Cases reported "Leukoplakia, Oral"

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1/18. A case of pachyonychia congenita with oral leukoplakia and steatocystoma multiplex.

    Pachyonchia congenita (PC) is an uncommon autosomal dominant genodermatosis affecting the nails and other ectodermal tissues. The most striking features are symmetrically thickened dysmorphic nails and hyperkeratotic skin lesions. We report a case of pachyonychia congenita in a 30-year-old male patient who had thickening and gray-brown discoloration of all nails and many nodules on his back and neck. He also had hyperkeratotic skin lesions on both feet. His tongue had irregularly-shaped, whitish plaques. histology of these nodules revealed the characteristic features of steatocystoma multiplex. After treatment with oral retinoic acid, his hyperkeratotic skin lesions improved.
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2/18. dyskeratosis congenita: report of a case.

    dyskeratosis congenita is a rare multisystem condition involving mainly the ectoderm. It is characterized by a triad of reticular skin pigmentation, nail dystrophy and leukoplakia of mucous membranes. Oral and dental abnormalities may also be present. Complications are a predisposition to malignancy and bone marrow involvement with pancytopenia. The case of a 14-year-old girl is described who presented with several of the characteristic systemic features of this condition, together with the following oral features: hypodontia, diminutive maxillary lateral incisors, delayed dental eruption, crowding in the maxillary premolar region, short roots, poor oral hygiene, gingival inflammation and bleeding, alveolar bone loss, caries and a smooth atrophic tongue with leukoplakia. Although this condition is rare, dental surgeons should be aware of the dental abnormalities that exist and the risk of malignant transformation within the areas of leukoplakia.
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3/18. White plaque of the lateral tongue.

    A healthy 48-year old white woman presented with a chief complaint of an 'irritated' sensation involving her tongue. The problem seemed to be limited to her left lateral tongue and had been noticed for at least six months by the patient. She also indicated the condition varied in severity.
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4/18. Hairy leukoplakia with involvement of the buccal mucosa.

    Oral hairy leukoplakia occurs mainly on the tongue of human immunodeficiency virus (hiv)-infected persons. An hiv-infected patient with hairy leukoplakia involving the tongue and buccal mucosa was studied by light and electron microscopic methods, in situ hybridization, and polymerase chain reaction. Our findings indicate that hairy leukoplakia may involve the buccal mucosa and should be considered in the differential diagnosis of white oral lesions in hiv-positive patients. Epstein-Barr virus particles were found in the epithelial cells of both buccal and tongue mucosa.
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5/18. Transformation of proliferative verrucous leukoplakia to oral carcinoma: a ten years follow-up.

    The authors present a case of proliferative verrucous leukoplakia (PVL) in a 78-year-old man. It was initially presented as leukoplakia on the tongue but a microscopic investigation in 1991 revealed it to be a mild epithelial dysplasia. After 5 years of follow-up, the lesion presented changes in size and location, and a recidivant behavior. In 1996, a red granular and indurated area that appeared on the tongue was found to be a microinvasive squamous cell carcinoma when microscopically investigated. After a review of the clinicopathologic behavior of this entity, the authors concluded that it was a typical PVL, whose diagnosis is difficult and retrospective, as indicated by others. The authors emphasize the importance of periodic detailed clinical and histological examination of this type of lesions in order to detect early signs of malignancy.
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6/18. 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.
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7/18. dyskeratosis congenita vs. chronic graft versus host disease: report of a case and a review of the literature.

    dyskeratosis congenita (DC) is a rare inherited bone marrow failure syndrome characterized by the triad of reticular pigmentation of the skin, nail dystrophy, and mucosal leukoplakia. DC is often associated with severe pancytopenia, and bone marrow failure is the principal cause of early mortality. Malignant transformation of mucosal leukoplakias may also occur. Rarely, aplastic anemia precedes the other clinical manifestations of the disease. We present a case of a 13-year-old boy who was diagnosed at age four with idopathic aplastic anemia, was treated successfully with an allogeneic bone marrow transplant, then subsequently developed skin, nail, and tongue lesions. While the initial impression was chronic graft-versus-host disease, additional work-up confirmed the diagnosis of DC.
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8/18. pachyonychia congenita. Case report.

    A 17-year old female patient was referred to our Department. Clinical examination revealed white, hyperkeratotic lesions on the dorsal part of the tongue, together with symmetric lesions on the buccal mucosa. The patient also showed dystrophic changes of the nails, both on hands and on feet, as well as bullous lesions on the soles. After detailed clinical and histologic examinations, diagnosis of pachyonychia congenita was made.
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9/18. Oral histoplasmosis as a presenting disease in acquired immunodeficiency syndrome.

    A 43-year-old homosexual man visited his dentist with painful, nodular, ulcerated lesions on the soft palate, right buccal mucosa, and right posterior maxillary gingiva. Serologic studies for exposure to human immunodeficiency virus, performed before biopsy, were positive. biopsy of the maxillary gingiva demonstrated sheets of histiocytes containing small intracellular yeasts, which on culture were identified as histoplasma capsulatum. Bilateral leukoplakic lesions with some vertical furrowing involving the lateral borders of the tongue were also noted. Histologically, hyperkeratosis and fungal hyphae were identified. The patient was treated for histoplasmosis with amphotericin b, which resulted in significant improvement of the oral lesions. He was subsequently hospitalized for fatigue and dyspnea and was found to have pneumocystis carinii pneumonia. Pulmonary status deteriorated within a 3-week period, and the patient died. autopsy findings were negative for histoplasmosis but positive for necrotizing and cavitary P. carinii pneumonia, pulmonary and hepatic herpes simplex infections, and pulmonary and intestinal cytomegalovirus infection.
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10/18. Oral hairy leukoplakia with extensive oral mucosal involvement. Report of two cases.

    Oral hairy leukoplakia (HL) is a lesion that occurs predominantly on the tongue in hiv-infected persons. Evidence strongly indicates that HL is related to the presence of Epstein-Barr virus in the epithelial cells. The lesion appears on the lateral border of the tongue as a painless, white plaque varying in size from a few millimeters to extensive lingual involvement. Histopathologically, the characteristic findings are hyperparakeratosis, hyperplasia, and ballooning of prickle cells resembling koilocytosis. HL is now considered a frequent, early, and specific sign of hiv infection and a strong indicator that AIDS will develop in the patient. We report on two cases of HL with marked oral mucosal involvement with extension to the pharyngeal mucosa.
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