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Biomedical subjects

Alfredo Aguirre

Publications and source records attributed to Alfredo Aguirre.

16 recordsLinked to original sources
PubMed2006

Subacute necrotizing sialadenitis: a clinicopathological study.

OBJECTIVE: To report cases of extra-palatal subacute necrotizing sialadenitis (SANS), an uncommon condition that usually affects palatal minor salivary glands, and to characterize the etiopathogenesis, clinical features, and histology of this lesion. STUDY DESIGN: Retrospective reviews of records for patients with SANS diagnosed between 1999 and 2005; only cases with complete clinical history and histology were included in the study. RESULTS: Five cases (3 women, 2 men) were identified. The majority of patients presented with painful 1.0 to 1.5 cm swellings, with sudden and rapid increase in size. Two cases occurred in the buccal mucosa, 2 on the ventral surface of tongue, and 1 on the upper lip. Histology showed acinar necrosis surrounded by a dense polymorphous inflammatory infiltrate with focal exuberant tissue eosinophilia. Ductal atrophy was seen with minimal squamous metaplasia. In all the cases, healing occurred without any further treatment in 3 weeks. No recurrence was observed. CONCLUSION: SANS is an uncommon, inflammatory condition of unknown etiology affecting minor salivary glands. SANS appears to be a self-limiting process that has distinct characteristic clinical and histologic features. Nevertheless, SANS shares some of the histologic features of early necrotizing sialometaplasia (NS), suggesting a possible relationship between the 2 conditions. Additional reporting of SANS would be helpful in better defining the condition and its delineation from NS.

Adult↗
PubMed2006

Oral pityriasis rubra pilaris.

Pityriasis rubra pilaris is a chronic, papulosquamous dermatosis of unknown etiology. Oral mucosal involvement of this condition is rare with only 3 previously reported cases in the English literature. A case of a 68-year-old man with pityriasis rubra pilaris with involvement of tongue and palate is presented. Clinical features, histopathologic features, and management of pityriasis rubra pilaris are discussed. We hereby present an additional case, the fourth worldwide, and review the literature.

Aged↗
PubMed2006

Cavernous hemangioma of the palate. A review of etiology, pathogenesis and treatment options.

Cavernous hemangiomas of the palate are a rare but not infrequent sighting in the oral and maxillofacial region. The etiology and pathogenesis of these lesions are not definitively understood and are currently being explored. Treatment options usually include, but are not limited to, surgical excision of the lesion. Alternative management paradigms should be considered when dealing with this type of lesion. Precaution should be taken before any surgical intervention.

Female↗
PubMed2005

Multiple suppurative cystic lesions of the lips and buccal mucosa: a case of suppurative stomatitis glandularis.

Cheilitis glandularis (CG) is a rare inflammatory salivary gland disease that usually affects the lips. Although the etiology of CG is still unknown, it is believed to be a hereditary disease with an autosomal dominant pattern of inheritance. Three clinical presentations of CG are described in the literature: simple, superficial suppurative, and deep suppurative. A case of deep suppurative CG that extended to the buccal mucosa has been previously reported as suppurative stomatitis glandularis (SSG). Here we report a case of SSG in a 64-year-old white female with a history of bilateral renal transplants for adult polycystic kidney disease, who presented with painful swollen lips and bilateral buccal mucosal lesions. The diagnosis and management of the case is discussed. To the best of our knowledge, this is the second report of SSG, a rare condition affecting the minor salivary glands in the oral cavity.

Cheilitis↗
PubMed2005

Bisphosphonate-associated osteonecrosis of the jaws: a review of current knowledge.

BACKGROUND: Increasing numbers of dental patients are taking bisphosphonate medications for a variety of indications. These drugs may be associated with poor healing, spontaneous intraoral ulceration and bone necrosis in the oral and maxillofacial region. CASE DESCRIPTION: The authors describe a case of osteonecroSis of the jaws in a patient receiving long-term bisphosphonate therapy for cancer. They offer recommendations for management and prevention of oral complications. CONCLUSION AND CLINICAL IMPLICATIONS: It is important that clinicians are aware of the association between bisphosphonate treatment and delayed wound healing and osteonecrosis of the jaws. They should consider referring patients in this population to specialists for even the most routine oral surgery. Clinicians should perform a thorough oral examination in patients before they begin any chemotherapy regimen.

Aged↗
PubMed2004

Mid-line swelling of the palate.

Sarcoidosis is a multi-system, non-caseating granulomatous disease of unknown aetiology that may affect any organ. The oral involvement of sarcoidosis is rare and usually an initial manifestation of the disease. In this case report the authors present a 25-year-old African-American woman with palatal sarcoidosis treated successfully with intra-lesional corticosteroid injections. The oral manifestations of sarcoidosis are relatively uncommon and may be the only manifestation of the disease. Suspected cases of oral sarcoidosis should be biopsied and subsequently referred to a physician to rule out systemic involvement.

Adult↗
PubMed2004

Intraosseous sarcoidosis of the jaws mimicking aggressive periodontitis: a case report and literature review.

BACKGROUND: Sarcoidosis is a relatively common systemic granulomatous disease of unknown etiology. The skeletal system is affected in up to 39% of patients, but intraosseous sarcoidosis affecting the maxilla and mandible is rare. Only 20 cases have been reported previously in the English literature. This paper presents a case of generalized intraosseous sarcoidosis of the jaw bones that mimicked rapidly progressive periodontitis. METHODS: A 46-year-old male patient presented with loose teeth for assessment of implants. He had been gradually losing his teeth since 1999. His past medical history was significant, with sarcoidosis diagnosed in 1998. A panoramic radiograph showed a bilateral cotton-wool appearance of the mandible. A soft tissue and bone biopsy was performed and sent for histological examination. RESULTS: Microscopic examination of hematoxylin and eosin-stained sections revealed non-caseating granulomatous inflammation consistent with skeletal sarcoidosis. CONCLUSIONS: Intraosseous sarcoidosis of the jaw bones is rare and presents commonly as progressive and rapid alveolar bone loss similar to periodontitis. Therefore, it is important for periodontists to be knowledgeable and able to diagnose this condition, as rapid alveolar bone loss may be the first sign of sarcoidosis.

Diagnosis, Differential↗
PubMed2004

Esthetic management of peripheral giant cell granuloma.

BACKGROUND: Peripheral giant cell granuloma (PGCG) is a relatively rare hyperplastic lesion of the oral cavity. The lesion occurs in females more frequently than males and more often in the mandible than the maxilla. Although the precise etiology of PGCG is unknown, it might represent a local reaction to trauma or irritation. METHODS: In general, treatment requires a wide excision of the lesion due to its possible recurrence. RESULTS: This report describes the clinical and histopathological findings of PGCG diagnosed in the maxilla of a young male, as well as the successful treatment of a gingival defect that occurred following excision of the lesion, by placement of a subepithelial connective tissue graft concurrently with the biopsy procedure. CONCLUSIONS: This report emphasizes the importance of having histopathological data to confirm the clinical diagnosis, and the importance of an adequate excision to prevent recurrence even in less extensive cases.

Adult↗
PubMed2004

Use of essential oil-containing mouthrinses by xerostomic individuals: determination of potential for oral mucosal irritation.

PURPOSE: To assess the irritation potential of an essential oil-containing mouthrinse (Listerine Antiseptic) in a population with objectively documented xerostomia (hyposalivation) using an exaggerated-exposure clinical model. METHODS: Following a baseline oral soft tissue examination, 19 qualifying female subjects with a mean age of 61 years and a mean unstimulated baseline salivary flow of 0.06 mL/min were randomly assigned either the essential oil mouthrinse or a negative control rinse. They rinsed under supervision with 20 ml of their assigned rinse for 30 seconds and 5 minutes later a second salivary flow rate was determined. They then rinsed unsupervised with 20 ml for 30 seconds three times daily for the next 14 days, and received soft tissue examinations on days 7 and 14. After a 1-week interim period, subjects switched to the alternate rinse and the examination and rinsing regimens were repeated during the subsequent 2 weeks. RESULTS: The oral irritation potential of the essential oil mouthrinse was minimal. Oral mucosal abnormalities attributable to the test rinses were seen in only 2 subjects, both at the 7-day examination. These subjects were both using the essential oil mouthrinse. The abnormalities consisted of an asymptomatic "whitish slough" which was readily wiped off leaving a normal appearing, non-erythematous mucosa. In both subjects, the oral mucosa appeared normal at the 14-day examination.

Aged↗
PubMed2003

Efficacy of human salivary mucin MUC7-derived peptide and histatin 5 in a murine model of candidiasis.

MUC7 16-mer (residues 36-51 of human salivary mucin, MUC7) and histatin 5 possess potent in vitro antifungal activity. In the present study, we have evaluated the efficacy of these peptides in vivo using the experimental model of murine vulvo-vaginal candidiasis. The treatment groups included MUC7 16-mer, histatin 5, clotrimazole (all in pluronic F127 gel), and placebo (gel alone). Mice were treated intravaginally for 7 consecutive days. At the end of the treatment, anticandidal activities were assessed by colony counts and by histological examination. All groups except clotrimazole presented positive cultures; no statistically significant differences were found in fungal burden amongst placebo and any treatment group except clotrimazole. Histopathological findings confirmed the microbiological results; all groups with the exception of clotrimazole showed variable signs of infection.

Amino Acid Sequence↗
PubMed2003

Chronic ulcerative stomatitis: clinical, histopathologic, and immunopathologic findings.

Chronic ulcerative stomatitis (CUS) is a mucocutaneous disease primarily involving mucosal surfaces, but occasionally may involve the skin. Clinically, CUS patients exhibit erosive or ulcerative lesions of the oral mucosa that resemble erosive oral lichen planus. Direct immunofluorescence (DIF) studies of mucosal or skin biopsies reveal a unique pattern of IgG immunoglobulin bound to nuclei of keratinocytes of the basal and lower one third cell layers, the stratified epithelial specific (SES) antinuclear antibody (ANA) pattern. Patient sera also exhibit circulating SES-ANA reactions on indirect immunofluorescence (IIF) using an esophagus substrate. We report the clinical and immunopathologic findings of 3 cases of CUS and demonstrate autoantibody recognition of the CUS antigen on Western blot. An important reason to distinguish CUS from other oral ulcerative conditions is that it may be refractory to standard treatments with topical corticosteroids, and favorable clinical responses may be achieved with hydroxychloroquine pharmacotherapy.

Adult↗
PubMed2003

Recurrent recalcitrant gingival hyperplasia and plasminogen deficiency: a case report.

BACKGROUND: Recurrent gingival hyperplasia due to plasminogen deficiency is a rare condition due to fibrin deposition in the connective tissue. Only eight cases have previously been reported in the English literature, and all cases were diagnosed before the age of 35 years. This paper presents an older patient with recurrent gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia). METHODS: A 59-year-old woman presented with recurrent gingival swelling of 6 years' duration. Multiple biopsies performed at various time periods were histologically reported to be gingival hyperplasia with chronic inflammation. Routine hematoxylin and eosin (H & E) staining and direct immunofluorescence were performed. RESULTS: H & E-stained sections showed subepithelial, eosinophilic, amorphous, acellular deposits. Direct immunofluorescence showed positive staining for fibrin, immunoglobulin (Ig) G, IgA, and IgM. Functional plasminogen and plasminogen activator inhibitor-1 assays were done and found to be deficient. A diagnosis of gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia) was rendered. CONCLUSIONS: Recurrent gingival hyperplasia due to plasminogen deficiency (hypoplasminogenemia) is a newly recognized and rare condition. H & E staining, direct immunofluorescence, and assessment of functional plasminogen levels are essential to differentiate this condition from other conditions in which subepithelial, eosinophilic, amorphous materials are deposited.

Deficiency Diseases↗
PubMed2002

Oral pemphigoid masquerading as necrotizing ulcerative gingivitis in a child.

BACKGROUND: Cicatricial pemphigoid (benign mucous membrane pemphigoid) is an autoimmune vesiculobullous disease that affects mucosal tissues of adults and rarely presents in children. Only 9 cases in the English literature have reported cicatricial pemphigoid in children, primarily as oral mucosal lesions. This paper presents a case of childhood cicatricial pemphigoid that clinically manifested as necrotizing ulcerative gingivitis (NUG). METHODS: A 9-year-old girl presented with gingival bleeding and discomfort for 2 weeks. NUG was suspected and the patient was treated with antibiotics and an oral hygiene regimen. When the condition did not improve after repeated treatment trials, routine hematoxylin and eosin (H&E) and direct immunofluorescence examinations were performed. RESULTS: Microscopic examination of H&E stained sections showed a non-specific ulceration with chronic inflammation. Direct immunofluorescence studies of peri-lesional tissue showed linear deposition of C3 at the basement membrane zone that was consistent with a diagnosis of cicatricial pemphigoid. CONCLUSION: Cicatricial pemphigoid is an autoimmune ulcerative condition that is rarely seen in children. Immunofluorescence studies are essential to differentiate this condition from other ulcerative oral lesions.

Child↗