Biomedical subjects
Publications and source records attributed to W F Hogewind.
A series of 212 patients with a histologically proven squamous cell carcinoma of the oral cavity has been studied for the coexistence of white lesions. Such lesions were found in 48% of the patients, more often in women than in men (p less than 0.05). No relation to a specific site could be found.
A review of oral leukoplakia, based on data from the literature and experience with 84 patients is presented. The leukoplakic lesions of 3 patients developed malignant transformation within an average period of 5 years. All three patients were elderly women with idiopathic leukoplakia, in two cases of the homogeneous and in one case of the non-homogeneous type. The initial biopsy of the former two patients showed only hyperorthokeratosis without epithelial dysplasia. In the first biopsy of the third patient epithelial dysplasia was recorded. One of the patients finally died of widespread metastases. The other two have been treated surgically and are still alive.
A white lesion located in the labial commissure can pose problems for both the clinician and the pathologist. The clinician may be limited in his surgical treatment because of aesthetic reasons, whilst the pathologist may be confronted with a lesion with or without candidal involvement, showing the histological features of hyperplastic candidiasis, verrucous hyperplasia, verrucous carcinoma, epithelial dysplasia, carcinoma-in-situ and, occasionally, squamous cell carcinoma. A retrospective study was undertaken of 10 patients with leukoplakic commissural lesions, who visited the Department of Oral Surgery in the Teaching Hospital of the Free University, Amsterdam in the period between 1973-1986. The clinical and histopathological findings are presented. Although a carcinoma in this particular region is rather rare, alertness remains necessary as one patient with the clinical appearance typical of leukoplakia, showed on biopsy the presence of a squamous cell carcinoma at this first visit. In another two patients the areas of leukoplakic change were shown histologically to be based on verrucous carcinoma. In one patient a squamous cell carcinoma developed after several years, in spite of treatment. In view of the small number of patients under discussion and also the somewhat debatable diagnosis of verrucous carcinoma, we do not feel justified in drawing any firm conclusions from our findings with regard to the malignant potential of leukoplakia of the oral commissures.
A survey of a special population, the outpatients of a Department of Oral Surgery of a Teaching Hospital in Amsterdam, revealed a comparatively low prevalence rate for oral leukoplakia of 14/1000 patients (1.4%). No difference was found in the age distribution compared with similar investigations elsewhere in the world. However, in contrast with previous findings, which show a significant difference between prevalences of leukoplakia for men and women, leukoplakia was equally distributed between both sexes.
A review of the literature on reverse smoking is presented, followed by a report of a case of reverse smoking in a 59-year-old woman, living in the Netherlands. This is the first report of a case of reverse smoking in the Netherlands so far. The clinical and histological findings are in accordance with those found in the literature. The patient refused to give up her habit. During the 4 years follow-up period, no clinical changes were noticed.
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