1/20. Proliferative verrucous leukoplakia: report of two cases and a discussion of clinicopathology.Proliferative verrucous leukoplakia (PVL) is a recently delineated but poorly recognized form of multifocal leukoplakia that is premalignant and of unproven origin. PVL generally presents as a simple benign form of hyperkeratosis that tends to spread and become diffuse. Although slow-growing, the disease is persistent and irreversible. Clinically, PVL often presents as an exophytic wart-like form of leukoplakia that appears to be resistant to nearly all forms of therapy. PVL of the oral cavity is best-defined as a continuum of oral epithelial disease with hyperkeratosis at one end of a clinical and microscopic spectrum and verrucous carcinoma or squamous cell carcinoma at the other. The microscopic findings associated with PVL are dependent on the stage of the disease and the adequacy of the biopsy. Microscopic findings can be markedly variable. PVL is a clinicopathologic disorder that includes the microscopic entity known as verrucous hyperplasia as a component of its histopathologic progression. This article reports on two cases of PVL, describes the clinicopathology of the disease process, and presents therapeutic and etiologic considerations.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/20. pachyonychia congenita tarda.A 42-year-old man presented with painful toenails which were overcurved transversely and onycholytic. Examination revealed that all toenails, the thumbs and index fingers were similarly affected. In addition, he had a small area of leukokeratosis in the mouth, epidermal cysts of the scrotal skin and a small area of hyperkeratosis on the ulnar borders of his hands. His characteristic nail changes began in the great toenails at the age of 20 years. After renal transplantation at age 39, the other nails changed and he developed the features described above. His sister has overcurvature of the fifth toenails. A diagnosis of pachyonychia congenita tarda was made. His case is compared with 14 other reported cases of this rare syndrome.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
3/20. Rapid progression from oral leukoplakia to carcinoma in an immunosuppressed liver transplant recipient.immunosuppression used to avoid graft rejection in solid organ transplantation recipients leads to a variety of side-effects, and an increased rate of infections and de novo malignancies. Oral conditions usually associated with immunosuppressive drugs include fungal and viral infection, and lip lesions, but intra-oral carcinoma has not been reported as having a high incidence. This report deals with a male liver transplant recipient receiving FK506 (5 mg/day) and prednisone (20 mg/day) who was diagnosed with a homogeneous leukoplakia on the floor of the mouth 4 months after transplantation, and 4 months later with a squamous cell carcinoma growth at the site of this lesion. The rapid transformation of the lesion suggests that in patients who display oral premalignant conditions, immunosuppression must be considered as an important risk factor for oral cancer.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
4/20. Hypertrophic lichen planus of the oral mucosa.Hypertrophic lichen planus is a variant of the condition not previously recognised as occurring in the mouth. Four cases are described that have been followed clinically for 18, 9, 6 and 3 years. The histopathology is described.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
5/20. Photodynamic Therapy of oral dysplasia with topical 5-aminolevulinic acid and light-emitting diode array.BACKGROUND AND OBJECTIVES: In taiwan, more than two million people have the betel quid (BQ) chewing habit which is a risk factor related to premalignant lesion and squamous cell carcinoma of oral cavity. We developed a light-emitting diode (LED) array combined with topical 5-aminolevulinic acid (ALA) for photodynamic therapy (PDT) and evaluated its effectiveness for the treatment of oral lesions. STUDY DESIGN/MATERIALS AND methods: We compared the ALA-PDT effect of the homemade LED array to that of a commercial light source on cultured Ca9-22 human gingival carcinoma cells and the DMBA-induced hamster buccal pouch carcinoma model. Furthermore, we treated several patients having an oral lesion using a topical ALA delivery system and the LED array. RESULTS: The LED array light source was as effective as the commercial light source for ALA-PDT in cultured Ca9-22 cells with LD(50) of 4.5 and 4.3 J/cm(2), respectively, using an MTT assay. This light source was also effective in the DMBA-induced hamster buccal pouch carcinoma model, and in the patients of oral leukoplakia. CONCLUSIONS: ALA-PDT is effective for premalignant lesions such as mucosal dysplasia and carcinoma in situ of oral cavity. Good results could be obtained by using the homemade LED array as light source. The LED array has the advantages of low cost, high reliability, and portability. It is safe, convenient and easy to use for the treatment of oral dysplasia.- - - - - - - - - - ranking = 1.0179801674514keywords = oral cavity, cavity (Clic here for more details about this article) |
6/20. Olmsted syndrome--a rare syndrome with oral manifestations.Olmsted syndrome is a rare, congenital condition characterized by severe palmo-planter keratosis, periorificial keratosis, and hypotrichosis. Though orofacial keratosis is one of the consistent findings of Olmsted syndrome, it has never been reported in the dental literature. We report a case of Olmsted syndrome in an eight-year-old boy who presented with massive and crippling palmoplanter keratosis and bilateral oral lesions in the form of keratotic plaques at the corners of the mouth, as well as on the dorsum of the tongue.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
7/20. Paraneoplastic changes of oropharyngeal mucosa in breast cancer.BACKGROUND: Paraneoplasias in the oral cavity are uncommon and have been rarely described so far. A woman with isolated papillomatosis and keratosis of oropharyngeal epithelia is reported. CASE REPORT: In a 43-year-old woman suffering from breast cancer, extensive changes of oropharyngeal epithelia were apparent 2.5 years after primary surgery and combined radiochemotherapy (RCT) as well as relapse therapy with RCT. At that time, radiologic investigations showed no locoregional or distant metastases. Nevertheless, after removal of the upper lip changes and skin resurfacing of the upper lip, progression of the oropharyngeal and labial changes was registered. Subsequent restaging showed advanced liver metastases. After treatment of the liver metastases, a regression of the extensive oropharyngeal changes became apparent. CONCLUSION: The appearance of untypical changes of oropharyngeal epithelia is suspective of paraneoplasia. In order to diagnose tumor recurrence, a restaging should be performed.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
8/20. dyskeratosis congenita: oral hyperkeratosis in association with lichenoid reaction.dyskeratosis congenita is an inherited disorder that usually presents in males, consisting of a triad of leukoplakia of the mucous membranes, nail dystrophy and skin pigmentation. Whilst most cases are X-linked, autosomal dominant and recessive forms have also been reported. The significance of the condition lies in premature mortality arising from either bone marrow failure or malignant change within the areas of mucosal leukoplakia. We present a case (X-linked recessive form) where the classic triad of signs were present, along with the development of lichenoid reaction in the buccal and labial mucosa. This is believed to be the first case in which such a reaction has been noted together with the oral hyperkeratosis. The identification of a white patch within the mouth of a child, in the absence of any other obvious cause must arouse suspicion of this rare condition. All clinicians should be aware of this rare genetic disorder so that early referral can be made and appropriate management instigated.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
9/20. Detecting oral cancer: a new technique and case reports.The VELscope is an important aid in patient assessment, and when added to a well-thought out clinical assessment process that takes into consideration the age of the patient and risk factors that include tobacco, alcohol, and immunologic status, it increases the clinician's ability to detect oral changes that may represent premalignant or malignant cellular transformation. False positive findings are possible in the presence of highly inflamed lesions, and it is possible that use of the scope alone may result in failure to detect regions of dysplasia, but it has been our experience that use of the VELscope improves clinical decision making about the nature of oral lesions and aids in decisions to biopsy regions of concern. Where tissue changes are generalized or cover significant areas of the mouth, use of the scope has allowed us to identify the best region for biopsy. As with all clinical diagnostic activities, no single system or process is enough, and all clinicians are advised to use good clinical practice to assess patients and to recall and biopsy lesions that do not resolve within a predetermined time frame. Lesions that are VELscope-positive and absorb light need to be followed with particular caution, and if they do not resolve within a 2-week period, then further assessment and biopsy are generally advised. It is much better to occasionally sample tissue that turns out to be benign than to fail to diagnose dysplastic or malignant lesions. In our fight to protect patients from cancer, the VELscope improves our odds for early detection, hopefully resulting in fewer deaths from oral cancer.- - - - - - - - - - ranking = 0.058242220638781keywords = mouth (Clic here for more details about this article) |
10/20. pachyonychia congenita. Manifestations for the otolaryngologist.When discovered, leukoplakia of the oral cavity is commonly an acquired lesion. pachyonychia congenita is a member of a rare group of disorders in which congenital white lesions of the oral cavity are present. Additional findings of note to the otolaryngologist are described as well.- - - - - - - - - - ranking = 2keywords = oral cavity, cavity (Clic here for more details about this article) |
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