Oral lichen planus (OLP) is a relatively common chronic mucocutaneous inflammatory disease and a search for novel therapeutic options has been performed. We sought to compare the efficacy of laser phototherapy (LPT) to topical clobetasol propionate 0.05% for the treatment of atrophic and erosive OLP. Forty-two patients with atrophic/erosive OLP were randomly allocated to two groups: clobetasol group (n=21): application of topical clobetasol propionate gel (0.05%) three times a day; LPT group (n=21): application of laser irradiation using InGaAlP diode laser three times a week. Evaluations were performed once a week during treatment (Days 7, 14, 21, and 30) and in four weeks (Day 60) and eight weeks (Day 90) after treatment. At the end of treatment (Day 30), significant reductions in all variables were found in both groups. The LPT group had a higher percentage of complete lesion resolution. At follow-up periods (Days 60 and 90), the LPT group maintained the clinical pattern seen at Day 30, with no recurrence of the lesions, whereas the clobetasol group exhibited worsening for all variables analyzed. These findings suggest that the LPT proved more effective than topical clobetasol 0.05% for the treatment of OLP.
Syphilis is an infectious disease caused by the bacterium Treponema pallidum. Syphilis has three clinical stages and may present various oral manifestations, mainly at the secondary stage. The disease mimics other more common oral mucosa lesions, going undiagnosed and with no proper treatment. Despite the advancements in medicine toward prevention, diagnosis, and treatment syphilis remains a public health problem worldwide. In this sense, dental surgeons should be able to identify the most common manifestations of the disease in the oral cavity, pointing to the role of this professional in prevention and diagnosis. This study describes a case series of seven patients with secondary syphilis presenting different oral manifestations.
The aim of this study was to evaluate the frequency of oral mucosal lesions and their associations with sociodemographic, health, and behavioral factors in a southern Brazilian population. Information was collected from participants (n = 801) using a structured questionnaire during an oral cancer screening campaign held at an agribusiness show in southern Brazil in 2009. Data were described using frequency distributions or means and standard deviations. Associations between independent variables and outcomes were assessed using the Chi-squared test. A total of 465 lesions were detected (actinic cheilitis: n = 204, 25.5%; candidiasis: n = 50, 6.2%; fibrous inflammatory hyperplasia: n = 42, 5.2%; ulceration, n = 33, 4.1%; hemangioma: n = 14, 1.7%; leukoplakia: n = 11, 1.4%). Candidiasis, actinic cheilitis, and fibrous inflammatory hyperplasia were associated significantly with literacy. Actinic cheilitis was also associated significantly with sun exposure and hat use, and leukoplakia was associated with smoking. The high frequency of oral mucosal lesions observed highlights the importance of education about risk factors. Additionally, training of health professionals, mainly those from public health services, in the use of preventive and community education strategies is needed.
Kindler syndrome is a rare genetic disorder showing some predominant clinical manifestations, for example, trauma-induced blisters, progressive poikiloderma, skin atrophy, and photosensitivity. Oral manifestations are not commonly described and can be often misdiagnosed. This report describes the case of a female patient diagnosed with Kindler syndrome showing the classical clinical features affecting the skin, in addition to oral lesions manifesting as keratotic plaques and ulcers affecting the buccal mucosa, floor of the mouth, alveolar ridge, hard palate, and soft palate. An incisional biopsy was performed to confirm the diagnostic hypothesis of an autoimmune lesion possibly related with the syndrome. Knowledge about the possible manifestations of the Kindler syndrome is important to improve its management.
Mucosite oral (MO)
IntroduçãoA cavidade bucal é revestida pela membrana mucosa, que é o forramento úmido que cobre tanto o trato gastrointestinal como as vias aéreas e as outras cavidades do organismo que se comunicam com o ambiente externo. A mucosa bucal é composta por epitélio pavimentoso estratificado, queratinizado ou não, cobrindo o tecido conjuntivo.Suas funções são de proteção, sensação, secreção e regulação térmica. É classificada em três tipos: 1) mastigatória, que cobre as áreas expostas às forças compressivas e ao atrito da mastigação, 2) mucosa de revestimento e 3) mucosa especializada da superfície dorsal da língua 1,2 .A mucosite oral (MO) 4 pode ser definida como uma alteração da mucosa de revestimento da cavidade bucal que pode ocorrer durante o tratamento oncológico. Segundo Neville et al. 3 (2009), o dano mucoso secundário ao tratamento antineoplásico é complexo e parece surgir de uma série de eventos celulares e moleculares que ocorrem não só em epitélio como também no estroma subjacente. Diferenças genéticas na taxa de apoptose tecidual, lesões microvasculares a partir da apoptose do endotélio e níveis séricos elevados de fator de necrose tumoral alfa e interleucina-6 parecem estar envolvidos.
This case report describes an uncommon manifestation of histoplasmosis on the
soft palate. The importance of appropriate treatment and follow-up in complex
cases is emphasized, especially in patients with chronic diseases. Oral lesions
may occur as multiple, granular and painful ulcers, as well as verrucous
growths. Lesions may also be deep, with infiltrative edges and erythematous or
with white areas, accompanied by local lymphadenopathy, resembling a carcinoma
on clinical examination. In this sense, a fast and accurate diagnosis is
essential to the success of treatment of oral histoplasmosis.
The present case-report describes tuberculosis on the oral mucosa, in a rare manifestation of the disease. The importance of appropriate diagnosis and awareness of the clinical manifestations is highlighted. Oral lesions seem to occur as chronic ulcers, nodular or granular areas, and rare, firm leukoplakia regions. Most extra-pulmonary lesions represent secondary infections of a primary lung infectious focus; therefore, early and accurate diagnosis is required for planning of the best treatment and strategies to control the disease.
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