scholarly journals Pigmented Oral Lesions: A Multicenter Study

Author(s):  
Kittipong Dhanuthai ◽  
Natchaya Theungtin ◽  
Natnicha Theungtin ◽  
Pantira Thep-akrapong ◽  
Sompid Kintarak ◽  
...  

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.

Author(s):  
Fatemeh Owlia ◽  
Hossein Tabatabaei ◽  
Mohammad Nima Motallaei ◽  
Reza Ayatollahy

Introdution: One of the most important signs of general health is oral health. Many systemic diseases have oral manifestations that could be appeared in the oral cavity at first. Therefore, considering the importance of timely diagnosis and treatment of oral lesions. This study was conducted to determine the prevalence of oral lesions in the patients admitted to Yazd ShahidSadoughi Hospital. Methods: In this cross sectional study, 443 hospitalized patients were clinically evaluated for oral mucosal lesions. All of the abnormal variations in oral mucosa in these patients, demographic data, type & location of oral lesion, existence of denture & smoking were documented. Data were analyzed by SPSS Inc., Chicago, IL; Version 19 was analyzed using Chi-square and Fisher exact tests. Results: Oral lesions were observed in 37.7% of patients. The most common type of lesion was related to red and white lesions, which was seen in 19.1% of patients.  Palate was the common location for red and white lesions. Most of vesiculobollous lesions were observed in the hard palate and tongue. The lesions rate increased with aging. Among the lesions, only pigmented lesions were significantly higher in males. Conclusion: Regarding the high prevalence of oral mucosal lesions in admitted patients, the importance of more attention to oral cavity for timely diagnosis and referral in the routine examination is emphasized.


Author(s):  
Vural Fidan ◽  
Handan Koyuncu ◽  
Okan Akin

Purpose: Since the beginning of the Covid 19 outbreak, many signs of the disease have been identified. It is known that Covid 19 uses the mouth area as an entrance to the respiratory tract. As with all diseases, early diagnosis and treatment is effective in the course of the disease in Covid 19. We aimed to identify the oral lesions of Covid 19 for detecting disease at early stages. Methods: Seventy-four patients whom detected Covid 19 in their nasopharyngeal swab were included in this study. Results: Fifty-eight of seventy-four patients had oral lesions. Aphthous-like ulcer was the most common oral lesion (n: 27). Respectively, other findings were erythema (n: 19) and lichen planus (n:12). The most common location of lesions was tongue (n: 23). Respectively, other lesion areas were buccal mucosa (n: 20), gingiva (n:11) and palate (n:4). Conclusion: In the study, more than half of Covid 19 patients had oral lesions. Therefore, oral evaluation is important in early diagnosis in cases whom suspected Covid 19.


Author(s):  
Timothy Collins

Oral lesions typically present as swellings/lumps or mucosal lesions. Mucosal lesions can be red, white, red-and-white or pigmented. Lesions are typically incidental findings in routine dental examinations of asymptomatic patients. Symptoms (typically soreness) prompt patients to seek advice from GPs as well as dentists. Oral ulceration is a common reason for presentation and may indicate a suspicion of underlying pathology. It is common for mucosal lesions to warrant referral, but it is useful to identify benign pathology to inform the urgency of referral. The study of suspicious oral pathology, in addition to benign pathology mimicking suspicious aetiology, forms a significant component of the dental undergraduate curriculum. This is a large topic and full familiarity will require reading beyond the scope of this article.


2021 ◽  
Vol 48 (4) ◽  
pp. 425-436
Author(s):  
Sang Hyun Park ◽  
Hyuntae Kim ◽  
Ji-Soo Song ◽  
Hong-Keun Hyun ◽  
Young-Jae Kim ◽  
...  

The aim of this study was to provide pathological information of pediatric oral lesions by retrospectively analyzing oral biopsy results from pediatric patients at the Seoul National University Dental Hospital. Biopsy results of all oral lesions from pediatric patients, aged 0 - 16 years, were collected from the files of the Department of Oral Pathology, Seoul National University Dental Hospital from January 2000 to April 2020. The patients were divided into 3 age groups: 0 - 5, 6 - 11 and 12 - 16 years. All oral lesions were classified into three main categories: inflammatory and reactive, tumor or tumor-like and cystic lesions. Among the total of 2928 biopsy specimens, tumor or tumor-like lesions(35.66%) were the most common, followed by inflammatory and reactive lesions(34.29%) and cystic lesions(30.05%). Regardless of the categories used in this study, odontoma was the most frequently found lesion, mucocele and dentigerous cyst being the next common. This study was the first retrospective review of pediatric oral pathology in Korea, and the results from this study may assist in providing informative insight into the pediatric oral pathology for pediatric dentists.


2020 ◽  
Vol 32 (3) ◽  
pp. 207
Author(s):  
Audrey Amber Vieri ◽  
Rosiliwati Wihardja ◽  
Tenny Setiani Dewi

Introduction: Inhalation therapy has become the first-line treatment for bronchial asthma patients. Studies have proved that not all of the inhaled drugs reach the target organ, but mostly are deposited in the mouth and cause local immunosuppressant and decrease saliva secretion. These conditions are closely linked to some adverse effects in the mouth. The purpose of this study was to describe the clinical appearance of oral lesion in bronchial asthma patients using inhalation drugs. Methods: This study was descriptive and conducted on 30 bronchial asthma patients that have been using inhalation drug for at least one year, free of other systemic diseases, not using denture and orthodontic appliances. Oral mucosa was examined, and any oral lesion was recorded. Results: The most number of oral lesions found in patients through clinical examinations were plaque (73.3%), followed by a fissure (36.7%), atrophy (30%), and the least oral lesions found were pigmentation (3.3%), bullae (3.3%), and petechiae (3.3%). The lesions found in patients using inhalation drugs in a range of up to 10 years were found more varyingly. Conclusion: Plaque, fissure, atrophy, pigmentation, bullae, and petechiae are oral lesions that are clinically found in bronchial asthma patients using inhalation drugs.


2021 ◽  
pp. 159101992199050
Author(s):  
Erol Akgul ◽  
Hasan Bilen Onan ◽  
Irem Islek ◽  
Mehmet Tonge ◽  
Yavuz Durmus ◽  
...  

Background We assessed the safety and efficacy of flow diverter stents (FDSs) in the treatment of recanalized or residual intracranial aneurysms treated endovascularly. Materials & Methods Patients whose recanalized or residual aneurysms were treated with FDSs in five tertiary hospitals were reviewed retrospectively. The patients’ demographic data, aneurysm characteristics, types of previous treatment, and clinical complications, or serious adverse events associated with FDSs, as well as the results of neurological and angiographic follow-up assessments, were recorded. Results Eighty-six patients (37 males) with 87 aneurysms were included in this study. Eighty (91.9%) aneurysms were in the anterior and seven (8.1%) in the posterior circulation. The initial treatment methods were the primary coiling or balloon remodeling technique in 69 (79.3%) and stent-assisted coiling in 18 (20.7%) aneurysms. The endovascular procedure was successful in all patients. Complications occurred in four patients, for a total complication rate of 4.6%. A technical complication developed in one patient (1.2%). An in-stent thrombosis treated with tirofiban was seen in two cases. Late in-stent stenosis exceeding 50% was treated with balloon angioplasty in one patient. The mean length of follow-up was 21.0 months. The first angiographic follow-up (3–6 months) revealed the complete occlusion of 74 aneurysms (85.1%). While 76 aneurysms (87.4%) were occluded at the last angiographic follow-up (mean: 26.0 months), 11 aneurysms (12.6%) were still filling. Morbimortality was zero. Conclusion The drawback of endovascular treatment is aneurysmal remnants or recurrences, which is safely and durably amenable to flow diversion.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 508.2-509
Author(s):  
K. Maatallah ◽  
H. Boussaa ◽  
H. Riahi ◽  
H. Ferjani ◽  
M. Habechi ◽  
...  

Background:Foot disease is a common problem in rheumatoid arthritis (RA). Therapeutic decisions are often based on clinical examination (CE) alone, which can be adversely affected by factors such as deformity, obesity, and peripheral edema. Ultrasonography (US) has previously been shown to be more sensitive than CE for detecting synovitis and tenosynovitis in RA forefeet, but few data exist for the hindfoot and ankle.Objectives:The aim of this study was to compare CE and US for the detection of hindfoot and ankle synovitis and tenosynovitis in patients with established RA.Methods:We conducted a cross-sectional study including patients with RA (ACR/EULAR 2010). Demographic data and disease parameters were collected. CE was performed by a rheumatologist for the presence or absence of tenderness, swelling, and mobility restriction of both ankles. The following tendons were examined for tenosynovitis: tibialis anterior (TA) and posterior (TP), fibularis longus (FL), and brevis (FB) (assessed together). In a second time, US examination of the tibiotalar, talonavicular, and subtalar joints and the same tendons as CE was performed by a blinded radiologist experienced in musculoskeletal imaging using a Philips HD11 device with a high-frequency linear transducer. The presence or absence of synovitis and tenosynovitis was recorded, and the composite synovitis score (power doppler / grayscale ultrasound (PDUS)) was measured for each joint. The US score of each patient was defined by the sum of the composite scores of the joints studied (0-30). A p-value <0.05 was considered significant.Results:Sixty-two feet were examined in 31 RA patients (25 women and six men) with a mean age of 54.8±10.8 years old [32-70]. The mean disease duration was 8.5±7.2 years [1-37]. Rheumatoid Factor (RF) and Anti-Citrullinated Peptides Antibodies (ACPA) were positive in 61.3% and 83.8% of cases. The mean DAS28 ESR was 3.8±1.5 [0.6-7].Clinical examination of ankles revealed tenderness in 57.4% of cases, swelling in 38.8% of cases, and restriction in the range of motion in 11.1% of cases. TA tenosynovitis was noted in 14.8% of cases, TP tenosynovitis in 22.2% of cases, and FL and FB tenosynovitis in 31.5% of cases.US showed tibiotalar synovitis in 59.3% of cases, talonavicular synovitis in 64.8% of cases, and subtalar synovitis in 46.3% of cases. TA tenosynovitis was noted in 5.6% of cases, TP tenosynovitis in 22.2% of cases, and FB and FL tenosynovitis in 25% and 11.1% of cases respectively.An association was found between clinical tenderness and US synovitis of the tibiotalar joint (p=0.013) and the talonavicular joint (p=0.027). No association was noted between clinical swelling and US synovitis in these joints.No association was noted between clinical and US tenosynovitis of TA (p=0.279), TP (p=0.436), FB (p=0.495) and FL (p=0.315).Conclusion:Clinical examination of RA ankles may be challenging and needs to be coupled with US, which is more sensitive and accurate in the detection of synovitis and tenosynovitis.Disclosure of Interests:None declared


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1119.1-1119
Author(s):  
L. Nacef ◽  
Y. Besbes ◽  
Y. Mabrouk ◽  
H. Ferjani ◽  
K. Maatallah ◽  
...  

Background:The lipid paradox is termed the decreased cholesterol level in rheumatoid arthritis (RA). Nevertheless, the apolipoprotein levels are usually higher than a healthy person and are predictors of cardiovascular events.Objectives:We aimed to describe lipid abnormalities in RA patients and to look for predictor factors of these changes.Methods:The prospective study was carried out on patients with RA who met the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria. These patients were followed in the rheumatology department of the Kassab Institute.We collected the socio-demographic data, biological and immunological parameters.The lipid assessment included: a measurement of total cholesterol (TC), HDL, LDL, and triglycerides (TG). Lipoproteins APOA1 and APOB were measured. All data were collected after patient consent.Results:Of the 47 patients recruited, 78.7% were female. The mean age was 52.5 ±11.06 [32-76]. The average RA progressed from 86.25 ±63 months [5-288] and was erosive in 81.6% of cases. The rheumatoid factor (RF) was positive in 57.8% of patients, and citrullinated antipeptide antibodies (ACPA) were present in 62.2%. Eight patients had a previous CV history.Mean TC was 4.42 ±1.3 [1.2-7.58], mean HDL was 1.38 ±0.73 [0.18-4.10], mean LDL was 2.55 ±1.16 [0.24-5.54]. The mean TG value was 1.28 ±0.6 [0.24-5.54]. TC elevation was found in 9.1% of cases, HDL in 21.3% of cases, LDL in 5.5% of cases, and TG in 16.4% of cases. Mean APOB/APOA1 ratio was 0.67 ±0.18 [0,46-1,11]. LDL elevation was associated to a high DAS28 (p=0.06, r=0.512). APOA1 was associated to a low DAS28 (p=0.04, r=-0.642).The mean value of APO A1 was 1.36 ±0.21 [0.84-1.81], that of APOB was 0.90 ±0.22 [0.58-1.40]. APOA1 values were lower in patients with high-level LDL (p=0.767). The APOB value was associated with lipid disturbance without significant correlation (p=0.291).Conclusion:Lipid test abnormalities can be found in RA patients outside of any known CV risk factors. APOA1 seems to have a protective effect. Screening and treatment of these abnormalities can prevent CV risk.References:[1]Miguel Bernardes and al. Coronary artery calcium score in female rheumatoid arthritis patients: Associations with apolipoproteins and disease biomarkers. Int J Rheum Dis. 2019;00:1–16.[2]Anna So dergren and al. Biomarkers associated with cardiovascular disease in patients with early rheumatoid arthritis. PLOS ONE. August 5, 2019.Disclosure of Interests:None declared


2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098187
Author(s):  
Justus Gille ◽  
Ellen Reiss ◽  
Moritz Freitag ◽  
Jan Schagemann ◽  
Matthias Steinwachs ◽  
...  

Background: Autologous matrix-induced chondrogenesis (AMIC) is a well-established treatment for full-thickness cartilage defects. Purpose: To evaluate the long-term clinical outcomes of AMIC for the treatment of chondral lesions of the knee. Study Design: Case series; Level of evidence, 4. Methods: A multisite prospective registry recorded demographic data and outcomes for patients who underwent repair of chondral defects. In total, 131 patients were included in the study. Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS) score for pain were used for outcome analysis. Across all patients, the mean ± SD age of patients was 36.6 ± 11.7 years. The mean body weight was 80.0 ± 16.8 kg, mean height was 176.3 ± 7.9 cm, and mean defect size was 3.3 ± 1.8 cm2. Defects were classified as Outerbridge grade III or IV. A repeated-measures analysis of variance was used to compare outcomes across all time points. Results: The median follow-up time for the patients in this cohort was 4.56 ± 2.92 years. Significant improvement ( P < .001) in all scores was observed at 1 to 2 years after AMIC, and improved values were noted up to 7 years postoperatively. Among all patients, the mean preoperative Lysholm score was 46.9 ± 19.6. At the 1-year follow-up, a significantly higher mean Lysholm score was noted, with maintenance of the favorable outcomes at 7-year follow-up. The KOOS also showed a significant improvement of postoperative values compared with preoperative data. The mean VAS had significantly decreased during the 7-year follow-up. Age, sex, and defect size did not have a significant effect on the outcomes. Conclusion: AMIC is an effective method of treating chondral defects of the knee and leads to reliably favorable results up to 7 years postoperatively.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kaili Yang ◽  
Liyan Xu ◽  
Qi Fan ◽  
Yuwei Gu ◽  
Bo Zhang ◽  
...  

AbstractChina is a populous country but lacks epidemiological data on keratoconus (KC). The present study aimed to investigate the clinical data, demographic data, and visual function (VF) data of KC patients in Central China. A total of 524 KC eyes in 307 KC patients (217 bilateral and 90 unilateral) from Henan Eye Hospital were included in the current study. Demographic and VF data were assessed with questionnaires administered by well-trained staff during face-to-face interviews. Visual acuity value was examined by a qualified optometrist, and the clinical data were measured by professional clinicians. The distributions of sex, residence and education level of KC patients were compared by Chi-square tests, and the ratios of people wearing glasses and rigid gas permeable (RGP) lenses were compared by McNemar tests. General linear models/Chi-squared tests were used to compare the clinical and demographic data according to KC severity. Spearman’s correlation analysis was used to test the associations between the data and KC severity. The mean age at diagnosis was 20.98 ± 6.06 years, and males had a higher ratio of KC than females (P < 0.001). Patients in rural areas had a higher rate of KC than those in urban areas (P = 0.039), and the proportion of KC patients with a higher education level (above high school) was high (P < 0.001). A total of 68.40% of the patients reported eye rubbing and 3.52% had a positive family history. The percentage of people wearing glasses was higher than that of patients wearing RGP lenses (P < 0.001). The total VF score of KC patients was 69.35 ± 15.25. The thinnest corneal thickness (TCT) and stiffness parameter at the first applanation (SP-A1) values were inversely correlated with KC severity (P < 0.05). The mean, steep, and max keratometry (Km, Ks and Kmax) values, the RGP lens use and keratoplasty were positively correlated with KC severity (all P < 0.05). The total VF score of the eye with better VA decreased as the severity increased (r = − 0.21, P = 0.002). The present study comprehensively describes various associated features of KC patients from a tertiary hospital in Central China, providing a reference for understanding the characteristics of KC patients in China.


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