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Mueller SM, Stoeckle M, Goldust M. Treatment options for oral hairy leucoplakia: A case report. Dermatol Ther 2020; 33:e13425. [DOI: 10.1111/dth.13425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Simon M. Mueller
- Department of Dermatology University Hospital Basel Basel Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology University Hospital Basel Basel Switzerland
| | - Mohamad Goldust
- Department of Dermatology University Hospital Basel Basel Switzerland
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2
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Prasad JL, Bilodeau EA. Oral hairy leukoplakia in patients without HIV: presentation of 2 new cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e151-60. [PMID: 25096885 DOI: 10.1016/j.oooo.2014.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 04/10/2014] [Accepted: 05/04/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We report 2 cases of oral hairy leukoplakia (OHL) in patients without HIV and present a comprehensive review of OHL in HIV-negative individuals. STUDY DESIGN Two cases of non-HIV-associated OHL are described. A PubMed search identified previously reported cases. The attributes of those cases were ascertained. RESULTS OHL was confirmed in both of our cases. Both patients used inhaled steroids for pulmonary disorders, and were found to have depressed levels of immunoglobulin M. Additionally, 76 cases were identified in the literature. The condition occurred in association with various medical conditions, with the majority of patients on immunosuppressant medications (67 of 76). Systemic drugs were implicated most frequently. The condition has also been reported in healthy individuals (6 of 76). CONCLUSIONS Although thought of as an HIV/AIDS-associated condition, OHL can develop in patients without HIV, including healthy individuals. There is a strong correlation between the use of immunosuppressants and development of OHL in these patients.
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Affiliation(s)
- Joanne Leger Prasad
- Clinical Assistant Professor, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
| | - Elizabeth Ann Bilodeau
- Assistant Professor, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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3
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Oliveira WR, Ferreira GN, Rady PL, Festa C, Tyring SK. Epidermodysplasia Verruciformis Associated with Myelodysplastic Syndrome: An Intriguing Association. J Cutan Med Surg 2009; 13:317-20. [DOI: 10.2310/7750.2009.08049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by massive infection with human papillomaviruses (HPVs) and development of skin cancer. Myelodysplastic syndromes (MDSs) are a group of chronic conditions that involve dysplastic hematopoiesis, peripheral blood cytopenias, and a high incidence of progression into leukemia. Methods: We describe the intriguing association of these two premalignant conditions (EV and MDS) in one patient. These diagnoses were confirmed by histopathologic examination and cytogenetic abnormalities of bone marrow cells. Results: The patient presented initially with clinical features typical of EV and impairment of cell-mediated immunity. In the skin lesions, HPVs 23 and 25 were identified by nested polymerase chain reaction. Six years later, he had recurrent episodes of mucosal bleeding with fever, weakness, and fatigue. At this time, severe refractory anemia and neutropenia were observed, and bone marrow smears showed hypercellularity with abnormal dysplastic megakaryocytes. The cytogenetic pattern showed abnormalities involving trisomy of chromosomes 8 and 21. The patient received a diagnosis of the indolent subtype of MDS. Conclusions: Through the observation of our patient and review of the literature, we hypothesized that the pathomechanisms, including the role of oncogenes and cytokines, are connected to the progression to malignancy in these settings.
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Affiliation(s)
- Walmar R. Oliveira
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Gustavo N. Ferreira
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Peter L. Rady
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Cyro Festa
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Stephen K. Tyring
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
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4
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Gröne D, Treudler R, de Villiers EM, Husak R, Orfanos CE, Zouboulis CC. Intravenous cidofovir treatment for recalcitrant warts in the setting of a patient with myelodysplastic syndrome. J Eur Acad Dermatol Venereol 2006; 20:202-5. [PMID: 16441633 DOI: 10.1111/j.1468-3083.2006.01380.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Cidofovir is an acyclic nucleoside phosphonate with broad-spectrum activity against DNA viruses, including human papilloma virus (HPV). However, data on the efficacy of cidofovir in an immunosuppressive setting remain contradictory. We report for the first time on the promotion of the healing of recalcitrant warts in a patient with myelodysplastic syndrome with intravenous cidofovir treatment.
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Affiliation(s)
- D Gröne
- Department of Dermatology, Charité University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
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5
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Porter SR, Scully C, Pedersen A. Recurrent aphthous stomatitis. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 1998; 9:306-21. [PMID: 9715368 DOI: 10.1177/10454411980090030401] [Citation(s) in RCA: 131] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal disorders. Nevertheless, while the clinical characteristics of RAS are well-defined, the precise etiology and pathogenesis of RAS remain unclear. The present article provides a detailed review of the current knowledge of the etiology, pathogenesis, and management of RAS.
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Affiliation(s)
- S R Porter
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, United Kingdom
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6
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Abstract
Human herpesviruses and human papillomaviruses are ubiquitous and may cause an array of oral disease. Herpesviruses are unique because recurrent localized disease occurs after the primary infection. Human papillomaviruses are known for their ability to produce benign epithelial proliferations and increasingly are implicated in the development of oral cancer. This article reviews the pathogenesis of common oral lesions induced by these viruses.
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Affiliation(s)
- C S Miller
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, USA
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7
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Scully C. New aspects of oral viral diseases. CURRENT TOPICS IN PATHOLOGY. ERGEBNISSE DER PATHOLOGIE 1996; 90:29-96. [PMID: 8791748 DOI: 10.1007/978-3-642-80169-3_2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C Scully
- Eastman Dental Institute for Oral HealthCare Sciences, University of London, England
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8
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Abstract
A patient presenting with cutaneous vasculitis was noted to be pancytopenic. Subsequent investigation showed a myelodysplastic syndrome (MDS)--refractory anaemia with excess of blasts. Within 3 months her MDS progressed to acute myeloid leukaemia.
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Affiliation(s)
- B F O'Donnell
- St John's Institute of Dermatology, UMDS, London, UK
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9
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De Kaminsky AR, Kaminsky C, Fernández Blanco G, Lago R, Sánchez G, Basso D, Fernández Alonso G, Meiss R. Hairy leukoplakia in an HIV-seronegative patient. Int J Dermatol 1995; 34:420-4. [PMID: 7657442 DOI: 10.1111/j.1365-4362.1995.tb04444.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A R De Kaminsky
- Department of Dermatology, Hospital Tornú, University of Buenos Aires, School of Medicine, Argentina
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10
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Briskin KB, Kerner MM, Calcaterra TC. Squamous papillomas of the nasopharynx treated by a uvulopalatopharyngoplasty approach. Am J Otolaryngol 1994; 15:379-82. [PMID: 7978042 DOI: 10.1016/0196-0709(94)90138-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- K B Briskin
- Division of Head and Neck Surgery, University of California Los Angeles School of Medicine
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11
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Porter SR, Scully C. Gingival and oral mucosal ulceration associated with the myelodysplastic syndrome. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1994; 30B:346-50. [PMID: 7703805 DOI: 10.1016/0964-1955(94)90037-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- S R Porter
- Eastman Dental Institute for Oral and Dental Healthcare Sciences, London, U.K
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12
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Labandeira J, Peteiro C, Toribio J. Hairy leucoplakia and HIV-2--a case report and review of the literature. Clin Exp Dermatol 1994; 19:335-40. [PMID: 7955479 DOI: 10.1111/j.1365-2230.1994.tb01209.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Type 2 human immunodeficiency virus (HIV-2), originally confined to West Africa, has lately appeared with increasing frequency in Europe. Oral lesions affect a large proportion of patients with AIDS. Hairy leucoplakia (HL), a clinical expression of Epstein-Barr virus (EBV), is a lesion of the oral mucosa (usually the lateral margin of the tongue) that is observed in patients who are immunocompromised due to HIV or, more rarely, due to immunosuppressive medication or other causes. We review the definition, clinical signs, histopathology, diagnosis, prognosis and treatment of HL, and report the (to our knowledge) first detailed description of an HIV-2-seropositive patient with HL, which affected the lateral and dorsal tongue and was the first clinical sign of HIV infection (this patient was at that time only the second native Spaniard in whom unique HIV-2 infection had been detected). EBV detection and subtyping by in situ hybridization and polymerase chain reaction were performed in paraffin-embedded tissue from the HL lesion of the dorsal tongue; EBV-1 and EBV-2 were detected by the latter technique.
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Affiliation(s)
- J Labandeira
- Department of Dermatology, General Hospital of Galicia, Faculty of Medicine, Santiago de Compostela, Spain
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13
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Ficarra G, Romagnoli P, Piluso S, Milo D, Adler-Storthz K. Hairy leukoplakia with involvement of the buccal mucosa. J Am Acad Dermatol 1992; 27:855-8. [PMID: 1469145 DOI: 10.1016/0190-9622(92)70266-i] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral hairy leukoplakia occurs mainly on the tongue of human immunodeficiency virus (HIV)-infected persons. An HIV-infected patient with hairy leukoplakia involving the tongue and buccal mucosa was studied by light and electron microscopic methods, in situ hybridization, and polymerase chain reaction. Our findings indicate that hairy leukoplakia may involve the buccal mucosa and should be considered in the differential diagnosis of white oral lesions in HIV-positive patients. Epstein-Barr virus particles were found in the epithelial cells of both buccal and tongue mucosa.
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Affiliation(s)
- G Ficarra
- Department of Human Anatomy and Histology, University of Florence, Italy
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14
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Ficarra G, Shillitoe EJ. HIV-related infections of the oral cavity. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 1992; 3:207-31. [PMID: 1571472 DOI: 10.1177/10454411920030030301] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral infections are among the first manifestations of infection by the human immunodeficiency virus (HIV). They include fungal, viral, and bacterial infections and range from being essentially trivial, through troublesome to life threatening. Although some infections are due to overproliferation of the normal oral flora, others are due to organisms that normally are not found in the mouth. The clinical features of many of these infections have now been characterized, and clinical trials have indicated the optimal management. However, for many infections, the underlying processes are still not clear, and improvements in treatment are necessary.
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Affiliation(s)
- G Ficarra
- Institute of Odontology and Stomatology, University of Florence, Italy
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15
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Adler-Storthz K, Ficarra G, Woods KV, Gaglioti D, DiPietro M, Shillitoe EJ. Prevalence of Epstein-Barr virus and human papillomavirus in oral mucosa of HIV-infected patients. J Oral Pathol Med 1992; 21:164-70. [PMID: 1318379 DOI: 10.1111/j.1600-0714.1992.tb00095.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Epstein-Barr virus (EBV) has been implicated in the genesis of oral hairy leukoplakia (OHL). Initially, OHL was also associated with human papillomavirus (HPV) as evidenced by staining with antiserum to papillomavirus common structural antigens and reports of two HPV-positive OHL as detected by in situ DNA hybridization. The aims of this study were to determine the prevalence of EBV and HPV DNA in OHL and normal oral mucosa and to explain the basis for the staining of OHL tissues with antibodies to papillomavirus common structural antigens. EBV DNA was detected by in situ hybridization in 47 of 47 cases of OHL from human immunodeficiency virus (HIV)-seropositive individuals and in 1 of 10 biopsies of clinically normal buccal mucosa from the same group of individuals. Twenty-five of 35 OHL specimens stained with antibody to papillomavirus common structural antigens. There was no staining of two EBV-containing lymphoblastoid lines, indicating that the staining with anti-papillomavirus antibody was not due to antigenic cross-reactivity with EBV antigens. HPV DNA was detected by polymerase chain reaction amplification in 10 of 18 OHL specimens and in 6 of 10 normal buccal mucosa specimens. Our results indicate that EBV and HPV are present frequently in OHL and that HPV can be found regularly in histologically normal mucosa.
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Affiliation(s)
- K Adler-Storthz
- Department of Microbiology, University of Texas Dental Branch, Houston 77225
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