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Oral manifestations of idiopathic lenticular mucocutaneous pigmentation (Laugier-Hunziker syndrome): a clinical, histopathological and ultrastructural review of 12 cases.

OBJECTIVE: To present a clinical, histopathological and ultrastructural study on a group of patients affected by idiopathic mucocutaneous pigmentation (Laugier-Hunziker syndrome: LHS). MATERIALS AND METHODS: Twelve patients were investigated: clinical examination, laboratory tests, and X-ray studies together with light microscopy and electron microscopy were performed in order to diagnose LHS. RESULTS: All cases showed acquired, benign, macular hyperpigmentation of buccal mucosa lips and nails. Histologically, pigmentations are due to an accumulation of melanin in the basal layer keratinocytes and an increase in the number of melanophages in the submucosa and/or papillary dermis. Ultrastructurally there were increased numbers of normal-appearing melanosomes in keratinocytes of the lower epithelium. No evidence of malignant changes were detected. CONCLUSIONS: The importance of this condition relates to it being included in the differential diagnoses of pigmentary disorders of the oral mucosa with associated nail involvement. It is important to recognize this acquired benign disorder to avoid unnecessary investigations and treatments.

Adult↗

Oral manifestations of HIV infection, Part II: Viral infections and neoplastic lesions.

The dental practitioner is in a unique position to detect the early signs of HIV infection that appear in the mouth. By identifying such lesions, the dentist can contribute to the early diagnosis and timely treatment of HIV-positive individuals. This article, the second of a two-part series, will review the clinical features, diagnosis, and treatment of the common viral infections and neoplastic lesions seen in association with HIV infection.

HIV Infections↗

Oral manifestations of patients with Turner syndrome.

OBJECTIVE: The purpose of this study was to conduct a complete analysis of orofacial abnormalities of patients with Turner syndrome. STUDY DESIGN: Twenty nine patients with Turner syndrome and 30 without Turner syndrome (control group) were studied. The subjects were screened for cariological and periodontal alterations, orthodontic anomalies, tooth crown morphologic condition, alveolar arch dimensions, and temporomandibular joint function. RESULTS: Significantly lower mean values for decayed, missing, and filled teeth were found for patients with Turner syndrome as compared with the control group. Plaque and gingival indices were significantly higher in the study group. Orthodontic anomalies were more frequent and severe in patients with Turner syndrome. Our investigation showed reduced tooth crown size in the study group. The alveolar arch of the maxilla was narrower and of normal length, but the mandibular arch was shorter and broader. There was no significant alteration in temporomandibular joint function in the 2 examined groups. CONCLUSIONS: Our examination showed the importance of early diagnosis of oral anomalies and timely treatment of dental problems for patients with Turner syndrome.

Adolescent↗

Hereditary hemorrhagic telangiectasia with oral manifestations. Report of periodontal treatment in two cases.

The periodontal conditions of two patients with hereditary hemorrhagic telangiectasia were successfully treated by a two-phase plan. The first phase of treatment eliminated inflammation from local etiologic factors by removing plaque and plaque-retaining factors. The second phase eliminated the residual anatomic defects of periodontal disease. Gingival bleeding has been indicated as a symptomatic factor of hereditary hemorrhagic telangiectasia, but such bleeding is more likely the result of periodontal inflammation.

Dental Scaling↗

Oral manifestations of giant cell arteritis.

Giant cell arteritis is a systemic disease of unknown origin characterized by vasculitis of medium-sized and larger vessels, found mainly in elderly women. It presents with a variety of symptoms, including temporal pain and tenderness, headache, and neuroophthalmic features. This report describes a case of giant cell arteritis in a 78-year-old woman with a large ulceration on the right side of the tongue, painful lesion in the right temporal area, and recent visus loss of the right eye.

Aged↗

[Recessive dystrophic epidermolysis bullosa. Oral manifestations apropos of 3 cases].

Epidermolysis Bullosa (EB) constitutes a group of genetic disorders characterized by bullae and vesicle formation on the skin and mucosa. Three cases of recessive EB that may be clinically classified as recessive dystrophic EB (RDEB) are described. In two cases dental treatment consisted of extractions and restorative therapy under local anesthesia. In all three cases individual home and professional preventive programs were established and no new decays were observed during the next years. Dental management under local anesthesia is emphasized by the authors.

Child↗

[Immunocytochemical venous blood studies in patients with manifest oral cavity carcinomas, oral precancerous conditions, benign tumors and in chronic alcoholic patients].

In a prospective pilot study we investigated the percentage of immunocompetent cells in the peripheral blood in 146 patients (lymphocytes, leucocytes, monocytes, T cells, B cells, NK cells, T-helper cells, T-suppressor cells, ratio T-helper/T-suppressor cells, activated T cells HLA-DR) by flow cytometry. The immunologic parameters were derived from patients with oral and oropharyngeal squamous cell carcinomas, precancerous lesions and benign tumours and from a group of heavy smokers and alcoholics. Carcinoma patients (n = 46) were compared with risk groups and a reference group consisting of patients with inflammatory disease. Within the collective of carcinoma patients we measured the immune status before and after chemo-, radio- and operative therapy. We also analysed the immune parameters in relation to clinical and histomorphological parameters (TNM status, grading). The univariate analysis of monocytes showed significant relationships between on the one hand carcinoma patients and on the other alcoholics and those with benign tumours and precancerous lesions. In precancerous lesions NK cells were significantly increased compared with alcoholics and the reference group. A significant decrease in B cells in carcinoma patients may show incipient insufficiency of the humoral immunity. The immune parameters showed a different reaction depending on therapy. After irradiation we found a significant increase of T-suppressor cytotoxic cells and decreases in B and T-helper cells. Chemotherapy showed an increase in T and T-helper cells and a decrease in B cells. Surgical therapy alone yielded an increase in B cells. The comparison of all pre- and posttherapeutic parameters showed significant changes only in activated T cells HLA-DR. We found no correlation between prognostic clinico-pathological factors and immune parameters. No changes were found in a multivariate analysis.

Alcoholism↗