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Kano Y. Black Tongue Discoloration. JAMA 2023:2805120. [PMID: 37171814 DOI: 10.1001/jama.2023.5894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
An 80-year-old man developed asymptomatic black discoloration of the dorsal surface of his tongue 1 week after hospitalization for surgical and antibiotic treatment of septic arthritis of the shoulder. He reported no prior lingual discoloration and did not smoke cigarettes, use chewing tobacco or illicit drugs, or drink alcohol. What is the diagnosis and what would you do next?
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Affiliation(s)
- Yasuhiro Kano
- Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
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Hamrah MH, Baghalian A, Ghadimi S, Mokhtari S, Kargar M, Khosrozadeh M, Dahi T, Charkazi A, Hamrah MS, Hamrah MH. The Prevalence and Correlates of Fissured Tongue Among Outpatients in Andkhoy City, Afghanistan: A Cross-Sectional Study. Clin Cosmet Investig Dent 2021; 13:335-342. [PMID: 34345186 PMCID: PMC8325757 DOI: 10.2147/ccide.s323428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/15/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Fissured tongue is a common manifestation of the tongue, marked by the presence of multiple prominent grooves or fissures on the dorsal surface of the tongue. However, there is a lack of studies focusing on the prevalence and factors associated with fissured tongue among patients attending an outpatient clinic in Afghanistan. AIM The purpose of the current study was to determine the prevalence and factors associated with fissured tongue and its effects on the general health of adult outpatients in Afghanistan. PATIENTS AND METHODS The cross-sectional survey was conducted among outpatient populations in Andkhoy City, Afghanistan, between September 2019 and December 2019. A convenience technique was applied by including 1182 patient aged 18-80 years. Socio-economic status, smoking, nass use (smokeless tobacco use) and medical data were collected using face-to-face interviews. We used logistic regression analysis to identify factors associated with fissured tongue. A convenience technique was applied by including patient aged 18-80 years. RESULTS The studied population consisted of 1182 participants, of whom 573 (48.5%) were males and 609 (51.5%) females. The prevalence of fissured tongue was 27.2% (95% CI: 24.7-29.9%) with males having significantly higher prevalence than females (47.5%, 95% CI: 43.3-51.6% versus 8.2%, 95% CI: 6.2-10.7%, p<0.001). Male participants (OR=7.1, 95% CI: 4.8-10.3), diabetes mellitus (OR=1.6, 95% CI: 1.1-2.3) and smokeless tobacco use (OR=12.0, 95% CI: 8.1-17.6) were the only variables independently associated with fissured tongue. CONCLUSION This study suggested that there was a high rate of fissured tongue among an outpatient clinic in Andkhoy, Afghanistan. Male gender, diabetes mellitus, and nass consumption were associated with fissured tongue. Therefore, these factors might usefully be targeted in local health promotion, prevention and early intervention programs.
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Affiliation(s)
- Mohammad Hassan Hamrah
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Curative Clinic, Andkoy, Faryab, Afghanistan
| | - Ali Baghalian
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Ghadimi
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeedeh Mokhtari
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mojgan Kargar
- Department of Paediatric Dentistry, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Khosrozadeh
- Department of Paediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Toba Dahi
- Abant Izzet Baysal University Faculty of Dentistry, Bolu, Turkey
| | - Abdurrahman Charkazi
- Health Education and Promotion, Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
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Olejnik M, Osmola-Mańkowska A, Ślebioda Z, Adamski Z, Dorocka-Bobkowska B. Oral mucosal lesions in psoriatic patients based on disease severity and treatment approach. J Oral Pathol Med 2020; 49:822-828. [PMID: 33245622 DOI: 10.1111/jop.13095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/12/2020] [Accepted: 07/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND This observational case-control study was designed to investigate the frequency of oral lesions in psoriatic patients and to identify an association between mucosal involvement, the severity of the disease, and a form of treatment. METHODS One hundred twenty-seven patients diagnosed with psoriasis were enrolled in this study from November 2018 to September 2019. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions. All patients completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The severity of skin involvement was assessed using the Psoriasis Area and Severity Index (PASI) scale. RESULTS The most common oral lesions in patients with psoriasis were found to be fissured (FT), white coated (CT), and geographic tongue (GT). A significantly lower prevalence of GT was evident in the group managed with a new class of biological drugs and smokers. There appeared to be no association between the oral manifestation and the PASI score. FT appeared significantly more often in patients that experienced an extremely large effect of psoriasis on their quality of life as determined by the DLQI questionnaire and smokers. Only 25% of patients presented normal oral mucosa. CONCLUSIONS Tongue lesions seem to be associated with skin psoriasis regardless of the treatment. The severity of the disease, according to the PASI scale, does not influence mucosal involvement. The type of treatment may affect the prevalence of oral lesions. Further investigations are required to confirm the influence of biological therapies on mucosal improvement.
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Affiliation(s)
- Maria Olejnik
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Zuzanna Ślebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Zygmunt Adamski
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
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Hallikeri K, Naikmasur V, Guttal K, Shodan M, Chennappa NK. Prevalence of oral mucosal lesions among smokeless tobacco usage: A cross-sectional study. Indian J Cancer 2019; 55:404-409. [PMID: 30829279 DOI: 10.4103/ijc.ijc_178_18] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Tobacco use is one of the most prevalent forms of habit and associated with development of potential malignant disorders. The aim of the present study was to investigate the prevalence and distribution of oral mucosal lesions (OMLs) among smokeless tobacco users. MATERIALS AND METHODS This is a hospital-based cross-sectional study. All the patients with the history of smokeless tobacco habit were included in the study. The patients were interviewed using the preformed questionnaire, including the patient's demographic details, the type of habit, duration, frequency, and the associated oral mucosal pathology. Further, patients were clinically examined and recorded on tobacco-related oral lesions. RESULTS Prevalence of OML was 54.18%, and 91.50% being among male and with higher frequency at the age of second and fourth decade. The prevalence of oral submucous fibrosis, leukoplakia, carcinoma, lichen planus, and erythroplakia was 26.95, 10.35, 9.94, 5.5, and 0.66%, respectively. Smokeless tobacco habit was prevailing among males (98.79%) compared to females (9.37%). Frequency of habit-associated OML was statistically significant with odds ratio 0.24. CONCLUSION The study proves a definite association between smokeless tobacco habit and OML. The data necessitate to correlate and follow up the individuals with smokeless form of tobacco habits to establish the definite correlation between the habit and oral mucosal lesions.
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Affiliation(s)
- Kaveri Hallikeri
- Department of Oral Pathology and Microbiology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
| | - Venktesh Naikmasur
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
| | - Kruthika Guttal
- Department of Oral Medicine and Radiology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
| | - Mangalore Shodan
- Department of Community, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
| | - Niranjan Kochli Chennappa
- Department of Oral Pathology and Microbiology, SDM College of Dental Sciences and Hospital, Sattur, Dharwad, Karnataka, India
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Schlager E, St Claire C, Ashack K, Khachemoune A. Black Hairy Tongue: Predisposing Factors, Diagnosis, and Treatment. Am J Clin Dermatol 2017; 18:563-569. [PMID: 28247090 DOI: 10.1007/s40257-017-0268-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Black hairy tongue (BHT) is a benign condition commonly found among people who smoke, have poor oral hygiene, are immunocompromised, or have a medical condition limiting their ability to practice good oral hygiene. Though this condition is harmless, patients need to be educated on etiology as many common medications are associated with this condition. Patients being placed on certain antibiotics or antipsychotics should be educated on the importance of good oral hygiene or cessation of habits that promote BHT. Similarly, those with medical conditions increasing the risk for the development of BHT should schedule routine visits with their dentist or dental hygienist. Prognosis is good, and treatment consists of gentle brushing of the tongue, but many anecdotal reports exist demonstrating the use of medications or other products to treat this condition. This review addresses the epidemiology, clinical presentation, pathophysiology, etiology, histology, differential diagnosis, and treatment of BHT and lists all of the medications reported to cause this condition.
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Affiliation(s)
- Emma Schlager
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Chelsea St Claire
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Kurt Ashack
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, 800 Poly Place, Brooklyn, NY, 11209, USA.
- SUNY Downstate, Department of Dermatology, Brooklyn, NY, USA.
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korkut Y, dizen namdar N. Siyah kıllı dil: vaka serisi. FAMILY PRACTICE AND PALLIATIVE CARE 2017. [DOI: 10.22391/920.283319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Najafi S, Gholizadeh N, Akhavan Rezayat E, Kharrazifard MJ. Treatment of Symptomatic Geographic Tongue with Triamcinolone Acetonide Alone and in Combination with Retinoic Acid: A Randomized Clinical Trial. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2016; 13:23-8. [PMID: 27536325 PMCID: PMC4983562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Geographic tongue or migratory glossitis is an inflammatory disorder with unknown etiology. Considering the accompanied burning pain, taste dysfunction, and lack of definite cure, it is important to treat this condition symptomatically. The objective of the current study was to compare the efficacy of a combination of 0.05% retinoic acid and 0.1% triamcinolone acetonide with that of triamcinolone acetonide alone for treatment of symptomatic geographic tongue. MATERIALS AND METHODS This randomized controlled double-blind clinical trial was performed on 28 patients with symptomatic geographic tongue, who were referred to two dental clinics. Participants were randomly divided into two groups and treated with triamcinolone alone or retinoic acid plus triamcinolone for 10 days. Patients were assessed for the level of pain, burning sensation and size of lesion at the beginning and at the end of the study. Participants were followed up for two months after cessation of treatment (at the end of each month). SPSS 11 was applied to compare the two therapeutic modalities. RESULTS Twenty-eight participants with a mean age of 40 years were evaluated including Seven (25%) males and 21(75%) females. There was a positive family history of geographic tongue in 21 patients. Despite the diminished pain and burning sensation as well as smaller size of lesions following treatment (P<0.05), no statistically significant differences were found between the two groups (P> 0.05). No side effect was reported. CONCLUSIONS The combination of triamcinolone and retinoic acid was not more effective than triamcinolone alone for symptomatic treatment of geographic tongue.
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Affiliation(s)
- Shamsoulmolouk Najafi
- Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral Medicine, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran, Iran,Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Gholizadeh
- Assistant Professor, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Oral and Maxillofacial Disease, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: N. Gholizadeh, Department of Oral and Maxillofacial Disease, Dental Research Center, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,
| | | | - Mohammad Javad Kharrazifard
- Statistical Consultant, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Williams M, Hatipoglu B. Development of Abnormal Pigmentation of the Oral Mucosa Following Adjuvant Radioactive Iodine Treatment. AACE Clin Case Rep 2016. [DOI: 10.4158/ep15670.cr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Newer Classification System for Fissured Tongue: An Epidemiological Approach. J Trop Med 2015; 2015:262079. [PMID: 26457087 PMCID: PMC4592719 DOI: 10.1155/2015/262079] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 09/01/2015] [Indexed: 11/18/2022] Open
Abstract
Introduction. Fissured tongue is a commonly encountered tongue disorder in dental practice. But there is a lack of data on different pattern, severity, and association of fissuring with various systemic disorders and other tongue anomalies. This study attempts to establish a classification system for fissured tongue and to know the correlation with the systemic health and other disorders of the tongue. Materials and Methods. A total of 1000 subjects between the age groups of 10 and 80 years were included in the study. Pattern of fissuring, allied systemic diseases, and related tongue anomalies were tabulated. Results. Out of 1000 subjects, 387 subjects presented with fissured tongue. Out of 387 subjects, hypertension was present in 57 cases, 18 subjects had diabetes, and 3 subjects had both hypertension and diabetes. Central longitudinal type was found to be the most common type of tongue fissuring. Conclusion. Fissured tongue has been found to be associated with certain systemic disease and further researches are required to know positive correlation. If a correlation exists, such disorders could be diagnosed earlier by identifying fissured tongue at an earlier age.
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Al-Maweri SA, Al-Jamaei AA, Al-Sufyani GA, Tarakji B, Shugaa-Addin B. Oral mucosal lesions in elderly dental patients in Sana'a, Yemen. J Int Soc Prev Community Dent 2015; 5:S12-9. [PMID: 25984462 PMCID: PMC4428014 DOI: 10.4103/2231-0762.156152] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES With aging, the oral mucosa becomes more susceptible to external stimuli. The aims of this study were to obtain baseline data on the prevalence of oral mucosal lesions (OMLs) in a population of elderly Yemeni patients and to investigate differences in the presentation of these findings in relation to age, gender, education level, and the wearing of dentures. PATIENTS AND METHODS The prevalence of OMLs was assessed by clinical examination of a sample of 310 elderly Yemeni patients aged 60 years and older. A single examiner performed detailed oral examinations of the oral cavity according to international criteria and the World Health Organization codes. RESULTS The overall prevalence of OMLs was 77.1%, with a significant difference (P < 0.05) between men (80.3%) and women (69.6%). The prevalence rate of OMLs indicated a significant decrease with advancing age. The most frequently observed lesions were fissured tongue (34.2%), benign tumors (17.1%), hairy tongue (16.5%), and qat-induced white lesions (12.6%). Hairy tongue, qat-induced white lesions, and shammah keratosis were associated with men (P < 0.01, P < 0.05, and P < 0.05, respectively), whereas geographic tongue was associated with women (P < 0.05). The presence of one or more lesions was significantly associated with low education level (P < 0.05). Certain OMLs showed a significant association with smoking and qat chewing (P < 0.05). No association was found between the occurrence of OMLs and denture wearing (P > 0.05). CONCLUSIONS The present study has shown a high prevalence of oral lesions among Yemeni elders.
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Affiliation(s)
- Sadeq Ali Al-Maweri
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | | | | | - Bassel Tarakji
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | - Bassam Shugaa-Addin
- Department of Oral and Maxillofacial Sciences, Al-Farabi Colleges of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
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Almoznino G, Zadik Y, Vered M, Becker T, Yahalom R, Derazne E, Aframian DJ, Czerninski R. Oral and maxillofacial pathologies in young- and middle-aged adults. Oral Dis 2015; 21:493-500. [PMID: 25580799 DOI: 10.1111/odi.12308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 12/05/2014] [Accepted: 12/18/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To evaluate the distribution of oral and maxillofacial pathologies (OMFPs) and its association with patient age in young- and middle-aged adults. METHODS Distribution of histopathologically diagnosed OMFPs (n = 385) treated during 2007-2010 was recorded and the association with patient age was retrospectively analyzed. RESULTS The main diagnostic categories included benign exophytic lesions (45.3%), white benign lesions (13.5%), potentially malignant lesions/disorders (10.1%), intrabony lesions (9.8%), mucosal discoloration (7.8%), benign pigmented lesions (7.3%), chronic trauma/inflammation (3.9%), and oral malignancy (2.1%). Potentially malignant lesions/disorders as a diagnostic category were positively associated with age (OR = 1.07 for 1 year; P < 0.001) and specifically the diagnoses of oral lichen planus (OR = 1.04 for 1 year; P = 0.037) and dysplastic changes (OR = 1.08 for 1 year; P = 0.013) that comprised this category. Pigmented melanocytic lesions were negatively associated with age (OR = 0.94 for 1 year; P = 0.039) as well as benign/reactive exophytic lesions (OR = 0.98 for 1 year; P = 0.038), the latter included the histopathological diagnosis of benign salivary gland pathologies (OR = 0.90 for 1 year; P < 0.001). CONCLUSION This study provided baseline information regarding the distribution OMFPs among young- and middle-aged adults. It is important to highlight the high frequency of potentially malignant lesions/disorders and oral malignancy in young- and middle-aged adults, as these lesions require lifelong follow-up.
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Affiliation(s)
- G Almoznino
- Department of Oral Medicine, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel; Department of Oral Medicine, Oral and Maxillofacial Center, Tel-Hashomer, Medical Corps, Israel Defense Forces, Tel Aviv, Israel
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Babu RA, Chandrashekar P, Kumar KK, Reddy GS, Chandra KLP, Rao V, Reddy B. A study on oral mucosal lesions in 3500 patients with dermatological diseases in South India. Ann Med Health Sci Res 2014; 4:S84-93. [PMID: 25184094 PMCID: PMC4145524 DOI: 10.4103/2141-9248.138019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Oral mucosal lesions that are observed in the dermatological diseases are categorized under mucocutaneous conditions. The oral lesions in dermatological diseases may be the early aspects of the disease manifestation or the most significant clinical appearance or the only sign/and or symptom of such dermatological diseases and occasionally lesions occur simultaneously in the skin as well as mucous membrane. AIM This present study attempts to find out the prevalence of oral mucosal lesions in patients with dermatological diseases. SUBJECTS AND METHODS The study includes 3500 patients who attended out-patient Department of Dermatology. Patients with oral manifestation were subjected for clinical examination in the Department of Oral Pathology. Diagnostic procedures were performed to confirm the clinical oral diagnosis. The results of the study were analyzed by SPSS software version 19.0 (Armonk, NY) and presented as descriptive statistics. Correlation of oral manifestions with their respective dermatological disease was statistically analysed by Pearson's correlation test.(P < 0.05 were considered as statistically significant). RESULTS The prevalence rate of oral mucosal lesions in the present study was 1.8% (65/3500). The most frequent lesions observed were psoriasis 32.3% (21/65), lichen planus 18.4% (12/65), Stevens Johnson Syndrome 18.4% (12/65), pemphigus 10.7% (7/65), toxic epidermal necrolysis 4.6% (3/65), systemic lupus erythematosus 3% (2/65), discoid lupus erythematosus 1.5% (1/65), pemphigoid 1.5% (1/65). Gender distribution in the study population was statistically significant (P < 0.001). Employed and unemployed individuals in the study population were statistically significant (P < 0.001). Pearson's correlation analysis of oral manifestations with their respective dermatological disease showed r = 0.466 and signifies a positive correlation and is statistically significant at the 0.01 level (two-tailed). CONCLUSION The prevalence rate of oral mucosal lesions in patients with dermatological diseases was relatively low. However, predominant oral mucosal lesions observed in the study were autoimmune in origin with a high morbidity and mortality index. Hence, multidisciplinary approach will definitely help in the prognosis of patients.
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Affiliation(s)
- Rs Arvind Babu
- Dentistry Programme, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica, West Indies
| | - P Chandrashekar
- Department of Oral and Maxillofacial Pathology and Microbiology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K Kiran Kumar
- Department of Oral and Maxillofacial Pathology and Microbiology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - G Sridhar Reddy
- Department of Oral and Maxillofacial Pathology and Microbiology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - K Lalith Prakash Chandra
- Department of Oral and Maxillofacial Pathology and Microbiology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - V Rao
- Department of Dermatology, Venereology and Leprology, Government General Hospital, Guntur, Andhra Pradesh, India
| | - Bvr Reddy
- Department of Oral and Maxillofacial Pathology and Microbiology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
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Gurvits GE, Tan A. Black hairy tongue syndrome. World J Gastroenterol 2014; 20:10845-50. [PMID: 25152586 PMCID: PMC4138463 DOI: 10.3748/wjg.v20.i31.10845] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 03/08/2014] [Accepted: 04/27/2014] [Indexed: 02/07/2023] Open
Abstract
Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient's re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.
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Almeida FT, Gomes RR, Leite AF, Sousa JB, Acevedo AC, Guerra ENS. Oral manifestations of hereditary nonpolyposis colorectal cancer syndrome: a family case series. J Med Case Rep 2014; 8:249. [PMID: 25012300 PMCID: PMC4106215 DOI: 10.1186/1752-1947-8-249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/28/2014] [Indexed: 11/16/2022] Open
Abstract
Introduction Hereditary nonpolyposis colorectal cancer is a colorectal cancer syndrome characterized by the development of colorectal cancer and extracolonic tumors, and this syndrome has an autosomal dominant mode of inheritance. To our knowledge, our study was the first to find dento-osseous anomalies and the second to observe Fordyce granules in a family with individuals with hereditary nonpolyposis colorectal cancer. Case presentations Twenty members of one Brazilian family with individuals with hereditary nonpolyposis colorectal cancer were analyzed according to the presence of colorectal cancer and the occurrence of Fordyce granules and dento-osseous anomalies. Their average age was 29.6 (range 7 to 53 years) years. Medical examinations of this family with hereditary nonpolyposis colorectal cancer were performed at the Coloproctology Division of our hospital. Then, all individuals were referred to our Oral Care Center for Inherited Diseases for intraoral examinations to verify the presence of Fordyce granules. Dental panoramic radiographs were done in order to describe dento-osseous anomalies on applying the Dental Panoramic Radiograph System. Of the 20 family members, four were diagnosed with hereditary nonpolyposis colorectal cancer and all four presented Fordyce granules in their upper lip, but only one of these four patients (Case 2) had a significant dento-osseous anomaly. Conclusions Our familial study verified the presence of Fordyce granules in all individuals diagnosed with hereditary nonpolyposis colorectal cancer, and the presence of significant dento-osseous anomalies in one of these cases. However, the relationship between oral manifestations and hereditary nonpolyposis colorectal cancer should be further investigated.
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Affiliation(s)
| | | | | | | | | | - Eliete Neves Silva Guerra
- Oral Care Center for Inherited Diseases, Division of Dentistry at University Hospital of Brasilia, Faculty of Health Sciences, University of Brasilia (UNB), Brasilia, Brazil.
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Do LG, Spencer AJ, Dost F, Farah CS. Oral mucosal lesions: findings from the Australian National Survey of Adult Oral Health. Aust Dent J 2014; 59:114-20. [PMID: 24494603 DOI: 10.1111/adj.12143] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The prevalence of oral mucosal lesions (OMLs) and factors associated with these has not previously been reported in the Australian population. This study aimed to report on the prevalence of OMLs in Australian adults and to evaluate their association with socio-demographic factors. METHODS This study utilized data from the Australian National Survey of Adult Oral Health 2004-06, which employs a multi-stage, stratified random sample selection procedure. Information on socio-demographics, smoking and presence of OMLs were collected using telephone interview, self-reported questionnaires and comprehensive oral examination. A multivariate regression model was generated to estimate effect of factors on the prevalence of non-ulcerated OMLs. RESULTS A total of 3551 dentate adult Australians had complete data for this analysis. Over 20% of study participants presented with an OML on the day of examination. The prevalence of suspected malignancy was less than 1% and over 17% for non-ulcerated OMLs. Prevalence of non-ulcerated OMLs was associated with age, gender, residential location, household income and smoking. CONCLUSIONS The study reported that epidemiological survey can provide useful information on OMLs. Certain population groups had a higher risk of having the condition. Preventing smoking uptake and smoking cessation can reduce the prevalence of OMLs in the population.
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Affiliation(s)
- L G Do
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia
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Gaballah KY, Rahimi I. Can presence of oral Fordyce's granules serve as a marker for hyperlipidemia? Dent Res J (Isfahan) 2014; 11:553-8. [PMID: 25426145 PMCID: PMC4241607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hyperlipidemia is a well-documented risk factor for coronary heart disease and a great wealth of clinical trials have shown that early detection of hyperlipidemia and prescribing drugs that lower elevated lipid levels reduce serious cardiovascular events, such as myocardial infarction, heart failure and stroke. Fordyce granules (FGs) are sebaceous glands without hair follicles, most often located under the epithelium of the cheek and the vermilion border of lip. The incidence of FGs is typically high and their presence is usually regarded as a normal variation of the oral mucosa. The aim of this study was to investigate the pattern of anatomical distribution and density of FGs and also to explore any potential relationship between the detection of FGs and the state of hyperlipidemia. MATERIALS AND METHODS A cross-sectional, prospective study was designed. The participants were divided into two groups; first group consisted of individuals with FGs and the second group included those with no FGs detected. All participants were fasting 9-12 h before they were subjected to a comprehensive oral examination and their blood was sampled and tested for complete lipid profile. The presence of FGs was scored based on the number of the granules and their anatomical distribution. Chi-square test was used and P < 0.05 was considered as significant. RESULTS A total of 350 patients were recruited for this study, nearly 90% (n = 314) elicit detectable FGs. The FGs were mainly located on the buccal mucosa with or without labial involvement and their density tend to reduce with age and also with smoking. Individuals with elevated lipid profile tend to have the highest score of the FGs. CONCLUSION According to this report, the presence of high numbers of FGs in people with high risk factors for cardiovascular disease should not be neglected.
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Affiliation(s)
- Kamis Y. Gaballah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Ajman University, Ajman, United Arab Emirates,Address for correspondence: Dr. Kamis Y. Gaballah, P.O. Box 5069, Ajman, United Arab Emirates. E-mail:
| | - Iman Rahimi
- Department of Surgical Dentistry, School of Dentistry, Ajman University, Ajman, United Arab Emirates
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Ali M, Joseph B, Sundaram D. Prevalence of oral mucosal lesions in patients of the Kuwait University Dental Center. Saudi Dent J 2013; 25:111-8. [PMID: 24179320 DOI: 10.1016/j.sdentj.2013.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 03/28/2013] [Accepted: 05/25/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine the number, types, and locations of oral mucosal lesions in patients who attended the Admission Clinic at the Kuwait University Dental Center to determine prevalence and risk factors for oral lesions. SUBJECTS AND METHODS Intraoral soft tissue examination was performed on new patients seen between January 2009 and February 2011. The lesions were divided into six major groups: white, red, pigmented, ulcerative, exophytic, and miscellaneous. RESULTS Five hundred thirty patients were screened, out of which 308 (58.1%) had one or more lesions. A total of 570 oral lesions and conditions were identified in this study, of which 272 (47.7%) were white, 25 (4.4%) were red, 114 (20.0%) were pigmented, 21 (3.7%) were ulcerative, 108 (18.9%) were exophytic, and 30 (5.3%) were in the miscellaneous group. Overall, Fordyce granules (n = 116; 20.4%) were the most frequently detected condition. A significantly higher (p < 0.001) percentage of older patients (21-40 years and ⩾41 years) had oral mucosal lesions than those in the ⩽20 years age group. A significantly higher (p < 0.01) percentage of smokers had oral mucosal lesions than did nonsmokers. Most of the lesions and conditions were found on the buccal mucosa and gingiva. CONCLUSIONS White, pigmented, and exophytic lesions were the most common types of oral mucosal lesions found in this study. Although most of these lesions are innocuous, the dentist should be able to recognize and differentiate them from the worrisome lesions, and decide on the appropriate treatment.
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Affiliation(s)
- Mohammad Ali
- Department of Diagnostic Sciences, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait
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18
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Bhatnagar P, Rai S, Bhatnagar G, Kaur M, Goel S, Prabhat M. Prevalence study of oral mucosal lesions, mucosal variants, and treatment required for patients reporting to a dental school in North India: In accordance with WHO guidelines. J Family Community Med 2013; 20:41-8. [PMID: 23723730 PMCID: PMC3663163 DOI: 10.4103/2230-8229.108183] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The aim of the study was to evaluate the prevalence of oral mucosal lesions (OML) in adult patients reporting to the dental outpatient department at the Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India. The purpose was to determine the priorities in oral health education, preventive measures, and identify the group in urgent need of treatment.
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Affiliation(s)
- Puneet Bhatnagar
- Department of Oral Medicine & Radiology, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, Uttar Pradesh, India
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HONARMAND M, FARHAD MOLLASHAHI L, SHIRZAIY M, SEHHATPOUR M. Geographic Tongue and Associated Risk Factors among Iranian Dental Patients. IRANIAN JOURNAL OF PUBLIC HEALTH 2013; 42:215-9. [PMID: 23515238 PMCID: PMC3595651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 12/16/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND Geographic Tongue is a benign disorder involving the dorsal surface of the tongue characterized by depapillated areas with leading and folded edges in yellowish or grayish white color and sometimes with unclear borders. Many studies have reported a relationship between such condition and different risk factors. This study aimed to investigate the prevalence rate and the risk factors of geographic tongue in the patients referring to the Department of Oral Medicine of Zahedan Dental School, in 2012. METHODS Using Poisson regression model, 2000 patients referred to the Department were selected for this cross-sectional study. Data collection method included an investigation into the medical history as well as doing intraoral examinations. Using SPSS 17 software and Chi-square statistical test, the collected data were analyzed. RESULT Among the 2000 patients selected, 7.8% (156 persons) suffered from geographic tongue. The results of our study show that there is a significant relationship between the occurrence of geographic tongue and a history of allergy and fissured tongue (P<0.001). There was no significant statistical relationship between the occurrence of geographic tongue and gender, smoking and medication. CONCLUSION The geographic tongue is more frequently in the patients suffering from atopy or allergy as well as the patients with fissured tongue.
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20
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Zbar AP, Ben-Horin S, Beer-Gabel M, Eliakim R. Oral Crohn's disease: is it a separable disease from orofacial granulomatosis? A review. J Crohns Colitis 2012; 6:135-42. [PMID: 22325167 DOI: 10.1016/j.crohns.2011.07.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 02/08/2023]
Abstract
Symptomatic oral Crohn's disease is comparatively rare. The relationship between orofacial granulomatosis, (where there is granulomatous inflammation and ulceration of the mouth in the absence of gastrointestinal disease) and true oral Crohn's disease is discussed along with the plethora of clinical oral disease presentations associated with both disorders and the differential diagnosis of oral ulceration in patients presenting to a gastroenterological clinic. Specific oral syndromes are outlined including the association between oral manifestations in Crohn's disease and the pattern of intestinal disease and their relationship to other recorded extraintestinal manifestations. The histological and immunological features of oral biopsies are considered as well as the principles of management of symptomatic oral disease. At present, it is suggested that both orofacial granulomatosis and oral Crohn's disease appear to be distinct clinical disorders.
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Affiliation(s)
- Andrew P Zbar
- Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Aviv, Israel.
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21
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Suliman NM, Astrøm AN, Ali RW, Salman H, Johannessen AC. Oral mucosal lesions in skin diseased patients attending a dermatologic clinic: a cross-sectional study in Sudan. BMC Oral Health 2011; 11:24. [PMID: 21929814 PMCID: PMC3187735 DOI: 10.1186/1472-6831-11-24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 09/19/2011] [Indexed: 12/02/2022] Open
Abstract
Background So far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML) in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. Methods A cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females) completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO). Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Cross tabulation and Chi-square with Fisher's exact test were used. Results A total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p < 0.05) skin diseased patients. Thus, a certain number of patients had more than one type of OML. Tongue lesions were the most frequently diagnosed OML (23.3%), followed in descending order by white lesions (19.1%), red and blue lesions (11%) and vesiculobullous diseases (6%). OML in various skin diseases were; vesiculobullous reaction pattern (72.2%), lichenoid reaction pattern (60.5%), infectious lesions (56.5%), psoriasiform reaction pattern (56.7%), and spongiotic reaction pattern (46.8%). Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p < 0.05), in males (63.2% males versus 52.6% females, p < 0.05), patients with a systemic disease (65.2% with systemic versus 51.9% without systemic disease, p < 0.05) and among current users of smokeless tobacco (toombak) (77% current use versus 54.8% no use, p < 0.00). Conclusions OML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination of oral mucosa in a dermatology clinic.
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Affiliation(s)
- Nada M Suliman
- Section for pathology, The Gade Institute, University of Bergen, Bergen, Norway
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Baeder FM, Pelino JEP, de Almeida ER, Duarte DA, Santos MTBR. High-power diode laser use on Fordyce granule excision: a case report. J Cosmet Dermatol 2010; 9:321-4. [PMID: 21122053 DOI: 10.1111/j.1473-2165.2010.00531.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fordyce granules are conventionally considered to be a developmental oral lesion with a higher incidence in men. OBJECTIVE To report a clinical case of surgical lip Fordyce granule excision in a 19-year-old male. METHODS Fordyce granules were excised using a high-power diode laser (gallium arsenide [GaAs], Diode Vision®, MDL, 10 Dental Laser Unit, GmbH, Lower Saxony, Germany) with wavelength emission at 980 ± 10 nm, in a continuous wave mode, pulse width of 0.5 μs, fiber optic delivery system of 400 μm in diameter, at 2.5 W. Subsequently, low-intensity laser therapy was applied (gallium-aluminum-arsenide [GaAlAs], at 670 nm, 50 mW, at 4 J/cm(2); Dentoflex®, São Paulo, Brazil] in order to stimulate a faster wound tissue-healing process and less postoperative pain and inflammation. CONCLUSION The excellent esthetic result demonstrated the effectiveness of both high- and low-intensity laser therapy on the excision of Fordyce granules.
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Abstract
Black hairy tongue (BHT) is a benign, self-limiting disorder characterized by abnormally hypertrophied and elongated filiform papillae on the surface of the tongue. The prevalence of BHT is quite variable, ranging from 0-53.8% depending on the population. Many predisposing factors to BHT exist, and several drugs and drug classes have been implicated in causing this disorder. A modified Naranjo adverse drug reaction probability nomogram specific for BHT was used to rate causality for the available published case reports of drug-induced BHT. From the available data, antibiotics and drugs capable of inducing xerostomia are the drug classes that have modest evidence of causality and a rational mechanism. The presence of underlying predisposing factors in these cases along with the variable prevalence of BHT make drawing firm conclusions difficult. Treatment for BHT involves eliminating any predisposing issues and practicing scrupulous oral hygiene. Drug therapy and physical removal of the elongated filiform papillae are available for resistant cases. Clinicians should be aware of the prevalence, the predisposing factors and drug classes that may play a role in the development, and the treatment of BHT.
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Affiliation(s)
- Dennis F Thompson
- Department of Pharmacy Practice, Southwestern Oklahoma State University, Weatherford, Oklahoma 73103, USA.
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Aghbali A, Pouralibaba F, Eslami H, Pakdel F, Jamali Z. White sponge nevus: a case report. J Dent Res Dent Clin Dent Prospects 2009; 3:70-2. [PMID: 23230487 PMCID: PMC3517290 DOI: 10.5681/joddd.2009.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 04/14/2009] [Indexed: 12/01/2022] Open
Abstract
White sponge nevus (WSN) is a rare hereditary dyskeratotic hyperplasia of mucous membranes. It is an autosomal dominant disorder with variable penetrance. We report a case of WSN in a healthy 21-year-old male with no history of familial involvement. A white smooth plaque with no erythema or other structural abnormalities was observed, which confirmed the diagnosis of WSN histopathologically.
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Affiliation(s)
- Amirala Aghbali
- Assistant Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Firouz Pouralibaba
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Eslami
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzaneh Pakdel
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Jamali
- Post-graduate Student, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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