BackgroundSo far there have been no studies focusing on the prevalence of a wide spectrum of oral mucosal lesions (OML) in patients with dermatologic diseases. This is noteworthy as skin lesions are strongly associated with oral lesions and could easily be neglected by dentists. This study aimed to estimate the frequency and socio-behavioural correlates of OML in skin diseased patients attending outpatient's facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan.MethodsA cross-sectional hospital-based study was conducted in Khartoum from October 2008 to January 2009. A total of 588 patients (mean age 37.2 ± 16 years, 50.3% females) completed an oral examination and a personal interview of which 544 patients (mean age 37.1 ± 15.9 years, 50% females) with confirmed skin disease diagnosis were included for further analyses. OML were recorded using the World Health Organization criteria (WHO). Biopsy and smear were used as adjuvant techniques for confirmation. Data were analysed using the Statistical Package for Social Science (Version 15.0.1). Cross tabulation and Chi-square with Fisher's exact test were used.ResultsA total of 438 OML were registered in 315 (57.9%, males: 54.6% versus females: 45.6%, p < 0.05) skin diseased patients. Thus, a certain number of patients had more than one type of OML. Tongue lesions were the most frequently diagnosed OML (23.3%), followed in descending order by white lesions (19.1%), red and blue lesions (11%) and vesiculobullous diseases (6%). OML in various skin diseases were; vesiculobullous reaction pattern (72.2%), lichenoid reaction pattern (60.5%), infectious lesions (56.5%), psoriasiform reaction pattern (56.7%), and spongiotic reaction pattern (46.8%). Presence of OML in skin diseased patients was most frequent in older age groups (62.4% older versus 52.7% younger, p < 0.05), in males (63.2% males versus 52.6% females, p < 0.05), patients with a systemic disease (65.2% with systemic versus 51.9% without systemic disease, p < 0.05) and among current users of smokeless tobacco (toombak) (77% current use versus 54.8% no use, p < 0.00).ConclusionsOML were frequently diagnosed in skin diseased patients and varied systematically with age, gender, systemic condition and use of toombak. The high prevalence of OML emphasizes the importance of routine examination of oral mucosa in a dermatology clinic.

BackgroundThere are only few studies considering the impact of oral mucosal lesions (OML) on the oral quality of life of patients with different dermatological conditions. This study aimed to assess the relationship between oral health-related quality of life (OHRQoL) and OML and reported oral symptoms, perceived general and oral health condition and caries experience in adult skin diseased patients attending an outpatient dermatologic clinic in Sudan.MethodsA cross-sectional survey was carried out with 544 diagnosed skin diseased patients (mean age 37.1 years, 50 % females), during the period October 2008 to January 2009. The patients were orally examined and OML and caries experience was recorded. The patients were interviewed using the Sudanese Arabic version of the OIDP. OHRQoL was evaluated by socio-demographic and clinical correlates according to number of types of OML diagnosed (no OML, one type of OML, > one type of OML) and number and types of oral symptoms.ResultsAn oral impact (OIDP > 0) was reported by 190 patients (35.6 %) (mean OIDP total score 11.6, sd = 6.7). The prevalence of any oral impact was 30.5 %, 36.7 % and 44.1 %, in patients with no OML, one type of OML and more than one type of OML, respectively. Number of types of OML and number and types of oral symptoms were consistently associated with the OIDP scores. Patients who reported bad oral health, patients with ≥ 1 dental attendance, patients with > 1 type of OML, and patients with ≥ 1 type of oral symptoms were more likely than their counterparts in the opposite groups to report any OIDP. The odds ratios (OR) were respectively; 2.9 (95 % CI 1.9-4.5), 2.3 (95 % CI 1.5-3.5), 1.8 (95 % CI 1.1-3.2) and 6.7 (95 % CI 2.6-17.5). Vesiculobullous and ulcerative lesions of OML disease groups associated statistically significantly with OIDP.ConclusionOIDP was more frequently affected among skin diseased patients with than without OML. The frequency of the impacts differed according to the number of type of OML, oral symptoms, and OML disease groups. Dentists and dermatologists should pay special attention to skin diseased patients because they are likely to experience oral impacts on daily performances.

BackgroundPemphigus is a rare group of life-threatening mucocutaneous autoimmune blistering diseases. Frequently, oral lesions precede the cutaneous ones. This study aimed to describe clinical and histological features of oral pemphigus lesions in patients with skin disease has been canceled aged 18 years and above, attending outpatient’s facility of Khartoum Teaching Hospital - Dermatology Clinic, Sudan. In addition, the study aimed to assess the diagnostic significance of routine histolopathology along with immunohistochemical (IHC) examination of formalin-fixed, paraffin-embedded biopsy specimens in patients with oral pemphigus.MethodsA cross-sectional hospital-based study was conducted from October 2008 to January 2009. A total of 588 patients with confirmed skin has been canceled disease diagnosis completed an oral examination and a personal interview. Clinical evaluations supported with histopathology were the methods of diagnosis. IHC was used to confirm the diagnosis. Location, size, and pain of oral lesions were used to measure the oral disease activity.ResultsTwenty-one patients were diagnosed with pemphigus vulgaris (PV), 19 of them (mean age: 43.0; range: 20–72 yrs) presented with oral manifestations. Pemphigus foliaceus was diagnosed in one patient. In PV, female: male ratio was 1.1:1.0. Buccal mucosa was the most commonly affected site. Exclusive oral lesions were detected in 14.2% (3/21). In patients who experienced both skin and oral lesion during their life time, 50.0% (9/18) had oral mucosa as the initial site of involvement, 33.3% (6/18) had skin as the primary site, and simultaneous involvement of both skin and oral mucosa was reported by 5.5% (1/18). Two patients did not provide information regarding the initial site of involvement. Oral lesion activity score was higher in those who reported to live outside Khartoum state, were outdoor workers, had lower education and belonged to Central and Western tribes compared with their counterparts. Histologically, all tissues except one had suprabasal cleft and acantholytic cells. IHC revealed IgG and C3 intercellularly in the epithelium.ConclusionsPV was the predominating subtype of pemphigus in this study. The majority of patients with PV presented with oral lesions. Clinical and histological pictures of oral PV are in good agreement with the literature. IHC confirmed all diagnoses of PV.

In drilling fluid program, selecting the drilling fluid that will reduce the lost time is the first objective, and will be economical regardless of its cost. The amount and type of solids in drilling fluid is the primary control of the rheological and filtration properties. Palygorskite clay (attapulgite) is an active solid that has the ability to reactive with its environment and form a gel structure within a fluid and due to its stability in the presence of brines and electrolytes this type of clay is preferred for use. The aim of this study is to improve properties of Iraqi palygorskite (PAL) by adding different chemical additives such as caustic soda NaOH and soda ash Na2CO3 with a different concentration in both fresh and salt water-based drilling fluid to satisfy the API specification and to compete with imported palygorskite. The palygorskite claystone of Late Cretaceous age is present in the Western Desert of Iraq within the Digma Formation. In this study, two areas in Western Desert palygorskite were obtained, Bahr Al-Najaf and Trefawi. The results of rheological properties showed that the performance of Bahr Al-Najaf PAL was more affected by caustic soda than Trefawi PAL. In contrast, Trefawi PAL performance was more affected with low concentrations of soda ash than Bahr Al-Najaf PAL in both fresh and salt water-based drilling fluid. Also, these additives lead to improve the value of pH in both fresh and salt drilling fluid that increases the ability of clay to be more dispersed in drilling fluid. Besides that, enhancement of drilling fluid prepared with Iraqi palygorskite stability to 85 and 80 in fresh and saltwater, respectively, was observed with soda ash additions.