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Disseminated histoplasmosis presenting with oral lesions - report of a case.

A case of disseminated histoplasmosis is presented in which the initial diagnosis was made on the histology from oral lesions. The clinical and microscopical differential diagnoses are discussed. Including the present case, 12 of the 13 subjects with disseminated histoplasmosis initially diagnosed in Great Britain have given a history of residence in an area where the disease is endemic. Many years of good health may intervene between the original infection and its subsequent reactivation. A diminished cellular immune response may precipitate this reactivation but could also facilitate the possibility of exogenous reinfection. The literature is reviewed.

Diagnosis, Differential↗

Intralingual cysts of foregut origin.

Intralingual cysts lined by epithelium of foregut origin are rarely reported. We present 16 patients seen over an 8-year period (1983 to 1990) with such lesions. Respiratory and squamous epithelium were the most commonly encountered. These unusual cysts generally presented in the neonatal period with feeding difficulty. Two children had multiple cysts. Histological varieties of epithelia are described and the clinical features are discussed. From our experience we conclude that these cysts are adequately treated by complete surgical excision through a sagittal glossal split. This can be safely done electively in the neonatal period. Cyst aspiration was found to be inadequate definitive treatment.

Cysts↗

Medication side effects of dental interest.

Many dental patients require continuing medication. With some, the medications will have side effects that have an oral or perioral manifestation. Commonly prescribed medications and their dental side effects are listed. This information may aid patients who have oral symptoms unrelated to the needed dental care.

Drug-Related Side Effects and Adverse Reactions↗

Hairy tongue.

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Humans↗

Prevalence of different morphologic forms of the human tongue in young Finns.

Morphologic variations on the surface of the human tongue were examined in 381 patients divided by age into three groups (Group I--3 to 8 years old; Group II--9 to 16 years old; and Group III--17 to 35 years old). In Group I there were 84 pre-school children; in Group II there were 146 schoolchildren; in Group III there were 151 dental students and dental nurse students. The prevalence of variations in the morphology of the tongue surface in the three groups combined was as follows: fissured tongue, 5.0 percent; filiform atrophy, 5.5 percent; geographic tongue, 2.1 percent, and hairy tongue, 8.3 percent. Prevalence of both fissured tongue (p less than 0.05) and filiform atrophy (p less than 0.01) increased with the age of the population. Geographic tongue and hairy tongue did not increase significantly with age. Fissured tongue was more common in males than in females (p less than 0.05). The amount of filiform atrophy and hairy tongue was not significantly different in males and females.

Adolescent↗

The pH of stimulated and resting saliva in different morphologic forms of the tongue surface in a young population.

Salivary condition and its correlation to tongue morphology was studied in 149 dental students. The students were divided according to the morphologic form of the tongue. The salivary pH and the buffer capacity of resting and stimulated saliva were determined. The pH values in the resting saliva of the fissured tongue group were more alkaline than those in the control group. The difference in pH values of stimulated saliva in the fissured tongue and control groups was only indicative. The stimulated saliva values of the normal tongue and the geographic tongue groups were similar. The pH valves of resting saliva in the geographic tongue group were more acidic than those in the normal tongue group. The salivary pH values of the filiform atrophy group were more acidic than those of the control group: resting salivar highly significantly and stimulated saliva significantly. The pH values of the hairy tongue group were also more acidic than those of the control group: both resting saliva and stimulated saliva highly significantly. No differences were observed in salivary buffer capacity, although buffer capacity in the hairy tongue group seemed to be lower than in the other groups.

Adult↗

Tuberous sclerosis.

Tuberous sclerosis (epiloia, Bourneville-Pringle syndrome) is an inherited disease with an autosomal pattern. Both sexes are affected equally with varied expression in successive generations. Two cases of this unusual disorder in siblings are reported. They illustrate heredofamilial nature, dissimilar expression, mutations, and oral manifestations.

Dental Caries↗