DOI: 10.17116/stomat201594269-72] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - D A Nemeryuk
- Moscow State Medical and Dental University, Moscow
| | | | - N A Glibina
- Moscow State Medical and Dental University, Moscow
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Schemel-Suárez M, López-López J, Chimenos-Küstner E. [Oral ulcers: Differential diagnosis and treatment]. Med Clin (Barc) 2015; 145:499-503. [PMID: 26049962 DOI: 10.1016/j.medcli.2015.04.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 04/22/2015] [Accepted: 04/27/2015] [Indexed: 11/19/2022]
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Use of a nonnarcotic antitussive for severe, treatment-resistant oral ulcers. J Am Acad Dermatol 2015; 72:e159. [DOI: 10.1016/j.jaad.2015.02.1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/21/2022]
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Differenzialdiagnose erosiver und ulzeröser Mundschleimhauterkrankungen im Kindesalter. Hautarzt 2015; 66:258-66. [DOI: 10.1007/s00105-015-3601-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Chiewchengchol D, Murphy R, Edwards SW, Beresford MW. Mucocutaneous manifestations in juvenile-onset systemic lupus erythematosus: a review of literature. Pediatr Rheumatol Online J 2015; 13:1. [PMID: 25587243 PMCID: PMC4292833 DOI: 10.1186/1546-0096-13-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/21/2014] [Indexed: 02/04/2023] Open
Abstract
Patients diagnosed with juvenile-onset systemic lupus erythematosus (JSLE) often have skin and oral lesions as part of their presentation. These mucocutaneous lesions, as defined by the American College of Rheumatology (ACR) in 1997, include malar rash, discoid rash, photosensitivity and oral ulcers. It is therefore essential to recognize mucocutaneous lesions to accurately diagnose JSLE. The mucocutaneous lesions can be divided into those with classical histological features (LE specific) and those strongly associated with and forming part of the diagnostic spectrum, but without the classical histological changes of lupus (LE nonspecific). A malar rash is the most commonly associated LE specific dermatological presentation. This skin manifestation is an acute form and also correlates with disease activity. Subacute (polycyclic or papulosquamous lesions) and chronic (discoid lesions) forms, whilst showing classical histological changes supportive of lupus, are less commonly associated with systemic lupus and do not correlate with disease activity. The most commonly associated skin lesions without classical lupus changes are cutaneous vasculitis, oral ulcers and diffuse non-scarring alopecia. These signs frequently relate to disease activity. An understanding of cutaneous signs and symptoms of lupus in children is important to avoid delay in diagnosis. They will often improve as lupus is adequately controlled and their reappearance is often the first indicator of a disease flare.
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Affiliation(s)
- Direkrit Chiewchengchol
- />Institute of Translational Medicine, Alder Hey Children’s NHS Foundation Trust, University of Liverpool, Liverpool, UK
- />Institute of Integrative Biology, University of Liverpool, Liverpool, UK
- />Immunology Unit & Center of Excellence in Immunology and Immune-mediated Disease, Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ruth Murphy
- />Department of Dermatology, Queens Medical Centre, Nottingham University Teaching Hospitals, Nottingham, UK
| | - Steven W Edwards
- />Institute of Integrative Biology, University of Liverpool, Liverpool, UK
| | - Michael W Beresford
- />Institute of Translational Medicine, Alder Hey Children’s NHS Foundation Trust, University of Liverpool, Liverpool, UK
- />Department of Women’s and Children’s Health, Institute of Translational Medicine, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, L12 2AP UK
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Abstract
Palatal ulcers are a common presentation and can be conveniently divided into developmental and acquired causes, the latter of which is subdivided into acute and chronic causes. Most commonly seen dermatologic causes have associated skin manifestations. Acute and multiple ulcers are usually infectious or drug induced in origin. Recurrent ulcers are largely dominated by aphthosis, while chronic ulcers are seen in immunocompromised patients and can occasionally be malignant. It is essential to involve the oral and maxillofacial surgeons early in the therapeutic management to tackle the inevitable complications that may ensue in the chronic cases.
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Affiliation(s)
- Kabir Sardana
- Department of Dermatology Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
| | - Shuchi Bansal
- Department of Dermatology Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Abenavoli L, Proietti I, Zaccone V, Gasbarrini G, Addolorato G. Celiac disease: from gluten to skin. Expert Rev Clin Immunol 2014; 5:789-800. [DOI: 10.1586/eci.09.46] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Use of endoscopy with narrow-band imaging system in detecting squamous cell carcinoma in oral chronic non-healing ulcers. Clin Oral Investig 2013; 18:949-59. [PMID: 23835583 DOI: 10.1007/s00784-013-1027-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/26/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVES This study seeks to analyze the factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers for more than 3 weeks and investigate the role of endoscopy with narrow-band imaging system (NBI) in detecting carcinoma in these lesions. METHODS The demographic and clinicopathological data of patients receiving surgical interventions for chronic oral non-healing ulcers, and the intraepithelial papillary capillary loop patterns shown by NBI were retrospectively reviewed and analyzed. RESULTS A total of 63 patients (41 males and 22 females) with mean age of 57.9 ± 16.7 years were enrolled. In univariate analysis, ulcers with induration, history of oral cancer, and intraepithelial microvasculature of NBI were factors associated with the occurrence of squamous cell carcinoma in oral non-healing ulcers. Multivariate analysis showed that the intraepithelial microvasculature of NBI was the only independent factor predicting the occurrence of carcinoma in oral chronic non-healing ulcers with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 93.75 %, 91.49 %, 78.95 %, 97.73 %, and 92.06 %, respectively. CONCLUSIONS Morphology of intraepithelial microvasculature of NBI, or twisted, elongated, and destructive pattern of intraepithelial papillary capillary loop, is the only independent factor associated with the occurrence of squamous cell carcinoma in oral chronic non-healing ulcers. Endoscope with NBI is a rapid, safe, and promising tool in detecting squamous cell carcinoma in oral chronic non-healing ulcers.
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Mays JW, Sarmadi M, Moutsopoulos NM. Oral manifestations of systemic autoimmune and inflammatory diseases: diagnosis and clinical management. J Evid Based Dent Pract 2013; 12:265-82. [PMID: 23040353 DOI: 10.1016/s1532-3382(12)70051-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
CONTEXT Systemic autoimmune and inflammatory diseases often manifest oral lesions in their earliest stages, and early diagnosis, which may be spurred by a dental examination, is key for improved outcomes. After systemic diagnosis, oral lesions benefit from specialized care by dentists in collaboration with the medical team. This review aims to educate dental clinicians about the most relevant systemic autoimmune and inflammatory conditions with accompanying oral lesions, their implications for health, and management strategies supported by the biomedical literature and clinical experience. Ulcerative conditions including Behcet and Crohn diseases are discussed, along with rheumatic conditions including Sjögren syndrome, lupus erythematosus, and rheumatoid arthritis. EVIDENCE ACQUISITION Evidence was accumulated through PubMed searches using pertinent keywords for each subsection. References were reviewed and original publications examined to verify the accuracy of the information. We focused on evidence included in current reviews and randomized trials. Recommendations were supported by multiple studies and consensus expert opinion. EVIDENCE SYNTHESIS Disease phenotypes described and clinical recommendations were synthesized from best-quality evidence available for each disease. Efforts were made to describe evidence selection within each disease section. CONCLUSIONS Dentists play an important role in the early detection and multidisciplinary medical management of complex autoimmune diseases. It is important to recognize prevalent medical and dental issues and special needs of patients with autoimmune conditions. The management of many inflammatory conditions is similar, and often begins with the use of topical steroids, analgesics, and antimicrobial treatments, in addition to careful attention to oral hygiene and appropriate fluoride usage. In this brief review, we aim to discuss the presentation/prevalence, diagnosis, and treatment of oral manifestations encountered in autoimmune, autoinflammatory and systemic chronic inflammatory diseases. Systemic autoimmune conditions are estimated to affect 5% to 8% of Americans.(1) Oral manifestations are encountered with high frequency, and are often the first clinical signs or symptoms of the general disease. Optimal management of complex autoimmune diseases requires a multidisciplinary medical team including dentists to care for lesions of the oral cavity. The dental practitioner may be asked to play a primary role in the diagnosis of such conditions and to participate with other health professionals working together to achieve effective clinical management. To aid in this process, we discuss in this article the current general knowledge of systemic autoimmune conditions that present with prevalent oral manifestations. The focus is on the diagnosis and management of the oral component of each disease. Importantly, whereas the etiology and pathogenesis and systemic clinical presentation may vary, presentation in the oral cavity is often similar and many conditions involve oral ulcerations. For this reason, we discuss the differential diagnosis and management of the most common oral ulcerations in a general section and subsequently address individual conditions that present with oral ulcerations. Similarly, treatment of various autoimmune/inflammatory oral conditions is often common and involves modulation or suppression of the immune response locally and/or systemically and will be therefore addressed in a common section as well as individually for each disease when unique treatment regimens are recommended. We present here our general treatment recommendations based on clinical experience and literature review; however, it is critical that good clinical judgment and specifics of an individual case should determine the appropriate dental/oral medicine intervention for a specific patient.
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Affiliation(s)
- Jacqueline W Mays
- Clinical Research Core, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
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Jinbu Y, Sase M, Kashimura K, Itoh H, Kusama M. Oral ulceration due to a dipeptidyl peptidase-4 inhibitor (sitagliptin): Report of a case. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2013. [DOI: 10.1016/j.ajoms.2012.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Maiti GP, Ghosh A, Chatterjee R, Roy A, Sharp TV, Roychoudhury S, Panda CK. Reduced Expression of Limd1 in Ulcerative Oral Epithelium Associated with Tobacco and Areca Nut. Asian Pac J Cancer Prev 2012; 13:4341-6. [DOI: 10.7314/apjcp.2012.13.9.4341] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Immunological diseases of buccal localisation]. Med Clin (Barc) 2012; 140:88-92. [PMID: 22989674 DOI: 10.1016/j.medcli.2012.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/04/2012] [Accepted: 06/14/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Martin SS, Alaminos M, Zorn TMT, Sánchez-Quevedo MC, Garzón I, Rodriguez IA, Campos A. The effects of fibrin and fibrin-agarose on the extracellular matrix profile of bioengineered oral mucosa. J Tissue Eng Regen Med 2011; 7:10-9. [DOI: 10.1002/term.490] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 02/08/2011] [Accepted: 07/12/2011] [Indexed: 12/18/2022]
Affiliation(s)
| | - M. Alaminos
- Department of Histology; University of Granada; Granada; Spain
| | - T. M. T. Zorn
- Institute of Biomedical Sciences; University of Sao Paulo; Sao Paulo; Brazil
| | | | - I. Garzón
- Department of Histology; University of Granada; Granada; Spain
| | | | - A. Campos
- Department of Histology; University of Granada; Granada; Spain
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Nicorandil-induced tongue ulceration with or without fungal infection. Odontology 2011; 100:100-3. [DOI: 10.1007/s10266-011-0015-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 12/12/2010] [Indexed: 10/18/2022]
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Gammon BL, Gleason BC, Thomas AB, Cibull TL. Sarcomatoid renal cell carcinoma presenting in the oropharynx. J Cutan Pathol 2011; 37:1255-8. [PMID: 20590964 DOI: 10.1111/j.1600-0560.2010.01578.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Metastasis stemming from a distant malignancy is far less common than an oropharyngeal primary and represents only 1% of all oral neoplasms. The difficulty in diagnosing a metastasis in the oropharynx may be compounded if the lesion is poorly differentiated and bears little resemblance to the primary tumor. We present the case of synchronous metastatic renal cell carcinoma of the mandibular gingiva in a woman with sarcomatoid clear cell renal cell carcinoma. The metastatic lesion was poorly differentiated and lacked expression of the renal cell carcinoma (RCC) antigen. In contrast, PAX-8 staining was strongly positive. This case serves to highlight the diagnostic difficulty posed by poorly differentiated lesions in the oropharynx and reinforces the sensitivity of the cell lineage-specific transcription factor PAX-8 in poorly differentiated RCC.
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Affiliation(s)
- Bryan Leigh Gammon
- Department of Dermatology, Northwestern University, Chicago, IL 60611, USA.
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Compilato D, Cirillo N, Termine N, Kerr AR, Paderni C, Ciavarella D, Campisi G. Long-standing oral ulcers: proposal for a new ‘S-C-D classification system’: Authors’ reply. J Oral Pathol Med 2010. [DOI: 10.1111/j.1600-0714.2010.00891.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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