Exfoliative cheilitis (EC) is a rare and chronic inflammatory condition. It is characterized by a continuous peeling of the vermilion of the lips and abnormal production of keratin scales. Treatment is difficult due to its chronic nature and it is often refractory. The objective of this article is to describe the management of EC and its impact on quality of life through two clinical cases. Two patients with EC are reported: one 21 years old with allergic rhinitis and gastric reflux, the other 18 years old, with a history of anxiety symptoms, without medication or psychiatric control. They had chronic scaly and crusty areas on both lip vermilions. In one of the patients, a biopsy was prescribed and he was treated with antifungals and topical vitamin E. Both patients were prescribed hydration, balanced diet, the application of moisturizing lip balm with sunscreen and modification of parafunctional habits, behavioral aid. The treatment healed the condition and eased their daily life and improved personal perception. Nibbling and lip licking favor dryness and superinfection in patients with EC; for its part, hydration, topical vitamin E and behavioral aid, improved this condition.
The torus are benign bony prominences that generally do not require treatment, however, they can occasionally present osteomyelitis (OM). The objective of this article is to describe the timely management of torus osteomyelitis through a series of clinical cases. Three patients with OM are reported. Two cases of men aged 66 and 69, diabetics, as well as a 57-year-old woman with a history of basal cell carcinoma of the nose. All had torus ulcers associated with trauma and without resolution of the same. In the three cases, a biopsy was performed to confirm the diagnosis and they were treated with anti-inflammatory drugs and antibiotic therapy, achieving complete resolution. Uncontrolled diabetes mellitus and trauma can favor the development of OM in patients with bone exostoses, therefore, when there are signs of infection in these structures, it is imperative to suspect the condition and offer treatment.
Current research highlighted the importance to recognize feasible biomarkers for early diagnoses and treatment in oral cancer. Our study analyzed the expression and spatial distribution of ALDH1A1, FGFR2, caspase-3, and CD44 in Oral Squamous Cell Carcinoma (OSCC) and leukoplakia with and without oral mucosal dysplasia. Paraffin-embedded samples of OSCC (n=5), leukoplakia with (n=5) and without (n=5) dysplasia obtained by incisional biopsies were processed using conventional histochemical techniques. Immunohistochemistry was performed using antibodies against ALDH1A1, FGFR2, caspase-3, and CD44. Images of the immunohistochemically stained tissue sections were analyzed according to the intensity of the immunostaining of each marker and classified in Scores. The Kruskal-Wallis test was performed (p≤0.05). Our results demonstrated a statically difference in the expression of all immunomarkers between OSCC and leukoplakia without dysplasia, being more significant in FGFR2 and ALDH1A1. Within the limitations of this study, our data showed that all biomarkers were overexpressed in OSCC and leukoplakia with oral mucosa dysplasia, suggesting that the presence of dysplasia is a significant clinic-pathologic predictor for malignant transformation.
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