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Klein B, Ubertalli J, Woo SB. Gingival pigmentation in a 15-year-old female patient. J Am Dent Assoc 2024; 155:788-792. [PMID: 38069963 DOI: 10.1016/j.adaj.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/27/2023] [Accepted: 10/30/2023] [Indexed: 09/07/2024]
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Abati S, Sandri GF, Finotello L, Polizzi E. Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review. Cancers (Basel) 2024; 16:2487. [PMID: 39001549 PMCID: PMC11240708 DOI: 10.3390/cancers16132487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
This paper examines the clinical differentiation of pigmented lesions in the oral mucosa, which poses significant diagnostic challenges across dental and medical disciplines due to their spectrum from benign to potentially malignant conditions. Through a literature review and analysis of clinical cases, this study clarifies current diagnostic methodologies, with an emphasis on differential diagnosis, to provide a practical guide for clinicians. The classification of pigmented lesions, such as endogenous, focal melanocytic, and multifocal pigmentation, based on clinical and histological features, highlights the necessity for a structured and informed approach. A retrospective examination of cases from our oral medicine and pathology clinic, coupled with analysis of photographic and histological records, aids in classifying these lesions. This fosters a better understanding and promotes informed discussions among clinicians, ultimately aiming to enhance early and precise diagnosis, thus improving patient management and outcomes.
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Affiliation(s)
- Silvio Abati
- Clinical Unit of Oral Medicine and Pathology, Dental School, IRCCS San Raffaele Hospital and University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Giacomo Francesco Sandri
- Clinical Unit of Oral Medicine and Pathology, Dental School, IRCCS San Raffaele Hospital and University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Leonardo Finotello
- Clinical Unit of Oral Medicine and Pathology, Dental School, IRCCS San Raffaele Hospital and University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Elisabetta Polizzi
- Center for Oral Hygiene and Prevention, Dental School, IRCCS San Raffaele Hospital and University Vita-Salute San Raffaele, 20132 Milan, Italy
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Zisis V, Papadopoulos P, Anagnostou E, Andreadis D, Poulopoulos A. Citalopram-Induced Oral Melanotic Macules in a Female Patient and a Review of the Literature. Cureus 2024; 16:e60889. [PMID: 38910786 PMCID: PMC11193105 DOI: 10.7759/cureus.60889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
Pigmented lesions in the oral cavity can arise from the accumulation of external substances or internal pigments, resulting in black or brown discoloration. The etiology can be categorized as physiologic, reactive, neoplastic, idiopathic, or indicative of systemic illness. Several systemic drugs have been linked to the development of oral and/or cutaneous pigmentation, either by stimulating the production of melanin or by the accumulation of the drug or its byproducts. The medications most commonly associated with this condition include antimalarials, hormones, oral contraceptives, phenothiazines, chemotherapeutics, amiodarone, minocycline, zidovudine, clofazimine, and ketoconazole. The aim of this case report is to illustrate the drug-induced appearance of multiple melanotic macules in an 89-year-old female patient. The patient was referred to the Department of Oral Medicine and Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, complaining of the recent and constant appearance of black spots in her oral cavity. Her medical history revealed a multitude of prescribed drugs, with citalopram being the most recently prescribed one, approximately one year prior to the examination. The clinical examination revealed multiple melanotic macules, on the upper and lower lip as well as on the hard and soft palate. Based on these findings, a biopsy of a melanotic macule of the lip was carried out. The histopathological examination showed that the basal layer of the stratified squamous epithelium exhibited hyperpigmentation (melanin-pigmented basal cells). In addition, scattered melaninophages were noted in lamina propria. Psychotropic drugs associated with cutaneous hyperpigmentation include citalopram. Therefore, our case constitutes an exception since citalopram induced intraoral and perioral, instead of cutaneous, hyperpigmentation.
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Affiliation(s)
- Vasileios Zisis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Petros Papadopoulos
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Dimitrios Andreadis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
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de Souto Medeiros MR, da Silva Barros CC, Rolim LSA, Pinto LP, Miguel MCDC, da Silveira ÉJD. Hamartomas, choristomas, and teratomas of the oral cavity: A 49-years cross-sectional study in an oral diagnostic service. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101765. [PMID: 38218332 DOI: 10.1016/j.jormas.2024.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/06/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND To investigate the incidence and demographic profile of hamartomatous, choristomatous, and teratoid lesions in a Brazilian population over a 49 years-period. METHODS A retrospective cross-sectional study was performed, and data regarding demographic and clinical aspects were obtained from the medical records of a [removed for blind peer review] referral center (1970-2019). The collected data were submitted to descriptive analysis and Pearson's chi-square, Fisher's exact, and Kruskal-Wallis tests (p ≤ 0.05). RESULTS In a total of 16,412 medical records analyzed, 300 (1.83 %) were hamartomatous, 2 (0.01 %) choristomatous, and 1 (0.01 %) teratoid lesions. Hamartomas were most diagnosed in females and adults. Statistical significance was observed between hamartoma and age group (p < 0.001). Odontoma was the most frequent hamartomatous lesion. In choristomatous and teratoid lesions, there was no occurrence in males. The jaws were the most affected anatomical site by hamartoma. Choristomas were observed on the mandible and tongue, while a teratoid lesion was seen on the floor of the mouth. CONCLUSIONS Low occurrence of choristomatous and teratoid lesions over hamartomatous lesions and a heterogeneous occurrence profile regarding sex, age group, and anatomic site were observed. Hamartomas are relatively common and benign conditions that may cause damage and require special care during dental treatment. Thus, the dentist needs to be able to identify and treat them appropriately. Likewise, although choristomas and teratomas present no risk to patients and have a lower occurrence than hamartomas, they also require treatment.
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Affiliation(s)
- Maurília Raquel de Souto Medeiros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Caio César da Silva Barros
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Larissa Santos Amaral Rolim
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Leão Pereira Pinto
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Márcia Cristina da Costa Miguel
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil
| | - Éricka Janine Dantas da Silveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Av. Salgado Filho, 1787, Lagoa Nova. CEP, Natal, RN 59056-000, Brazil.
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Souza PRM, Dupont L, Mosena G, Dantas ML, Bulcão LA. Variations of oral anatomy and common oral lesions. An Bras Dermatol 2024; 99:3-18. [PMID: 37722995 DOI: 10.1016/j.abd.2023.06.001] [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: 02/16/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 09/20/2023] Open
Abstract
Several topics related to the oral cavity are briefly addressed in this article, from anatomical variations that, when recognized, avoid unnecessary investigations, to diseases that affect exclusively the mouth, mucocutaneous diseases, as well as oral manifestations of systemic diseases. A complete clinical examination comprises the examination of the mouth, and this approach facilitates clinical practice, shortening the path to diagnosis in the outpatient clinic as well as with in-hospital patients. The objective of this article is to encourage the examination of the oral cavity as a useful tool in medical practice, helping to recognize diseases in this location.
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Affiliation(s)
- Paulo Ricardo Martins Souza
- Dermatology Service, Hospital da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Department of Internal Medicine/Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
| | - Letícia Dupont
- Dermatology Service, Hospital da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Department of Internal Medicine/Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Gabriela Mosena
- Dermatology Service, Hospital da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Manuela Lima Dantas
- Dermatology Service, Hospital da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Department of Internal Medicine/Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Lucas Abascal Bulcão
- Department of Internal Medicine/Dermatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
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Mojahedi Nasab SM, Frentzen M, Mayr A, Rahmani S, Anbari F, Meister J, Azari-Marhabi S, Mojahedi Nasab D. Comparison of the Diode Laser Wavelengths 445 nm and 810 nm in Gingival Depigmentation - A Clinical Evaluation. J Lasers Med Sci 2023; 14:e63. [PMID: 38318220 PMCID: PMC10843237 DOI: 10.34172/jlms.2023.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/24/2023] [Indexed: 02/07/2024]
Abstract
Introduction: Nowadays, esthetic appearance plays an important role in the field of dentistry. Discolorations and pigmentations of the gingiva reduce the appearance of a healthy-looking smile. On this occasion, the use of lasers shows a promising approach for a fast and non-aggressive treatment in this field. Different laser wavelengths are being used for gingival depigmentation this clinical study aimed to investigate the effect of the novel laser wavelength (445 nm) in this field and compare it with an 810 nm diode laser. Methods: Two diode laser wavelengths (445 nm and 810 nm) were used for depigmentation. The laser output power chosen was 1 W. An optical fiber with a diameter of 400 µm was used. 21 patients with pigmented gingiva were selected. Depigmentation was carried out in a split-mouth design for a direct comparison of the clinical effect. Outcomes were documented by photograph after one month and six months of follow-up. Results: For each wavelength, 21 volunteers evaluated 21 clinical cases of depigmentation, which means that 441 comparisons were carried out in total regarding the color change from brownish to pinkish. A 100% clarification was achieved for 445 nm. In the 810 nm group, the color change in 44 of 441 cases (10%) could not be clearly identified. No statistically significant difference in pain experience was reported for both laser treatments. Conclusion: The clinical evaluation showed that within the limitations of this study, most of the clinical outcome parameters were highly acceptable by the patients due to mild pain and discomfort for both laser systems.
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Affiliation(s)
- Seyed Masoud Mojahedi Nasab
- Department of Periodontology, Operative and Preventive Dentistry, Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
- Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Matthias Frentzen
- Department of Periodontology, Operative and Preventive Dentistry, Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
- Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
| | - Andreas Mayr
- Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Bonn University, Venusberg-Campus 1 Bldg. 11, 53127 Bonn, Germany
| | - Somayeh Rahmani
- Department of Oral and Maxillofacial Medicine, Shahid Beheshti Dental School, Tehran, Iran
| | - Fahimeh Anbari
- Department of Oral and Maxillofacial Medicine, Shahid Beheshti Dental School, Tehran, Iran
| | - Jörg Meister
- Department of Periodontology, Operative and Preventive Dentistry, Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
- Center of Applied Medical Laser Research and Biomedical Optics (AMLaReBO), Bonn University, Welschnonnenstrasse 17, 53111 Bonn, Germany
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Elwadhi A, Neha KC, Gupta D, Sharawat IK, Panda PK. Sodium Valproate-Induced Hyperpigmentation. J Pediatr 2023; 263:113660. [PMID: 37541425 DOI: 10.1016/j.jpeds.2023.113660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Aman Elwadhi
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - K C Neha
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Diksha Gupta
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Yankov YG, Nenova-Nogalcheva AK, Dimanov SN, Stoev LL, Konstantinova DA. Clinically Unusual Pigmented Lesion of the Buccal Mucosa: A Case Report. Cureus 2023; 15:e45050. [PMID: 37829959 PMCID: PMC10566642 DOI: 10.7759/cureus.45050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
We present a rare clinical case of a 64-year-old patient with a pigmented lesion localized in the left buccal mucosa. Subjective complaints of slight pain and discomfort in the process of eating and increased sensitivity when consuming hot food were reported. According to the information provided by the patient, the lesion had progressively increased in size. A history of previous dental manipulations was reported, namely, the extraction of teeth with amalgam obturations in the left half of the maxilla as per relevant indications. During the intraoral examination, a flat, black-colored lesion, 0.4 cm in diameter, with well-defined borders was observed in the buccal mucosa. Teeth 25, 26, and 27 were previously extracted five to seven years ago. An orthopantomography was performed as a routine procedure. It did not show any presence of X-ray contrast areas that could explain the symptoms of the patient. The symptomatic nature of the lesion as well as the negative radiological findings prompted surgical treatment and excisional biopsy with subsequent histological evaluation to rule out oral malignancy. An excision was performed. During the follow-up examination in the next eight days, all the symptoms of the patient were gone. The conclusion of the pathology report was "histological findings and clinical data consistent with amalgam tattoo". The amalgam tattoo is the most frequent iatrogenic pigmented lesion of the oral mucosa, which results from the implantation of amalgam particles in the soft tissues and it is usually asymptomatic. In this case, no surgical treatment is needed. However, in some rare cases, like the one we are presenting, some symptoms can occur and complicate the diagnostic process. In these cases, the complete excision of the lesion is to be performed with subsequent histological evaluation. The atraumatic intervention of teeth, obturated with definitive amalgam fillings, is a main factor for preventing this kind of pigmentation of the oral mucosa.
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Affiliation(s)
- Yanko G Yankov
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
| | | | - Simeon N Dimanov
- Department of Oral Surgery, Medical University of Varna, Varna, BGR
| | - Lyuben L Stoev
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Desislava A Konstantinova
- Department of Dental Material Science and Prosthetic Dental Medicine, Medical University of Varna, Varna, BGR
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Mahayni M, Kujan O, Hamadah O. Aesthetic Gingival Melanin Pigmentation Treatment in Smokers and Non-Smokers: A Comparison Study Using Nd:YAG Laser and Ceramic Bur. J Pers Med 2023; 13:1034. [PMID: 37511647 PMCID: PMC10381627 DOI: 10.3390/jpm13071034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/28/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Aesthetic concerns are increasing rapidly; thus, several approaches have been suggested for treating gingival melanin pigmentation. Lasers have been reported as an effective new tool, and the Nd:YAG laser beam has an affinity for melanin and haemoglobin. However, ceramic gingival bur is simple and has less bleeding effect during operation than conventional techniques. This study aimed to compare the outcomes of gingival depigmentation using the Nd:YAG laser and ceramic bur in two different groups (smokers and non-smokers). A total of 40 patients presenting with gingival melanin pigmentation were enrolled in this split-mouth study. The sample was divided into two groups: smokers and non-smokers. Treatment was performed using the Nd:YAG laser (3 W, 60 mJ/pulse, and 50 Hz) and ceramic bur with a one-week interval between the two methods. Clinical indices were recorded, including intraoperative bleeding, wound healing, post-operative pain, and the recurrence of pigmentation, and follow-up periods were determined in the 3rd, 6th, and 9th months postoperatively. Both treatments promoted a similar pain experience and recurrence rate of pigmentation (p > 0.489, p = 1.000, respectively). Bleeding during surgery and complete healing recovery after one week were statistically significantly higher when using ceramic bur (p = 0.00, p = 0.041, respectively). Concerning the effect of smoking on the treatment, a higher recurrence rate was observed in SG than N-SG in laser sites (50%, and 95%, respectively) and bur sites (60%, and 85%, respectively), but statistically no significant difference was observed (p > 0.080). In conclusion, both procedures are adequate for aesthetic gingival depigmentation treatment. The Nd:YAG laser showed greater effectiveness in controlling bleeding, while ceramic bur showed a faster clinical recovery. Furthermore, smokers were more likely to have low depigmentation treatment stability.
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Affiliation(s)
- Massa Mahayni
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA 6009, Australia
| | - Omar Hamadah
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria
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Albagieh H, Aloyouny A, Alshagroud R, Alwakeel A, Alkait S, Almufarji F, Almutairi G, Alkhalaf R. Habitual khat chewing and oral melanoacanthoma: A case report. World J Clin Cases 2023; 11:449-455. [PMID: 36686340 PMCID: PMC9850976 DOI: 10.12998/wjcc.v11.i2.449] [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: 10/14/2022] [Revised: 12/04/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Habitual khat (Catha edulis) chewing has been proven to cause numerous oral tissue changes. However, oral melanoacanthoma triggered by chronic khat chewing is rare. Oral melanoacanthoma is an uncommon, sudden, asymptomatic, benign pigmentation of the oral cavity. Under the microscope, the epithelial layer of the oral mucosa showed dendritic melanocyte proliferation and acanthosis. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.
CASE SUMMARY In the current study, we report a case of a 26-year-old male patient with a rare presentation of oral melanoacanthoma triggered by regular khat chewing. Many intrinsic and extrinsic factors can cause oral pigmentation. Chewing khat is an extrinsic factor that can cause several diseases, including oral pigmentation. In this case, the definitive diagnosis was oral melanoacanthoma. This diagnosis was made based on the patient’s history, clinical lesion presentation, and microscopic biopsy results.
CONCLUSION Habitual khat (Catha edulis) chewing causes many oral tissue changes including oral melanoacanthoma. The study aimed to highlight chronic khat chewing as a trigger for oral melanoacanthoma.
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Affiliation(s)
- Hamad Albagieh
- Oral Medicine and Diagnostic Science Department, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | - Ashwag Aloyouny
- Basic Dental Science, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Rana Alshagroud
- Oral Medicine and Diagnostic Science Department, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia
| | | | - Shahad Alkait
- Postgraduate, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Fatimah Almufarji
- Postgraduate, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Ghadeer Almutairi
- Postgraduate, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Rana Alkhalaf
- Postgraduate, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
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Horvat Aleksijević L, Prpić J, Muhvić Urek M, Pezelj-Ribarić S, Ivančić-Jokić N, Peršić Bukmir R, Aleksijević M, Glažar I. Oral Mucosal Lesions in Childhood. Dent J (Basel) 2022; 10:214. [PMID: 36354659 PMCID: PMC9689283 DOI: 10.3390/dj10110214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 06/22/2024] Open
Abstract
Childhood diseases are a continuous source of interest in all areas of general and dental medicine. Congenital, developmental, and hereditary diseases may either be present upon birth or appear in early childhood. Developmental anomalies, although often asymptomatic, may become grounds for different infections. Furthermore, they can indicate certain systemic disorders. Childhood age frequently brings about benign tumors and different types of traumatic lesions to the oral mucosa. Traumatic lesions can be caused by chemical, mechanical, or thermal injury. Mucocele and ranula are, by definition, traumatic injuries of the salivary glands or their ducts. Recurrent aphthous lesions are the most common type of ulcerations in childhood, and their etiology is considered multifactorial. Oral mucosal lesions in children require different treatment approaches depending on etiological factors and clinical presentation. Clinicians should have adequate knowledge of oral anatomy in order to diagnose and treat pathological conditions.
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Affiliation(s)
- Lorena Horvat Aleksijević
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jelena Prpić
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Miranda Muhvić Urek
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Sonja Pezelj-Ribarić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Nataša Ivančić-Jokić
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Pediatric Dentistry, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Romana Peršić Bukmir
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
| | - Marko Aleksijević
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Irena Glažar
- Clinic of Dental Medicine, Clinical Hospital Center Rijeka, Krešimirova 42, 51000 Rijeka, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Krešimirova 40, 51000 Rijeka, Croatia
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Ruddocks LA, Bhattacharyya I, Cohen DM, Islam MN, Roca AL. Multifocal pigmentation of the oral mucosa. J Am Dent Assoc 2022:S0002-8177(22)00396-8. [PMID: 36068093 DOI: 10.1016/j.adaj.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/03/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
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Bugălă NM, Carsote M, Stoica LE, Albulescu DM, Ţuculină MJ, Preda SA, Boicea AR, Alexandru DO. New Approach to Addison Disease: Oral Manifestations Due to Endocrine Dysfunction and Comorbidity Burden. Diagnostics (Basel) 2022; 12:diagnostics12092080. [PMID: 36140482 PMCID: PMC9497746 DOI: 10.3390/diagnostics12092080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/17/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
This review highlights oral anomalies with major clinical impact in Addison disease (AD), including dental health and dermatologic features, through a dual perspective: pigmentation issues and AD comorbidities with oral manifestations. Affecting 92% of AD patients, cutaneomucosal hyperpigmentation is synchronous with or precedes general manifestations by up to a decade, underlying melanocytic infiltration of the basal epidermal layer; melanophages in the superficial dermis; and, rarely, acanthosis, perivascular lymphocytic infiltrate, and hyperkeratosis. Intraoral pigmentation might be the only sign of AD; thus, early recognition is mandatory, and biopsy is helpful in selected cases. The buccal area is the most affected location; other sites are palatine arches, lips, gums, and tongue. Pigmented oral lesions are patchy or diffuse; mostly asymptomatic; and occasionally accompanied by pain, itchiness, and burn-like lesions. Pigmented lingual patches are isolated or multiple, located on dorsal and lateral areas; fungiform pigmented papillae are also reported in AD individuals. Dermoscopy examination is particularly indicated for fungal etiology; yet, it is not routinely performed. AD’s comorbidity burden includes the cluster of autoimmune polyglandular syndrome (APS) type 1 underlying AIRE gene malfunction. Chronic cutaneomucosal candidiasis (CMC), including oral CMC, represents the first sign of APS1 in 70–80% of cases, displaying autoantibodies against interleukin (IL)-17A, IL-17F ± IL-22, and probably a high mucosal concentration of interferon (IFN)-γ. CMC is prone to systemic candidiasis, representing a procarcinogenic status due to Th17 cell anomalies. In APS1, the first cause of mortality is infections (24%), followed by oral and esophageal cancers (15%). Autoimmune hypoparathyroidism (HyP) is the earliest endocrine element in APS1; a combination of CMC by the age of 5 years and dental enamel hypoplasia (the most frequent dental complication of pediatric HyP) by the age of 15 is an indication for HyP assessment. Children with HyP might experience short dental roots, enamel opacities, hypodontia, and eruption dysfunctions. Copresence of APS-related type 1 diabetes mellitus (DM) enhances the risk of CMC, as well as periodontal disease (PD). Anemia-related mucosal pallor is related to DM, hypothyroidism, hypogonadism, corresponding gastroenterological diseases (Crohn’s disease also presents oral ulceration (OU), mucogingivitis, and a 2–3 times higher risk of PD; Biermer anemia might cause hyperpigmentation by itself), and rheumatologic diseases (lupus induces OU, honeycomb plaques, keratotic plaques, angular cheilitis, buccal petechial lesions, and PD). In more than half of the patients, associated vitiligo involves depigmentation of oral mucosa at different levels (palatal, gingival, alveolar, buccal mucosa, and lips). Celiac disease may manifest xerostomia, dry lips, OU, sialadenitis, recurrent aphthous stomatitis and dental enamel defects in children, a higher prevalence of caries and dentin sensitivity, and gingival bleeding. Oral pigmented lesions might provide a useful index of suspicion for AD in apparently healthy individuals, and thus an adrenocorticotropic hormone (ACTH) stimulation is useful. The spectrum of autoimmune AD comorbidities massively complicates the overall picture of oral manifestations.
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Affiliation(s)
- Narcis Mihăiţă Bugălă
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- C.I. Parhon National Institute of Endocrinology, Aviatorilor Ave. 34–38, Sector 1, 011683 Bucharest, Romania
- Correspondence: ; Tel.: +40-744851934
| | - Loredana Elena Stoica
- Department of Dermatology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dana Maria Albulescu
- Department of Anatomy, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Jana Ţuculină
- Department of Odontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Smaranda Adelina Preda
- Department of Odontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ancuta-Ramona Boicea
- Department of Occupational Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Dragoș Ovidiu Alexandru
- Department of Medical Informatics and Biostatistics, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Souza LL, Roza ALOC, Leite AA, Gallagher KPD, Mariz BALA, Santos MRG, Santos-Silva AR, Vargas PA. A PIGMENTED NODULE IN THE BUCCAL MUCOSA. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:465-469. [PMID: 36153301 DOI: 10.1016/j.oooo.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Affiliation(s)
- L L Souza
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Amanda Almeida Leite
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | | | - Mariana Rates Gonzaga Santos
- Department of Immunology, Science Biological Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil; Department of Oral Pathology and Oral Biology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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15
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Medeiros YDL, Faria LV, Chandretti PCDS, Mainenti P. Laser therapy and light sources for labial lentigines in patients with
Peutz‐Jeghers
syndrome. Dermatol Ther 2022; 35:e15519. [DOI: 10.1111/dth.15519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | - Luan Viana Faria
- School of Dentistry Universidade Federal de Juiz de Fora Minas Gerais Brazil
| | | | - Pietro Mainenti
- Department of Pathology, School of Medicine Universidade Presidente Antônio Carlos Minas Gerais Brazil
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16
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Silva PUJ, Oliveira MB, Vieira W, Cardoso SV, Blumenberg C, Franco A, Siqueira WL, Paranhos LR. Oral pigmentation as an adverse effect of chloroquine and hydroxychloroquine use: A scoping review. Medicine (Baltimore) 2022; 101:e29044. [PMID: 35356915 PMCID: PMC10684193 DOI: 10.1097/md.0000000000029044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/23/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Chloroquine and hydroxychloroquine are 2 medications used to treat some systemic diseases. OBJECTIVE The aim of this scoping review was to assess the occurrence of oral pigmentation induced by chloroquine or hydroxychloroquine and to understand the pathogenic mechanism behind this phenomenon. METHODS The review was performed according to the list of PRISMA SrC recommendations and the JBI Manual for Evidence Synthesis for Scoping Reviews. MEDLINE (PubMed), Scopus, EMBASE, SciELO, Web of Science, Lilacs, and LIVIVO were primary sources, and "gray literature" was searched in OpenThesis and Open Access Thesis and Dissertations (OATD). Studies that screened the occurrence of oral pigmentation associated to the use of chloroquine or hydroxychloroquine were considered eligible. No restrictions of year and language of publication were applied. Study selection and data extraction were performed by 2 independent reviewers. The risk of bias was assessed through the JBI tool, depending on the design of the selected studies. RESULTS The initial search resulted in 2238 studies, of which 19 were eligible. Sixteen studies were case reports, 2 had case-control design and 1 was cross-sectional. Throughout the studies, 44 cases of oral pigmentation were reported. The hard palate was the anatomic region most affected with pigmentation (66%). According to the case reports, most of the lesions (44%) were bluish-gray. The minimum time from the beginning of treatment (chloroquine or hydroxychloroquine) to the occurrence of pigmentation was 6 months. The mean treatment time with the medications was 4.9 years, and the mean drug dosage was 244 mg. Most of the studies (63.1%) had low risk of bias (high methodological quality). CONCLUSIONS The outcomes of this study suggest that hyperpigmentation depend on drug dosage and treatment length. Hyperpigmentation was detected after a long period of treatment with chloroquine or hydroxychloroquine.
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Affiliation(s)
| | | | | | | | | | | | - Walter Luiz Siqueira
- Correspondence: Walter Luiz Siqueira, University of Saskatchewan, College of Dentistry, Saskatoon, Canada (e-mail: ).
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17
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Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031473] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The oral cavity constitutes a complex anatomical area that can be affected by many developmental, inflammatory, and tumoural diseases. MultiSlice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) currently represent the essential and complementary imaging techniques for detecting oral cavity abnormalities. Advanced MRI with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced perfusion-weighted imaging (DCE-PWI) has recently increased the ability to characterise oral lesions and distinguish disease recurrences from post therapy changes. The analysis of the oral cavity area via imaging techniques is also complicated both by mutual close appositions of different mucosal surfaces and metal artifacts from dental materials. Nevertheless, an exact identification of oral lesions is made possible thanks to dynamic manoeuvres and specific stratagems applicable on MSCT and MRI acquisitions. This study summarises the currently available imaging techniques for oral diseases, with particular attention to the role of DWI, DCE-PWI, and dynamic manoeuvres. We also propose MSCT and MRI acquisition protocols for an accurate study of the oral cavity area.
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18
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Dhanuthai K, Theungtin N, Theungtin N, Thep-Akrapong P, Kintarak S, Klanrit P, Chamusri N, Sappayatosok K. Pigmented Oral Lesions: A Multicenter Study. Eur J Dent 2021; 16:315-319. [PMID: 34753186 PMCID: PMC9339917 DOI: 10.1055/s-0041-1735790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives
The aim of this study was to determine the prevalence and clinical features of pigmented oral lesions from Thailand.
Materials and Methods
Biopsy records of the Department of Oral Pathology, Chulalongkorn University, Department of Oral Diagnosis, KhonKaen University, Department of Oral Biology and Oral Diagnostic Sciences, Chiangmai University, Department of Stomatology, Prince of Songkla University, and Rangsit University were reviewed for oral pigmented lesions diagnosed during 1999 to 2019. Demographic data were culled from the biopsy records. Ages of the patients were subdivided into 10-year intervals. Locations of the lesions were classified as gingiva, labial/buccal mucosa, palate, floor of the mouth, tongue, as well as the combination of sites. Data were analyzed by descriptive statistics using SPSS version 20.0.
Results
Of the 47,175 accessioned cases, 241 cases (0.51%) were diagnosed in the category of pigmented oral lesions. The age of the patients ranged from 1 month to 88 years with the mean ± standard deviation = 38.74 ± 20.96 years. Regarding gender, 172 patients (71.37%) with pigmented lesions were females, while 69 patients (28.63%) were males. The female-to-male ratio was 2.49:1. The majority of the pigmented lesions were encountered at the gingiva (29.88%) followed by labial/buccal mucosa (26.97%), palate (14.94%), lip (10.79%), alveolar mucosa (9.54%), and others (7.88%), respectively. The three most common pigmented oral lesions in the present study were nevus (39.83%), followed by melanotic macule (28.63%) and amalgam tattoo (17.43%), respectively.
Conclusions
The most common pigmented oral lesion in the present study is nevus. Demographic data of the patients in the present study are in accordance with previous studies with minor differences. Even though pigmented lesions of the oral cavity constitute a small portion of the oral pathology biopsies, accurate diagnosis is important since there is an overlap in clinical appearance of benign pigmented lesions and melanoma.
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Affiliation(s)
- Kittipong Dhanuthai
- Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | | | | | - Sompid Kintarak
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, Prince of Songkla University, Songkhla, Thailand
| | - Poramaporn Klanrit
- Department of Oral Biomedical Sciences, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Nutchapon Chamusri
- Department of Oral Biology and Oral Diagnostic Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Kraisorn Sappayatosok
- Department of Oral Diagnostic Sciences, College of Dental Medicine, Rangsit University, Pathumtani, Thailand
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19
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Costa AM, Pontes FS, Souza LL, Lopes MA, Santos-Silva AR, Vargas PA, Andrade BA, Bezerra KT, Romañach MJ, Gomez RS, Costa RF, Júnior DD. What is the frequency of floor of the mouth lesions? A descritive study of 4,016 cases. Med Oral Patol Oral Cir Bucal 2021; 26:e738-e747. [PMID: 34704985 PMCID: PMC8601650 DOI: 10.4317/medoral.24537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 09/06/2021] [Indexed: 01/07/2023] Open
Abstract
Background The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth from representative oral pathology centres in Latin America. Material and Methods This study was conducted on biopsies obtained from January of 1978 to December of 2018 at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis were evaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons. Results From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases (94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases), followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964 cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The most common histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oral leukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in 2,129 cases and females in 1,897 cases. Conclusions In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oral pathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions. Key words:Epidemiology, floor of the mouth, benign, malignant.
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Affiliation(s)
- A-M Costa
- João de Barros Barreto University Hospital Department of Surgery and Oral Pathology Mundurucus Street, nº 4487 Zip Code 66073-000, Belém, Pará, Brazil
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20
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Tavares TS, Da Costa AAS, Aguiar MCF, Loyola AM, Barcelos NS, Abreu MHNG, Mesquita RA, Tarquínio SBC, De Moraes Ê, Vasconcelos ACU, Costa NL, Mendonça EF, Cardoso SV, Nonaka CFW, Andrade ADO, Johann ACBR, Michels AC, Libório-Kimura TN, Neto GOP, Caldeira PC. Differential diagnoses of solitary and multiple pigmented lesions of the oral mucosa: Evaluation of 905 specimens submitted to histopathological examination. Head Neck 2021; 43:3775-3787. [PMID: 34519124 DOI: 10.1002/hed.26872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/29/2021] [Accepted: 08/31/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The aim was to analyze the frequency, clinical and demographic features of solitary and multiple/diffuse oral pigmented lesions submitted to histopathological examination, and to summarize the features that guide the clinical differential diagnosis. METHODS Clinical and demographic data were retrieved from biopsy records and descriptive statistics were performed. RESULTS Nine hundred and five (0.51%) oral pigmented lesions were retrieved among 177 356 specimens, being 95.9% solitary and 4.1% multiple/diffuse lesions. Regardless the overlapping clinical presentation, age, site, association with amalgam restoration, and a nodular appearance may help in the clinical differential diagnosis of solitary oral pigmentations. Patient's habits, site, and systemic signs and symptoms are helpful in the clinical differential diagnosis of multiple/diffuse lesions. CONCLUSIONS Oral pigmented lesions are a rare diagnosis in oral pathology and solitary lesions are more commonly submitted to biopsy. Some key features help in the differential diagnosis, though biopsy can be warranted in doubtful cases.
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Affiliation(s)
- Thalita Soares Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Maria Cássia Ferreira Aguiar
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriano Mota Loyola
- Area of Pathology, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Natália Santos Barcelos
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Êmile De Moraes
- Department of Semiology and Clinics, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | | | - Nádia Lago Costa
- Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Sérgio Vitorino Cardoso
- Area of Pathology, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | | | | | | | - Arieli Carini Michels
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Gerson Oliveira Paiva Neto
- Department of Pathology and Forensic Medicine, School of Medicine, Universidade Federal do Amazonas, Manaus, Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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21
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Hughes C, Ferro A, Dubb S, Gass J, Hook L, Santhanam V, Kinsler V, Polubothu S. Epidermal choristoma: a case series and review of the literature. Pediatr Dermatol 2021; 38:1243-1246. [PMID: 34338332 DOI: 10.1111/pde.14589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Epidermal choristoma is a rare, congenital lesion in which islands of ectopic skin are found within the oral cavity. They present as pigmented macules or papules on the tongue. Histologic appearances are characteristic and benign. We present three cases review the current literature and recommend observation of the lesion rather than complete excision should be considered as a reasonable management option.
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Affiliation(s)
- Connor Hughes
- Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, and UCL GOS Institute of Child Health, London, UK.,Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK
| | - Ashley Ferro
- Department of Oral and Maxillofacial Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sukhpreet Dubb
- Department of Oral and Maxillofacial Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Julia Gass
- Department of Dermatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Liz Hook
- Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Vijay Santhanam
- Department of Oral and Maxillofacial Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Veronica Kinsler
- Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, and UCL GOS Institute of Child Health, London, UK.,Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK
| | - Satyamaanasa Polubothu
- Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Foundation Trust, and UCL GOS Institute of Child Health, London, UK.,Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK
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22
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Radhakrishnan S, Santhosh K, Anbuselvan GJ, Kanthasamy G. A Focal Intrinsic Physiologic Pigmentation of Tongue. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S878-S880. [PMID: 34447221 PMCID: PMC8375959 DOI: 10.4103/jpbs.jpbs_745_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 01/11/2023] Open
Abstract
Pigmentation is defined as the process of deposition of pigments in the tissues. It can be endogenous or exogenous in origin and may be physiological or pathological. Pigmentation is a common intraoral finding; various diseases can lead to varied discolorations of the mucosa. Diagnosis of pigmented lesions of the oral cavity is a challenging task, therefore understanding of the causes of mucosal pigmentation and appropriate evaluation of the patient are essential in the diagnosis of the pigmented lesions.
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Affiliation(s)
| | - Kalaiselvi Santhosh
- Department of Oral Medicine and Radiology, Karpaga Vinayaga Institute of Dental Sciences, Kanchipuram, Tamil Nadu, India
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23
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Duarte da Silva K, Vargas-Ferreira F, Dâmaso Bertoldi A, Celso Lopes Fernandes de Barros F, Fernando Demarco F, Britto Correa M, Beatriz Chaves Tarquinio S. Oral mucosal lesions in pregnant women: A population-based study. Oral Dis 2021; 28:1891-1900. [PMID: 34333827 DOI: 10.1111/odi.13981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the prevalence of oral mucosal lesions (OML) and oral self-examination and their associated factors among pregnant women from the 2015 Pelotas Birth Cohort Study, Brazil. METHODS Pregnant women who would deliver babies in 2015 were included in the antenatal study. Data related to demographic, socio-economic and behavioural conditions were collected using questionnaires. Participants were also clinically assessed for oral health outcomes. The outcomes were the presence of OMLs and oral self-examination. Size, location, time of onset and symptomatology of the lesions were collected. Descriptive and bivariate analysis, and Poisson regression were performed. p-Value <0.05 was set to indicate statistical significance. RESULTS Data from 2481 pregnant women were analysed. Four hundred and nine (16.5%) had at least one OML. The most prevalent lesions were exostosis (80/16.6%), coated tongue (70/14.5%) and benign oral brownish pigmentation (68/14.1%). Non-white skin colour was associated with a higher prevalence of OMLs (PR 1.3; 95% CI 1.1-1.6), while daily use of dental floss was positively associated with the prevalence of oral self-examination (PR 1.4; 95% CI 1.2; 1.5). CONCLUSIONS Almost 20% of pregnant women presented OML, which were more prevalent in non-white individuals. Women with better oral care were more likely to perform oral self-examination.
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Affiliation(s)
| | - Fabiana Vargas-Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Flávio Fernando Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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24
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Rodrigues BT, Cunha JL, Albuquerque DM, Chagas WP, Freire ND, Agostini M, Canedo NH, Albuquerque Júnior RL, de Sousa SF, Abrahão AC, Romañach MJ, Almeida OP. Primary melanoma of the oral cavity: A multi-institutional retrospective analysis in Brazil. Med Oral Patol Oral Cir Bucal 2021; 26:e379-e386. [PMID: 33340079 PMCID: PMC8141310 DOI: 10.4317/medoral.24240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/30/2020] [Indexed: 02/03/2023] Open
Abstract
Background Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this study was to describe the clinicopathologic features of a series of oral melanomas.
Material and Methods A retrospective descriptive study was performed. A total of 15,482 biopsy records from two oral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed, and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, immunohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, Melan A, and Ki-67) were performed.
Results The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range: 45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the most common affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph node metastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were melanotic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100 and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positive cells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months.
Conclusions Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly in adult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previous studies and reflected the characteristics of the services from where lesions were retrieved. Key words:Head and neck cancer, melanoma, oral melanoma, oral mucosa.
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Affiliation(s)
- B-T Rodrigues
- Oral Pathology Section, Department of Oral Diagnosis Piracicaba Dental School, University of Campinas (UNICAMP) Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903, Brazil
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Albuquerque DM, Cunha JL, Roza AL, Arboleda LP, Santos-Silva AR, Lopes MA, Vargas PA, Jorge J, de Almeida OP, Abrahão AC, Agostini M, Romañach MJ. Oral pigmented lesions: a retrospective analysis from Brazil. Med Oral Patol Oral Cir Bucal 2021; 26:e284-e291. [PMID: 32856618 PMCID: PMC8141314 DOI: 10.4317/medoral.24168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/24/2020] [Indexed: 02/03/2023] Open
Abstract
Background Pigmented lesions are uncommon in the oral mucosa, and studies investigating the incidence and types of these lesions are desired to improve the diagnostic knowledge of clinicians. The aim of this study was to analyze the distribution of oral pigmented lesions in a Brazilian population.
Material and Methods A retrospective descriptive cross-sectional study was performed. Oral pigmented lesions were retrieved from the files of two oral and maxillofacial pathology services from Brazil over a 45-year period (1974-2019). The clinical data and the diagnoses of each case were retrieved and included in a Microsoft Excel® database.
Results From 77.074 lesions diagnosed in this period, 761 (0.99%) represented pigmented lesions of the oral mucosa, including 351 (46.1%) melanocytic and 410 (53.9%) non-melanocytic lesions, with a higher incidence in females (73.2%) between the fourth and seventh decades of life. Amalgam tattoo (53.6%) represented the most common lesion, followed by melanotic macule (18.3%) and racial pigmentation (10.8%). Other pigmented lesions included nevus (9.9%), post-inflammatory pigmentation (3%), melanoma (2.1%), melanoacanthoma (1.4%), smoker's melanosis (0.4%), drug-induced pigmentation (0.3%), and melanotic neuroectodermal tumor of infancy (0.1%). The buccal mucosa was the most commonly affected site (25.2%), followed by the alveolar ridge (14.5%), and gingiva (11.8%).
Conclusions The current findings were similar to previous studies with minor differences due methodology and characteristics of the services from where lesions were retrieved. The knowledge of these data may contribute to a better understanding of oral pigmented lesions and assist clinicians to better recognize and manage them. Key words:Pigmented lesions, pigmentation, melanin, amalgam, oral cavity.
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Affiliation(s)
- D-M Albuquerque
- Department of Oral Diagnosis and Pathology Federal University of Rio de Janeiro School of Dentistry Av. Carlos Chagas Filho 373, Prédio do CCS, Bloco K, 2° andar, Sala 56 Ilha da Cidade Universitária, Rio de Janeiro/RJ. 21.941-902
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Rawson RV, Wilmott JS, Scolyer RA. Mucosal Melanoma: A Review Emphasizing the Molecular Landscape and Implications for Diagnosis and Management. Surg Pathol Clin 2021; 14:293-307. [PMID: 34023107 DOI: 10.1016/j.path.2021.01.005] [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: 11/16/2022]
Abstract
Mucosal melanomas are rare, often aggressive tumors that can arise at any mucosal site but most frequently occur in the head and neck, vulvovaginal, and anorectal regions. They have distinct biological, clinical, and histopathologic features, which have important management implications. Recent whole-genome sequencing studies have led to a greater understanding of the molecular landscape of mucosal melanomas and uncovered oncogenic drivers that could potentially be susceptible to therapeutic manipulation. The authors provide a brief overview of epidemiologic, clinical, and histopathologic features of mucosal melanoma, with particular emphasis on recent advances in understanding, which have arisen from analyzing their molecular landscape.
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Affiliation(s)
- Robert V Rawson
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, New South Wales, Australia
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, North Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, New South Wales, Australia.
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Faustino ISP, Mariz BALA, Santos-Silva AR, Vargas PA, Lopes MA. Pigmented lesion in the maxillary alveolar mucosa. J Am Dent Assoc 2020; 152:770-773. [PMID: 32950207 DOI: 10.1016/j.adaj.2020.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/12/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022]
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Altalhab S, Aljamal M, Mubki T, AlNomair N, Algoblan S, Alalola A, AlJasser MI, Alissa A. Q-switched 532 nm Nd:YAG laser therapy for physiological lip hyperpigmentation: novel classification, efficacy, and safety. J DERMATOL TREAT 2020; 33:1324-1328. [PMID: 32748662 DOI: 10.1080/09546634.2020.1805400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Physiological lip hyperpigmentation (PLH) is a common cosmetic concern in the Middle East and Asia. It is characterized by homogeneous symmetric diffuse hyperpigmentation affecting both lips. There is no satisfactory treatment for this condition. The aim of this study is to evaluate the efficacy and safety of Q-switched (QS) 532 nm Nd:YAG laser for PLH. METHODS A total of 30 patients with clinical diagnosis of PLH were retrospectively reviewed and included in the study. Patients underwent at least one laser treatment using QS 532 nm with a minimum follow up of six months. Laser parameters were as follows: spot size 2-3 mm, pulse duration 20 ns, fluence 2-4 J/cm2. One to three sessions were performed depending on clinical response. Two methods were used for assessment: patient satisfaction and independent physician assessment. PLH was classified as grade 1 (upper lip fully affected plus only border of lower lip), grade 2 (upper lip fully affected plus most of lower lip), and grade 3 (majority of both lips hyperpigmented). RESULTS Excellent (>75% improvement) response was achieved in 30% of patients. Good (51-75% improvement) response was seen in 37% and 43% of patients according to patient satisfaction and independent physician assessment, respectively. Majority of patients required only one treatment session. Reactivation of herpes labialis occurred in two patients, and mottled hypopigmentation in three patients. None of the patients developed persistent hyperpigmentation or scarring. CONCLUSIONS PLH can be effectively treated with QS 532 nm Nd:YAG laser and is well tolerated by patients.
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Affiliation(s)
- Saad Altalhab
- Dermatology Department, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Mohammed Aljamal
- Division of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Thamer Mubki
- Dermatology Department, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Naief AlNomair
- Division of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Shoug Algoblan
- Division of Internal Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ammar Alalola
- Dermatology Department, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Mohammed I AlJasser
- Division of Dermatology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Alissa
- Dermatology Department, Derma Clinic, Riyadh, Saudi Arabia
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Choufani A, Folliguet M, Chahine N, Rammal S, Doumit M. Prevalence of Oral Mucosal Lesions Among the Institutionalized Elderly Population in Lebanon. Gerontol Geriatr Med 2020; 6:2333721420925189. [PMID: 32676521 PMCID: PMC7339905 DOI: 10.1177/2333721420925189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 01/16/2023] Open
Abstract
This study aimed to determine the prevalence of oral mucosal lesions and risk factors among the institutionalized elderly Lebanese population. A representative sample of 526 individuals (49% males and 61% females) aged 65 years and above was examined. A questionnaire and clinical examination were administered. Bivariate and multivariate regressions were carried out. The frequency of oral mucosal lesions was 22.8% and it was associated to the use, integrity (p < .002), and hygiene level (p < .047) of removable mandibular and maxillary prosthesis. Multiple regression analysis also predicted the relationship between the mandibular prosthesis hygiene level and the occurrence of mucosal lesions. The factors controlling the occurrence of oral mucosal lesion were mainly related to the level of oral care given to the individuals. Therefore, a proper oral health care system should be implemented in the Lebanese residential homes to ensure the well-being of the residing population.
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Affiliation(s)
- Antoine Choufani
- Lebanese University, Lebanon
- Antoine Choufani, Faculty of Dental Medicine, Pediatric and Public Health Dentistry Department, Lebanese University, Hadath 0000, Beirut, Lebanon.
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Achieving a Good Aesthetic Result in the Correction of Giant Nevus of the Labiomental Area. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2726. [PMID: 32440403 PMCID: PMC7209834 DOI: 10.1097/gox.0000000000002726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/31/2020] [Indexed: 11/26/2022]
Abstract
Benign skin lesions of the face require appropriate surgical treatment. Giant pigmented skin lesions possess the high risk of malignancy which sometimes is not possible to diagnose preoperatively. Majority of the traditional techniques for lower lip and chin reconstruction were developed for the skin cancer resections and are extensively aggressive and disfiguring in case of benign lesions. Perhaps the less invasive approach based on local skin flaps would lead to better aesthetic and functional outcome. We present a case report of the 67-year-old patient who has passed through numerous unsuccessful attempts of correction of the giant nevus of the chin and lower lip area with continued growth. At the time of our surgery, lesion almost covered the whole chin and lower lip area. Appropriate unaffected skin margins excision was performed, and the defect was addressed with combination of traditional incision patterns with local skin flap technique. We believe that our approach provides a good aesthetic and functional outcome in benign lesions correction of the labiomental area.
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Chacón-Dulcey V, López-Labady J, Villarroel-Dorrego M, Frías J, Tirado W, González N, Pérez Alfonzo R. Oral manifestations associated with antimalarial therapy in patients with systemic lupus erythematosus. Lupus 2020; 29:761-766. [PMID: 32362181 DOI: 10.1177/0961203320922620] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Lupus erythematosus (LE) is an autoimmune disease often treated with antimalarial drugs. The prolonged use of chloroquine and hydroxychloroquine can cause hyperpigmentation in the skin, oral mucosa and retinal pigment epithelium, which in turn can trigger toxicity in this epithelium, which in some cases causes vision loss. The objective of the present work was to establish the association between the presence of oral pigmented macules by antimalarial and secondary retinal toxicity. METHODS A total of 105 patients diagnosed with LE being treated with chloroquine/hydroxychloroquine were evaluated. All patients were ophthalmologically evaluated for retinopathy screening. When the patient showed oral hyperpigmented maculae, an incisional biopsy was performed with the corresponding histopathological study with informed consent. The variables were compared using the chi-square test for quantitative variables and the non-parametric Mann-Whitney U-test for categorical variables. The confidence level was established at 95%, and p-values of ≤0.005 were considered statistically significant. RESULTS Only 9.5% of the patients showed oral brown spots. Histopathologically, 100% of the oral macules showed characteristics of oral pigmentation by drug and 100% ophthalmological parameters of normality. Two patients presented with a diagnosis of pre-retinopathy, but none showed oral lesions. CONCLUSION Hyperpigmented macules in the buccal mucosa in lupus patients receiving antimalarial treatment are not frequent and do not represent a predictive finding of toxicity of the drug.
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Affiliation(s)
| | | | | | - Jennifer Frías
- Institute of Biomedicine, Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Wirman Tirado
- School of Dentistry, Central University of Venezuela, Caracas, Venezuela
| | - Nieves González
- Institute of Biomedicine, Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Ricardo Pérez Alfonzo
- Institute of Biomedicine, Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela
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Datta A, Lamba AK, Tandon S, Urs A, Lnu M. A Unique Presentation of Gingival Melanoacanthoma: Case Report and Review of Literature. Cureus 2020; 12:e7315. [PMID: 32313756 PMCID: PMC7164714 DOI: 10.7759/cureus.7315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Melanoacanthoma is a benign, deeply pigmented condition of the oral mucosa characterized by the proliferation of melanocytes and keratinocytes. A 60-year-old male, with no history of systemic diseases or medical treatment, presented with an asymptomatic diffuse pigmentation involving the maxillary and mandibular gingiva. The histopathology of the anomalous pigmented area was analyzed and the dendritic melanocytes expressed positively for Masson-Fontana, S-100, and HMB-45. The clinical and microscopic findings were indicative of melanoacanthoma. Depigmentation with a diode laser was performed in the areas of esthetic concern. A regular periodic screening was done to rule out any alteration in color, size, and shape. A one-year follow-up disclosed no new lesions. The observations noted in this case are rare, and our literature review identified only a single previously documented case of gingival melanoacanthoma in the Indian subpopulation.
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Affiliation(s)
- Archita Datta
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Arundeep K Lamba
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Shruti Tandon
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Aadithya Urs
- Oral Pathology and Microbiology, Maulana Azad Institute of Dental Sciences, New Delhi, IND
| | - Mahima Lnu
- Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, IND
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Dika E, Starace M, Lambertini M, Patrizi A, Veronesi G, Alessandrini A, Piraccini BM. Oral and nail pigmentations: a useful parallelism for the clinician. J Dtsch Dermatol Ges 2020; 18:7-14. [PMID: 31951106 DOI: 10.1111/ddg.14023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/21/2019] [Indexed: 12/20/2022]
Abstract
Oral (OP) and nail (NP) pigmentations may occur simultaneously in physiological or pathological conditions, and may be a sign of underlying syndromic conditions that necessitate further investigation and treatment. Interestingly, the nail unit and oral cavity show a clinical parallelism that may help the clinician to conduct a correct examination and reach a prompt diagnosis. Both OP and NP can manifest clinically with focal or diffuse involvement and are due to external factors (exogenous pigmentation, drug-induced pigmentation) or endogenous factors (racial pigmentation, post-inflammatory pigmentation, nevi, genetic conditions and other disorders). The most concerning differential diagnosis is melanoma. Here we report the pathogenetic basis of OP and NP, together with the description of similar clinical features. To the best of our knowledge this is the first paper to summarize and describe the causes of pigmentation of both the oral cavity and the nail unit.
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Affiliation(s)
- Emi Dika
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Michela Starace
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giulia Veronesi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Dika E, Starace M, Lambertini M, Patrizi A, Veronesi G, Alessandrini A, Piraccini BM. Orale und Nagelpigmentierungen: eine für den Kliniker nützliche Parallelität. J Dtsch Dermatol Ges 2020; 18:7-16. [DOI: 10.1111/ddg.14023_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 07/21/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Emi Dika
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Michela Starace
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Martina Lambertini
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Annalisa Patrizi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Giulia Veronesi
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Aurora Alessandrini
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
| | - Bianca Maria Piraccini
- DermatologyDepartment of ExperimentalDiagnostic and Specialty MedicineUniversity of Bologna Bologna Italy
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Abstract
Benign and malignant neoplasm of oral cavity is usually presented as swellings or ulcerations of affected tissue. The lesions are broadly categorized as potentially malignant disorders, benign and malignant neoplasm of epithelial and connective tissue origin for the convenience of learning. Neoplasm of oral cavity has a significantly lower incidence. Because of uncommon occurrence of oral neoplasm, retention of diagnostic skills is a challenging task. However, comprehensive understanding on clinical and pathologic details will help in correlating and presenting complaint and assisting in formulation of possible diagnosis. The key for successful therapeutic management depends on achieving right and timely diagnosis.
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Affiliation(s)
- B V Ramana Reddy
- Department of Oral and Maxillofacial Pathology, SIBAR Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh 522 509, India.
| | - K Kiran Kumar
- Department of Oral and Maxillofacial Pathology, SIBAR Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh 522 509, India
| | - Arvind Babu Rajendra Santosh
- School of Dentistry, Faculty of Medical Sciences, The University of the West Indies, Mona campus, Kingston 7, West Indies
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Maymone MB, Greer RO, Burdine LK, Dao-Cheng A, Venkatesh S, Sahitya PC, Maymone AC, Kesecker J, Vashi NA. Benign oral mucosal lesions: Clinical and pathological findings. J Am Acad Dermatol 2019; 81:43-56. [DOI: 10.1016/j.jaad.2018.09.061] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 02/08/2023]
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Oliveira SR, de Azevedo Branco LG, Rocha AL, Travassos DV, Magalhães GHR, Fonseca FP, Mesquita RA, Abreu LG, da Silva TA. Association of oral mucosa hyperpigmentation with imatinib mesylate use: a cross-sectional study and a systematic literature review. Clin Oral Investig 2019; 23:4371-4382. [PMID: 30968242 DOI: 10.1007/s00784-019-02886-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/27/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To assess the association between oral mucosa hyperpigmentation in patients with leukemia and imatinib mesylate use. Additionally, we compared our data to those obtained from a systematic review. MATERIALS AND METHODS A cross-sectional study was conducted with 74 patients undergoing treatment with imatinib mesylate. Sociodemographic characteristics, oral mucosa alterations, and medical history were evaluated. Oral hyperpigmentation was scored. The use of imatinib mesylate and hydroxyurea was evaluated. Association between oral hyperpigmentation and imatinib mesylate was assessed. A systematic review was also conducted to retrieve case reports or case series of patients with oral hyperpigmentation associated with imatinib mesylate. RESULTS Among the 74 participants, 41 were male (55.4%) and 33 were female (44.6%). Participants' mean age was 49.3 years. Sixty-six (89.2%) patients developed hyperpigmented lesions in the hard palate mucosa. In multivariate analysis, patients who had used imatinib mesylate for > 72 months had a hyperpigmentation score 1.62 times higher than those who had used this medication during a shorter period. Patients who had used hydroxyurea for > 30 days had a hyperpigmentation score 1.43 times higher than those who had used this medication during a shorter period. The systematic review retrieved 20 clinical cases of patients undergoing imatinib mesylate treatment and exhibiting oral hyperpigmentation. CONCLUSIONS The development of oral hyperpigmentation is associated with imatinib mesylate use. Hydroxyurea seems to increment such an association. CLINICAL RELEVANCE To assist providers in the differential diagnosis of hyperpigmented lesions associated with imatinib mesylate, as well as in the clinical management of such lesions.
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Affiliation(s)
- Sicília Rezende Oliveira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Amanda Leal Rocha
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gustavo Henrique Romani Magalhães
- Department of Hematology and Oncology, Chronic Myeloproliferative Diseases Outpatient Clinic, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Tarcília Aparecida da Silva
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Gonçalves IMF, Gomes DQC, Pereira JV, Nonaka CFW, Alves PM. Clinical and histopathological study of the oral multifocal melanoacanthoma: A case report. J Clin Exp Dent 2019; 11:e391-e394. [PMID: 31110620 PMCID: PMC6522109 DOI: 10.4317/jced.55344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/04/2019] [Indexed: 01/24/2023] Open
Abstract
Melanoacanthoma is a blackened mucocutaneous lesion, mainly affecting individuals with dark skin and exhibiting rapid development. Differential diagnosis includes nevus, amalgam tattoo and melanoma. This article reports a case of a 53-year-old white woman, who exhibited multiple blackened lesions on the gingiva and upper lip. After incisional biopsy, the presence of numerous melanin-containing dendritic cells distributed throughout the epithelial thickness, which were S-100 (+), were observed microscopically. Final diagnosis was multifocal oral melanoacanthoma. Follow-up for 28 months has shown appearing of more lesions in gingiva and upper lip. Therefore, the importance of differential diagnosis of oral melanoma with the group of oral pigmented lesions, and possible associated systemic diseases were evaluated.
Key words:Melanocytes, pigmentation, oral mucosa, gingiva, differential diagnosis.
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Affiliation(s)
| | | | - Jozinete-Vieira Pereira
- MSc, PhD. Professor Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | - Pollianna-Muniz Alves
- MSc, PhD. Professor Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
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Penmetsa GS, Mopidevi A, Dwarakanath CD, Raju MAKV. Melanocyte Response Following Depigmentation by Cryosurgery and Mucosal Excision: A Comparative Clinical and Histopathological Study. Contemp Clin Dent 2019; 10:214-219. [PMID: 32308280 PMCID: PMC7145241 DOI: 10.4103/ccd.ccd_364_18] [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] [Indexed: 11/18/2022] Open
Abstract
AIMS The main aim of this study was to evaluate the melanocyte response following depigmentation by cryosurgery and mucosal excision at both clinical and histopathological levels during 6 months. SUBJECTS AND METHODS A total of 15 individuals, aged 25-45 years with hyperpigmentation on the facial aspect of the gingiva present in the esthetic zone were included. A split-mouth approach was used, wherein one side received depigmentation by a scalpel and the other side received cryotherapy, with the choice of the therapy and side chosen by the spin of the coin. For determining the melanocyte assay, a small amount of gingival tissue that was excised was studied under a special staining technique, i.e., Masson-Fontana method for melanin, a histochemistry procedure which determines the activity of melanin both quantitatively and qualitatively. Clinical and histological observations for the intensity of pigmentation were recorded at baseline and 6 months after surgery. STATISTICAL ANALYSIS USED Paired and unpaired t-test. Results: The mean value of the Dummett Oral Pigmentation Index (DOPI) was 2.44 ± 0.51 at baseline; following depigmentation with scalpel technique, the mean DOPI was 1.05 ± 0.23 at 6 months; and there was a statistically significant difference in the mean DOPI when compared with that of the baseline (P = 0.001). Following depigmentation with cryosurgery technique, the mean DOPI was 0.33 ± 0.48 at 6 months which also varied statistically significantly with that of the baseline (P = 0.001). The mean value of melanin histopathological count (MHC) was 95.53 ± 9.03 at baseline; following depigmentation with the scalpel technique, the mean DOPI was 89.49 ± 7.56 at 6 months, which was not statistically significant (P = 0.795). Following depigmentation with the cryosurgery technique, the mean MHC was 75.38 ± 5.63 at 6 months, which was not statistically significant (P = 0.285). CONCLUSIONS The mean histologic count of the melanocytes, which accounts for the re-pigmentation process has shown low recurrence values in cryosurgery over the scalpel technique even though the difference was not statistically significant.
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Affiliation(s)
- Gautami S. Penmetsa
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Anudeep Mopidevi
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - C. D. Dwarakanath
- Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - M. A. K. V. Raju
- Department of Orthodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Analysis of nicotinamide N-methyltransferase in oral malignant melanoma and potential prognostic significance. Melanoma Res 2019; 29:151-156. [DOI: 10.1097/cmr.0000000000000548] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Rosebush MS, Briody AN, Cordell KG. Black and Brown: Non-neoplastic Pigmentation of the Oral Mucosa. Head Neck Pathol 2019; 13:47-55. [PMID: 30671761 PMCID: PMC6405786 DOI: 10.1007/s12105-018-0980-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/24/2018] [Indexed: 01/14/2023]
Abstract
Black and brown pigmentation of the oral mucosa can occur due to a multitude of non-neoplastic causes. Endogenous or exogenous pigments may be responsible for oral discoloration which can range from innocuous to life-threatening in nature. Physiologic, reactive, and idiopathic melanin production seen in smoker's melanosis, drug-related discolorations, melanotic macule, melanoacanthoma and systemic diseases are presented. Exogenous sources of pigmentation such as amalgam tattoo and black hairy tongue are also discussed. Determining the significance of mucosal pigmented lesions may represent a diagnostic challenge for clinicians. Biopsy is indicated whenever the source of pigmentation cannot be definitively identified based on the clinical presentation.
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Affiliation(s)
- Molly S. Rosebush
- Louisiana State University, 1100 Florida Avenue, New Orleans, LA 70119 USA
| | | | - Kitrina G. Cordell
- Louisiana State University, 1100 Florida Avenue, New Orleans, LA 70119 USA
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Decmann A, Patócs A, Igaz P. Overview of Genetically Determined Diseases/Multiple Endocrine Neoplasia Syndromes Predisposing to Endocrine Tumors. EXPERIENTIA SUPPLEMENTUM (2012) 2019; 111:105-127. [PMID: 31588530 DOI: 10.1007/978-3-030-25905-1_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this chapter, we present an overview of multiple endocrine neoplasia syndromes including their most important clinical and molecular features. Multiple endocrine neoplasia type 1 and 2 syndromes (MEN1 and MEN2) are discussed in detail. Syndromes that are presented in other chapters are only briefly mentioned. We discuss the relevance of germline gene alterations in apparently sporadic endocrine tumors, e.g., medullary thyroid cancer, primary hyperparathyroidism, and neuroendocrine tumors. McCune-Albright syndrome that only exists in non-hereditary, sporadic forms is also discussed in detail, as tumors of several endocrine organs can develop in the same individual.
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Affiliation(s)
- Abel Decmann
- 2nd Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Patócs
- Department of Laboratory Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- "Lendület" Hereditary Endocrine Tumors Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary
- Department of Molecular Genetics, National Institute of Oncology, Budapest, Hungary
| | - Peter Igaz
- 2nd Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
- MTA-SE Molecular Medicine Research Group, Hungarian Academy of Sciences and Semmelweis University, Budapest, Hungary.
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Laimer J, Henn R, Helten T, Sprung S, Zelger B, Zelger B, Steiner R, Schnabl D, Offermanns V, Bruckmoser E, Huck CW. Amalgam tattoo versus melanocytic neoplasm - Differential diagnosis of dark pigmented oral mucosa lesions using infrared spectroscopy. PLoS One 2018; 13:e0207026. [PMID: 30399191 PMCID: PMC6219804 DOI: 10.1371/journal.pone.0207026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Accepted: 10/22/2018] [Indexed: 12/14/2022] Open
Abstract
Background Dark pigmented lesions of the oral mucosa can represent a major diagnostic challenge. A biopsy is usually required to determine the nature of such intraoral discolorations. This study investigates the potential use of infrared spectroscopy for differential diagnosis of amalgam tattoos versus benign or malignant melanocytic neoplasms. Materials and methods For this retrospective study, formalin-fixed paraffin-embedded tissue (FFPE) specimens of dark pigmented lesions concerning the oral mucosa or the lip were investigated using mid infrared spectroscopy. The samples were chosen from patients who had undergone a mucosal biopsy at the University Hospital Innsbruck (Austria) between the years 2000 and 2017. Principal component analysis was used for data exploration. Evaluation was based on the superimposition of the recorded spectra and the corresponding histologic slides. Results In total, 22 FFPE specimens were analyzed. Clear differences were found between amalgam and non-amalgam samples. A general weakening of the penetrating infrared radiation allowed for unspecific discrimination between these two classes. An overall accuracy in predicting the correct class of 95.24% was achieved. Conclusion Infrared spectroscopy appears to be a suitable technique to differentiate between amalgam tattoos and melanocytic lesions in FFPE samples. It could potentially be applied in vivo, too, serving as a non-invasive diagnostic tool for intraoral dark pigmented lesions.
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Affiliation(s)
- Johannes Laimer
- University Hospital for Craniomaxillofacial and Oral Surgery, Innsbruck, Austria
| | - Raphael Henn
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - Tom Helten
- University Hospital for Craniomaxillofacial and Oral Surgery, Innsbruck, Austria
| | - Susanne Sprung
- Institute of Pathology, Medical University, Innsbruck, Austria
| | - Bettina Zelger
- Institute of Pathology, Medical University, Innsbruck, Austria
| | - Bernhard Zelger
- University Hospital for Dermatology, Venereology and Allergology, Innsbruck, Austria
| | - René Steiner
- University Hospital for Dental Prosthetics and Restorative Dentistry, Innsbruck, Austria
| | - Dagmar Schnabl
- University Hospital for Dental Prosthetics and Restorative Dentistry, Innsbruck, Austria
| | - Vincent Offermanns
- University Hospital for Craniomaxillofacial and Oral Surgery, Innsbruck, Austria
| | | | - Christian W. Huck
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
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Affiliation(s)
- Meghan E Fredette
- Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Lisa Swartz Topor
- Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI
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Tavares TS, Meirelles DP, de Aguiar MCF, Caldeira PC. Pigmented lesions of the oral mucosa: A cross-sectional study of 458 histopathological specimens. Oral Dis 2018; 24:1484-1491. [DOI: 10.1111/odi.12924] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/28/2018] [Accepted: 06/19/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Thalita S. Tavares
- Department of Oral Pathology and Surgery; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Daniela P. Meirelles
- Department of Oral Pathology and Surgery; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Maria Cássia F. de Aguiar
- Department of Oral Pathology and Surgery; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - Patrícia C. Caldeira
- Department of Oral Pathology and Surgery; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
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46
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An unusual birthmark. J Am Dent Assoc 2018; 149:802-806. [PMID: 29935725 DOI: 10.1016/j.adaj.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 04/30/2018] [Accepted: 05/09/2018] [Indexed: 01/11/2023]
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47
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Kang IH, Jeong KH, Lee MH, Shin MK. Atopic labial pigmentation: a new diagnostic feature in Asian patients with atopic dermatitis. Int J Dermatol 2018; 57:817-821. [DOI: 10.1111/ijd.14010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/22/2018] [Accepted: 04/02/2018] [Indexed: 01/15/2023]
Affiliation(s)
- In-Hye Kang
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Ki-Heon Jeong
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Mu-Hyoung Lee
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
| | - Min-Kyung Shin
- Department of Dermatology; School of Medicine; Kyung Hee University; Seoul Korea
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Zaki H, Sabharwal A, Kramer J, Aguirre A. Laugier-Hunziker Syndrome Presenting with Metachronous Melanoacanthomas. Head Neck Pathol 2018; 13:257-263. [PMID: 29450847 PMCID: PMC6514033 DOI: 10.1007/s12105-018-0897-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/12/2018] [Indexed: 12/15/2022]
Abstract
Laugier-Hunziker syndrome (LHS, also termed idiopathic lenticular mucocutaneous hyperpigmentation) is an unusual condition characterized by progressive pigmentation of the mucous membranes. LHS displays a benign course and is not associated with malignancy. Here we present a case of LHS with a 7-year follow-up. We document metachronous oral melanoacanthomas in this individual. In addition, we found that the oral melanotic macules in this patient waxed and waned in a cyclical manner. To our knowledge, this is the first report of these findings in the context of LHS. Finally, we provide an overview of other conditions that can present with mucosal hyperpigmentation. It is critical to distinguish LHS from other conditions characterized by mucosal pigmentation in order to facilitate optimal patient care.
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Affiliation(s)
- Hattan Zaki
- Oral Basic and Clinical Sciences Department, Faculty of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Amarpreet Sabharwal
- Department of Periodontics and Endodontics, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Jill Kramer
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY USA
| | - Alfredo Aguirre
- Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, The State University of New York, 355 Squire Hall, 3435 Main Street, Buffalo, NY 14214-3008 USA
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Seitz SD, Dinh TN, Yoon TY. Melanotic Macule in Conjunction with a Giant Cell Fibroma. J Contemp Dent Pract 2017; 18:981-985. [PMID: 28989141 DOI: 10.5005/jp-journals-10024-2160] [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
INTRODUCTION The aim of this study is to describe a case of a melanotic macule found in conjunction with a giant cell fibroma (GCF). For oral pigmented lesions without an identifiable etiologic factor, critical factors in determining the differential diagnosis are clinical history, symmetry, and uniformity of the lesions. Potential differential diagnosis includes racial pigmentation, endocrine disturbance, Peutz-Jeghers syndrome, trauma, hemochromatosis, oral malignant melanoma, or idiopathic etiology and melanotic macules. Melanotic macules are the most common solitary pigmented melanocytic lesions in the oral mucosa, corresponding to 86.1% of melanocytic lesions of the mouth. Giant cell fibromas are reactive connective tissue lesions in the oral cavity. They were first described as a distinct entity in 1974 by Weathers and Callihan and make up around 5 to 10% of all oral mucosa fibrous lesions. They are commonly mistaken for other growths, such as pyogenic granuloma and fibroma, and diagnosis is accurately based on its distinctive histopathology. This article presents the clinicopathologic findings of a 15-year-old Hispanic male presenting for biopsy of a melanotic macule on the mandibular anterior buccal gingiva. Histologic evaluation of the specimen revealed that the lesion also contained a GCF. Pathologic lesions of the mouth should be carefully diagnosed. Conventionally, histologic evaluation is the gold standard to produce a final diagnosis. As evidenced in this article, multiple lesions may exist in a site and may be mistakenly diagnosed as a single entity. CLINICAL SIGNIFICANCE While each lesion has been reported individually, in reviewing the literature, no cases were reported in which both histopathologic findings of GCF and melanotic macule were present within the same lesion.
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Affiliation(s)
- Samantha D Seitz
- Department of Restorative Dentistry, Lake Erie College of Osteopathic Medicine, School of Dental Medicine, Bradenton Florida, USA
| | - Thanhphuong N Dinh
- Department of Restorative Dentistry, Lake Erie College of Osteopathic Medicine, School of Dental Medicine, Bradenton Florida, USA
| | - Thomas Yh Yoon
- Department of Periodontology, Lake Erie College of Osteopathic Medicine, School of Dental Medicine, Bradenton, Florida, USA, Phone: +9414051506, e-mail:
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Houshmand B, Janbakhsh N, Khalilian F, Talebi Ardakani MR. Efficacy of Conventional Laser Irradiation Versus a New Method for Gingival Depigmentation (Sieve Method): A Clinical Trial. J Lasers Med Sci 2017; 8:88-94. [PMID: 28652902 DOI: 10.15171/jlms.2017.16] [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] [Indexed: 01/13/2023]
Abstract
Introduction: Diode laser irradiation has recently shown promising results for treatment of gingival pigmentation. This study sought to compare the efficacy of 2 diode laser irradiation protocols for treatment of gingival pigmentations, namely the conventional method and the sieve method. Methods: In this split-mouth clinical trial, 15 patients with gingival pigmentation were selected and their pigmentation intensity was determined using Dummett's oral pigmentation index (DOPI) in different dental regions. Diode laser (980 nm wavelength and 2 W power) was irradiated through a stipple pattern (sieve method) and conventionally in the other side of the mouth. Level of pain and satisfaction with the outcome (both patient and periodontist) were measured using a 0-10 visual analog scale (VAS) for both methods. Patients were followed up at 2 weeks, one month and 3 months. Pigmentation levels were compared using repeated measures of analysis of variance (ANOVA). The difference in level of pain and satisfaction between the 2 groups was analyzed by sample t test and general estimate equation model. Results: No significant differences were found regarding the reduction of pigmentation scores and pain and scores between the 2 groups. The difference in satisfaction with the results at the three time points was significant in both conventional and sieve methods in patients (P = 0.001) and periodontists (P = 0.015). Conclusion: Diode laser irradiation in both methods successfully eliminated gingival pigmentations. The sieve method was comparable to conventional technique, offering no additional advantage.
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Affiliation(s)
- Behzad Houshmand
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noushin Janbakhsh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khalilian
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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