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At least 523 records · Page 29Linked to original sources
PubMed1999

Role of human papillomaviruses in cutaneous and oral manifestations of immunosuppression.

Long-term immunosuppressive drug regimes, used to prevent organ transplant rejection, are associated with an increased risk of epithelial malignancies particularly anogenital and cutaneous cancers. Premalignant and malignant lesions of the oral mucosa have also been reported in renal transplant recipients (RTRs), particularly of sun-exposed lip lesions. Many of these anogenital lesions are associated with the detection of high-risk mucosal human papillomaviruses (HPV). Novel degenerate and nested polymerase chain reaction (PCR) techniques have found high levels of epidermodysplasia verruciformis (EV) HPVs (high-risk cutaneous oncogenic HPVs) in cutaneous warts, dysplastic keratoses, and squamous cell carcinomas. Unusual appendageal and spindle cell carcinomas are being observed in RTRs. Increasing survival times of HIV-positive patients may be associated with dysplasia of orogenital mucosal epithelium, and careful epidemiologic studies of cutaneous lesions are needed. The role of HPVs in the development of these lesions has yet to be established.

Adult↗
PubMed2006

Oral manifestations of HIV infection in children and adults receiving highly active anti-retroviral therapy [HAART] in Dar es Salaam, Tanzania.

BACKGROUND: The aim of the study was to compare the prevalence and types of HIV-related oral lesions between children and adult Tanzanian patients on HAART with those not on HAART and to relate the occurrence of the lesions with anti-HIV drug regimen, clinical stage of HIV disease and CD4+ cell count. METHODS: Participants were 532 HIV infected patients, 51 children and 481 adults, 165 males and 367 females. Children were aged 2-17 years and adults 18 and 67 years. Participants were recruited consecutively at the Muhimbili National Hospital (MNH) HIV clinic from October 2004 to September 2005. Investigations included; interviews, physical examinations, HIV testing and enumeration of CD4+ T cells. RESULTS: A total of 237 HIV-associated oral lesions were observed in 210 (39.5%) patients. Oral candidiasis was the commonest (23.5%), followed by mucosal hyperpigmentation (4.7%). There was a significant difference in the occurrence of oral candidiasis (chi2 = 4.31; df = 1; p = 0.03) and parotid enlargement (chi2 = 36.5; df = 1; p = 0.04) between children and adults. Adult patients who were on HAART had a significantly lower risk of; oral lesions (OR = 0.32; 95% CI = 0.22-0.47; p = 0.005), oral candidiasis (OR = 0.28; 95% CI = 0.18-0.44; p = 0.003) and oral hairy leukoplakia (OR = 0.18; 95% CI = 0.04-0.85; p = 0.03). There was no significant reduction in occurrence of oral lesions in children on HAART (OR = 0.35; 95% CI = 0.11-1.14; p = 0.15). There was also a significant association between the presence of oral lesions and CD4+ cell count < 200 cell/mm3 (chi2 = 52.4; df = 2; p = 0.006) and with WHO clinical stage (chi2 = 121; df = 3; p = 0.008). Oral lesions were also associated with tobacco smoking (chi2 = 8.17; df = 2; p = 0.04). CONCLUSION: Adult patients receiving HAART had a significantly lower prevalence of oral lesions, particularly oral candidiasis and oral hairy leukoplakia. There was no significant change in occurrence of oral lesions in children receiving HAART. The occurrence of oral lesions, in both HAART and non-HAART patients, correlated with WHO clinical staging and CD4+ less than 200 cells/mm3.

Journal Article↗
PubMed1995

An overview of the oral manifestations of AIDS-related Kaposi's sarcoma.

Acquired immunodeficiency syndrome-associated Kaposi's sarcoma (AIDS-KS) is the most common malignancy in human immunodeficiency virus infection and is seen most often in homosexual men. The oral cavity is frequently involved by AIDS-KS and may represent the initial site of this malignancy in up to 60% of patients. A number of treatment modalities, including systemic and localized chemotherapy and radiotherapy, are available for AIDS-KS. The initial diagnosis of AIDS-KS requires microscopic evaluation of biopsy material because this disease can mimic a number of intraoral lesions, including atrophic candidiasis, erythroplakia, pyogenic granuloma, bacillary angiomatosis, median rhomboid glossitis, hemangioma, and lymphoma. Overall, treatment of AIDS-KS does not significantly affect the prognosis or survival of AIDS patients, however, treatment can alleviate aerodigestive and/or respiratory dysfunction, allow for adequate nutritional intake, and improve the quality of life for these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Oral manifestations of tumor and opportunistic infections in the acquired immunodeficiency syndrome (AIDS): findings in 53 homosexual men with Kaposi's sarcoma.

Fifty-three homosexual men with Kaposi's sarcoma (KS) were studied. Twenty-seven had biopsy-proved oral KS, the palate being the most common site. Past or present infections with cytomegalovirus, hepatitis, venereal diseases, and gastrointestinal microorganisms occurred in more than 70%. Oral candidiasis was confirmed in 57%. Heavy marijuana smoking was the most common habit. Transmission of AIDS is thought to be by a viral agent. Precautions involving the use of gloves, eyeglasses, and masks, similar to those recommended for the management of patients with hepatitis B, are urged.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Oral manifestations in the era of HAART.

AIDS has reached epidemic proportions in the United States, disproportionately affecting African-Americans and other minorities. As highly active antiretroviral therapy (HAART) have improved the length and quality of life for HIV-Infected people, oral health care has made similar strides. It is important that physicians and dentists recognize the earliest signs and symptoms of HIV infection in order that a timely diagnosis and patient referral can be made for early counseling testing, and treatment. At the same time, dentists have seen themselves at considerable risk from HIV Infection. Some dentists believe that they may also be more at risk from stigma then other providers if they treat HIV patients.

Antiretroviral Therapy, Highly Active↗
PubMedDate not supplied

Hereditary epidermolysis bullosa: oral manifestations and dental management.

Epidermolysis bullosa (EB) is a diverse group of disorders that have as a common feature blister formation with tissue separation occurring at variable depths in the skin and/or mucosa depending on the specific EB type. There may be marked oral involvement, potentially creating devastating alterations in the soft and hard tissues. Oral tissue fragility and blistering is common to all EB types. However, oral debilitation as a result of soft tissue scarring is primarily limited to the recessive dystrophic EB subtypes. Generalized enamel hypoplasia appears to be limited to junctional EB, although rampant dental caries is associated with many individuals having generalized recessive dystrophic EB. While systemic treatment remains primarily palliative, it is possible to prevent destruction and subsequent loss of the dentition through appropriate interventions and dental therapy. The majority of individuals with mild EB subtypes may receive dental treatment with only minor modifications in approach. Even the most severely affected individuals with EB can retain their dentition using general anesthesia and conventional restorative techniques. With aggressive preventive interventions and management of developing malocclusions using serial extraction, it also is possible to reduce the likelihood of rampant caries, achieve an acceptable occlusion without the need for active tooth movement or appliance therapy, and allow these individuals to benefit from maintaining a natural healthy dentition.

Anesthesia, Dental↗
PubMed1995

Oral manifestations of alpha-mannosidosis: report of a case with ultrastructural findings.

Alpha-mannosidosis is a rare storage disease with distinct biochemical, clinical, histological and ultrastructural features. The oro-facial findings in a 26-year-old man are described. Gingival and oral mucosal hyperplasias were studied using histology and transmission electron microscopy (TEM). The TEM findings were comparable to those of other tissues examined in previous reports, consisting of histiocytic cells containing storage vacuoles with fine reticulo-granular material.

Adult↗
PubMed2001

Oral manifestations of congenital neutropenia or Kostmann syndrome.

Infantile congenital agranulocytosis or Kostmann syndrome is a rare hereditary kind of severe neutropenia. The typical symptoms, which appear since the first days of life, are abscesses located on various parts of the body: ear, cutis, lung and oral cavity. These abscesses are due to an almost total disimmunity typical of the neutropenia. The aim of this article is to describe the most typical signs of this pathology in the oral cavity, reporting a case observed in our department in Florence, Italy. On the basis of the personally observed case and of the review of the literature, it is possible to consider, as a characteristic finding in Kostmann syndrome, a typical very serious periodontal pathology, which is similar to the prepubertal periodontitis in deciduous dentition. At the age of 19 years the patient showed a dramatic compromise of the masticatory function. It is obvious that the lack of response of the host can obstruct the interaction between the host and the microbic flora, because the lack of neutrophils increases the susceptibility of the patient to every kind of infection, even to periodontitis. A periodontal prophylaxis, since the very first observations, followed by a rigorous maintenance with frequent and regular professional hygienic treatments could be effective in controlling the effects of periodontal disease and could reduce the tragic evolution. We need to recognise that it could be hard to monitor the oral situation correctly in these patients, as they have a continuously poor systemic condition. Finally in these cases the rehabilitative therapy is very problematical.

Adult↗
PubMed1997

[Oral manifestations of autoimmune diseases with sicca symptoms. Comparative studies of patients with primary and secondary Sjögren syndrome].

Sjögren's syndrome is a chronic autoimmune disease which mainly affects exocrine glands. We present a study where 123 patients with Sjögren's syndrome were examined according to their oral symptoms. A high percentage of patients showed mild or moderate inflammation of the oral mucosa. Remarkable is the high number of extracted teeth in older patients with Sjögren's syndrome. Oral ulcerations and erythema were found only in the group with secondary Sjögren's syndrome and systemic lupus erythematosus.

Adult↗