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Santana T, Nagata G, Saturno JL, Trierveiler M. Histopathological features of photodamage and mast cell infiltrate in actinic cheilitis with different grades of epithelial dysplasia. J Cutan Pathol 2020; 47:592-600. [PMID: 32133685 DOI: 10.1111/cup.13677] [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] [Received: 09/30/2019] [Revised: 02/11/2020] [Accepted: 02/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Actinic cheilitis is induced by chronic exposure to ultraviolet radiation and shows solar elastosis, a feature that has been associated with mast cell infiltrates. This study aimed to investigate the area of solar elastosis, collagen loss, and mast cell infiltrates in a series of actinic cheilitis. METHODS We evaluated the epithelial dysplasia in 52 cases of actinic cheilitis and the solar elastosis with Weigert's resorcin-fuchsin. Collagen loss was evaluated with Picrosirius red, analyzed under polarized microscopy, and scored from 1 to 3. Elastosis proportionate area (EPA) was calculated with image software. Mast cells were highlighted with toluidine blue stain. RESULTS EPA varied from 2% to 45%, with a mean of 17.1% in the cases, with no differences among epithelial dysplasia degrees. Most cases presented collagen loss scores of 2 or 3, and higher loss of type I collagen was associated with older age. Mast cell density was higher in severe epithelial dysplasia (P = 0.002) and in high-risk cases (P = 0.01). CONCLUSION Actinic cheilitis presented variable EPA and marked loss of type I collagen; however, these features were not associated with the degrees of epithelial dysplasia. Besides, mast cell density increased with epithelial dysplasia worsening and this was not associated with elastosis area or collagen loss.
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Affiliation(s)
- Thalita Santana
- Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
| | - Gabriela Nagata
- School of Dentistry, Hermínio Ometto University Center, UNIARARAS, Araras, Brazil
| | - Juvani Lago Saturno
- Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
| | - Marília Trierveiler
- Oral and Maxillofacial Pathology Department, School of Dentistry, University of São Paulo - USP, São Paulo, Brazil
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Gonzaga AKG, de Oliveira PT, da Silveira ÉJD, Queiroz LMG, de Medeiros AMC. Diclofenac sodium gel therapy as an alternative to actinic cheilitis. Clin Oral Investig 2017; 22:1319-1325. [PMID: 28986686 DOI: 10.1007/s00784-017-2237-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/29/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Actinic cheilitis (AC) is a potentially malignant lesion caused by prolonged exposure to ultraviolet light. The aim of this research was to analyze the efficacy of diclofenac sodium 3% gel in the treatment of this condition, through clinical follow-up. METHODS Thirty-one patients diagnosed with AC were instructed to perform a topical application of the gel three times a day for a period of 90 days. In each visit, a digital photography was obtained for verified progress and response to treatment. Two researchers evaluated all images after treatment was completed and assigned the following scores regarding clinical aspect of the lip: 1, complete improvement; 2, partial improvement; 3, no changes; 4, worsening of the clinical condition. In addition, the patients' tolerability to the drug and their satisfaction after treatment were evaluated. RESULTS Twelve cases abandoned the treatment for reasons unrelated to the study. Ten participants showed total remission of all clinical features of the lesion and three had partial improvement of the characteristics. One participant presented worsening of clinical condition, and in five cases, treatment was discontinued due to development of mild adverse effects at the site of gel application. Regarding satisfaction analyses and tolerability to the drug, from 14 patients who completed treatment without adverse effects or complications, most agreed fully that they were satisfied with the therapy (n = 11) and that the drug was not irritating to the mouth (n = 9). Patients are being monitored without clinical signs of recurrence and/or progression of the lesions. CONCLUSION Topical application of the drug has provided a convenient and well tolerated in most cases. CLINICAL RELEVANCE Diclofenac sodium gel (3%) may be a promising alternative for treatment of actinic cheilitis.
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Affiliation(s)
- Amanda Katarinny Goes Gonzaga
- Postgraduate Program in Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, Brazil. .,Department of Dentistry, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN, CEP 59056-000, Brazil.
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Gonzaga AKG, Lopes MLDS, Ribeiro CMD, Aquino ARL, Nonaka CFW, Silveira EJD, Medeiros AMC. Participation of cyclooxygenase-2 in lip carcinogenesis. J Eur Acad Dermatol Venereol 2017; 32:e69-e71. [PMID: 28833615 DOI: 10.1111/jdv.14524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A K G Gonzaga
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - M L D S Lopes
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - C M D Ribeiro
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - A R L Aquino
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - C F W Nonaka
- Department of Dentistry, State University of Paraíba, Campina Grande, ParaÍba, Brazil
| | - E J D Silveira
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - A M C Medeiros
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Rojas IG, Spencer ML, Zapata PA, Martínez A, Alarcón R, Marchesani FJ, Tezal M. CD8+ and FoxP3+ T-cell infiltration in actinic cheilitis. Int J Dermatol 2016; 56:54-62. [PMID: 27778327 DOI: 10.1111/ijd.13446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/11/2016] [Accepted: 07/13/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Differences in immune profile between actinic cheilitis (AC), a precursor of lip squamous cell carcinoma, and normal lip vermillion (NL) have not been elucidated. OBJECTIVES To compare density, distribution, and ratios of CD8+ and FoxP3+ cells between AC and NL and assess their associations with clinicopathologic variables. METHODS Samples of AC and NL obtained between 2001 and 2013 at the College of Dentistry of the University of Concepcion, Chile, were retrospectively analyzed for immunohistochemical detection of CD8+ and FoxP3+ cells. Differences between groups were tested by Mann-Whitney U and Fisher's exact tests. Independent effects of cell densities and CD8/FoxP3 ratio with AC were assessed by multiple logistic regression analysis after adjustment for potential confounding. RESULTS A total of 62 AC and 24 NL biopsies were included. Densities of CD8+ and FoxP3+ cells in AC were significantly higher than in NL. Conversely, the CD8+/FoxP3+ ratio was significantly lower in AC as compared to NL. After adjustment for sun exposure, age, gender, and smoking status, a stromal FoxP3+ cell density higher than 0.35 cells/field was significantly associated with increased odds of AC (odds ratio [OR] = 5.01, 95% confidence interval [CI]: 1.18-21.31), while a stromal CD8+/FoxP3+ ratio higher than 5.91 was associated with decreased odds of AC (OR = 0.29, 95% CI: 0.08-1.08). CONCLUSIONS AC is characterized by increased FoxP3+ cell infiltration and a reduced CD8/FoxP3 ratio as compared to NL. Therefore, increased infiltration of FoxP3+ cells relative to CD8+ cells may contribute to the transition from normal to preneoplastic stages in lip carcinogenesis.
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Affiliation(s)
- Isolde G Rojas
- Department of Oral Surgery, College of Dentistry, University of Concepción, Concepción, Chile.,Department of Periodontics and Endodontics, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Maria L Spencer
- Anatomopathology Section, Regional Hospital of Concepción "Dr. Guillermo Grant Benavente", Concepción, Chile
| | - Paulina A Zapata
- Department of Oral Surgery, College of Dentistry, University of Concepción, Concepción, Chile
| | - Alejandra Martínez
- Department of Oral Pathology, College of Dentistry, University of Concepción, Concepción, Chile
| | - Rosario Alarcón
- Department of Internal Medicine, Dermatology Section, College of Medicine, University of Concepción, Concepción, Chile
| | - Francisco J Marchesani
- Department of Oral Pathology, College of Dentistry, University of Concepción, Concepción, Chile
| | - Mine Tezal
- Department of Oral Biology, School of Dental Medicine, State University of New York at Buffalo, Buffalo, NY, USA
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Correlation between cell cycle proteins and hMSH2 in actinic cheilitis and lip cancer. Arch Dermatol Res 2016; 308:165-71. [PMID: 26842232 DOI: 10.1007/s00403-016-1625-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/14/2015] [Accepted: 01/20/2016] [Indexed: 10/24/2022]
Abstract
This study aims to evaluate and verify the relationship between the immunoexpression of hMSH2, p53 and p21 in actinic cheilitis (AC) and lower lip squamous cell carcinoma (SCC) cases. Forty AC and 40 SCC cases were submitted to immunoperoxidase method and quantitatively analyzed. Expression was compared by Mann-Whitney test, Student t test or one-way ANOVA. To correlate the variables, Pearson's correlation coefficient was calculated. The expression of p53 and p21 showed no significant differences between histopathological grades of AC or lower lip SCC (p > 0.05). Immunoexpression of p53 was higher in SCC than in AC (p < 0.001), while p21 expression was more observed in AC when compared to SCC group (p = 0.006). The AC group revealed an inverse correlation between p53 and hMSH2 expression (r = -0.30, p = 0.006). Alterations in p53 and p21 expression suggest that these proteins are involved in lower lip carcinogenesis. Moreover, p53 and hMSH2 seem to be interrelated in early events of this process.
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Yadav A, Desai RS, Bhuta BA, Singh JS, Mehta R, Nehete AP. Altered immunohistochemical expression of mast cell tryptase and chymase in the pathogenesis of oral submucous fibrosis and malignant transformation of the overlying epithelium. PLoS One 2014; 9:e98719. [PMID: 24874976 PMCID: PMC4038611 DOI: 10.1371/journal.pone.0098719] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/07/2014] [Indexed: 02/06/2023] Open
Abstract
Mast cells (MCs) expressing serine proteases; tryptase and chymase, are associated with fibrosis in various diseases. However, little is known about their involvement in oral submucous fibrosis (OSF). Our goal was to evaluate the role of MC tryptase and chymase in the pathogenesis of OSF and its malignant transformation. Immunohistochemical expression of MC tryptase and chymase was evaluated in 20 cases of OSF, 10 cases of oral squamous cell carcinoma (OSCC) and 10 cases of healthy controls. Subepithelial zone of Stage 1 and 2 while deep zone of Stage 3 and 4 OSF demonstrated increased tryptase positive MCs. OSCC revealed a proportionate increase in tryptase and chymase positive MCs irrespective of areas of distribution. An altered balance in the subepithelial and deep distribution of tryptase and chymase positive MCs play an important role in the pathogenesis of OSF and its malignant transformation.
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Affiliation(s)
- Archana Yadav
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
| | - Rajiv S. Desai
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
- * E-mail:
| | - Bansari A. Bhuta
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
| | - Jatinder S. Singh
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
| | - Reema Mehta
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
| | - Akash P. Nehete
- Department of Oral Pathology, Nair Hospital Dental College, Mumbai, India
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Do laser and led phototherapies influence mast cells and myofibroblasts to produce collagen? Lasers Med Sci 2014; 29:1405-10. [DOI: 10.1007/s10103-014-1537-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/28/2014] [Indexed: 10/25/2022]
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