Cases reported "Leukoplakia, Oral"

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11/18. dyskeratosis congenita preceded by severe aplastic anemia: report of one case.

    dyskeratosis congenita is a rare hereditary disease which usually manifests with skin hyperpigmentation, nail dystrophy, and leukoplakia of the mucous membrane (triad). This report describes a six-year-old boy with severe aplastic anemia who was later diagnosed to have dyskeratosis congenita. His unusual presentation was pancytopenia followed by leukoplakia of the tongue, hyperpigmentation of the skin and dystrophy of the nails. Treatment with horse anti-human lymphocyte immunoglobulin (ALG) for his aplastic anemia was not effective.
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12/18. Dermatophilus congolensis and "hairy" leukoplakia.

    The authors report the first human case (to our knowledge) of infection of the oral mucosa by Dermatophilus congolensis. Septate branching filaments morphologically identical to those of D. congolensis were identified in the lingual epithelium of a male homosexual employed as an animal handler. This actinomycete is the cause of dermatophilosis, a proliferative exudative dermatitis affecting many animal species. Clinical features suggested "hairy" leukoplakia (HL), a hyperkeratotic tongue lesion for which human papillomavirus (HPV) and Epstein-Barr virus (EBV) have been implicated as etiologic agents. Immunoperoxidase staining for HPV capsid antigen was negative. Direct immunofluorescent staining with a conjugate specific for D. congolensis identified the bacterial structures as those of this species while excluding morphologically similar organisms.
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13/18. Oral hairy leukoplakia in a HIV-negative renal transplant patient: a marker for immunosuppression?

    We report the case of a 58-year-old renal transplant patient who developed oral hairy leukoplakia. Examination for hiv-1 and hiv-2 infection was negative. biopsy of the lateral tongue showed ballooned prickle cells and electron microscopy revealed herpes-type viruses. in situ hybridization and examinations with the Southern blot technique yielded Epstein-Barr virus. serology for Epstein-Barr virus was reactive. Immunological investigation of the patient showed a marked decrease of T-helper and T-suppressor cells as the result of immunosuppressive regimen. Oral hairy leukoplakia may be a marker for severe immunosuppression but is not necessarily associated with HIV infection.
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14/18. Oral hairy leukoplakia. A distinctive marker of human T-cell lymphotropic virus type III (HTLV-III) infection.

    Oral hairy leukoplakia (HL) is a newly described lesion occurring principally on the lateral borders of the tongue in immunosuppressed homosexual men infected with human T-cell lymphotropic virus type III (HTLV-III). Clinically, HL appears as a slightly raised, poorly demarcated lesion with a corrugated or "hairy" surface. Histologically, the lesion is characterized by keratin projections on the surface (which often resemble hairs), parakeratosis, and acanthosis. In addition, large pale-staining cells with pyknotic nuclei are seen in the upper stratum malpighii, which appear similar to the koilocytes described in uterine condylomata. candida organisms are frequently observed on the lesion surface. Little, if any, subepithelial inflammation is present. Human papillomavirus and Epstein-Barr virus have been identified in biopsy specimens from lesions of oral HL. The association of this lesion in patients with HTLV-III infection has been established. We saw a patient with HTLV-III infection and HL, in whom the immunochemical and ultrastructural findings revealed the presence of a mixed viral infection. Because oral HL may be of diagnostic value as an early indicator of HTLV-III infection, awareness of its characteristic clinical, histologic, immunochemical, and ultrastructural features is important.
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15/18. Regression of oral hairy leukoplakia during zidovudine therapy.

    We describe two patients with human immunodeficiency virus infection and oral hairy leukoplakia whose tongue lesions resolved on oral zidovudine therapy. During therapy, each patient had a measurable reduction in human immunodeficiency virus antigen corresponding with clinical regression of oral lesions. The clinical course suggests that zidovudine may have contributed to the resolution of these lesions either indirectly through immunologic improvement or through an antiviral effect.
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16/18. Oral squamous-cell carcinoma within a white-sponge nevus.

    A 59-year-old woman had thick plaques of leukoplakia on the tongue bilaterally. The condition was initially diagnosed by biopsy as a white-sponge nevus. A second biopsy of a suspicious area on the right side showed squamous-cell carcinoma two years later. It is speculated that prednisone therapy for steroid-dependent intrinsic asthma may have caused a loss of "immunologic surveillance," which permitted development of malignancy in a previously benign condition.
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17/18. pachyonychia congenita with late onset of nail dystrophy--a new clinical entity?

    pachyonychia congenita syndrome (PCS) is a genetic disease with an autosomal dominant mode of transmission in which the main sign, pachyonychia, usually arises at birth or in childhood together with other disorders of keratinization. A 28-year-old woman developed subungual hyperkeratosis of all toe-nails and thumb-nails associated with pain on pressure and walking. She had a scrotal tongue with leucokeratotic areas, blister formation, plantar hyperkeratosis, palmoplantar hyperhidrosis and dental cavities since childhood. The present case, interpreted as PCS of late onset, could be a clinical variant of the Jadassohn-Lewandowsky syndrome with the late onset of pachyonychia or else an additional form of PCS due to the expression of a new and different allele.
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18/18. mucous membrane involvement in generalized pustular psoriasis: Report of three cases and review of the literature.

    Pustular eruptions on both skin and mucous membranes occur in the various forms of generalized pustular psoriasis. Three patients with generalized pustular psoriasis also had an eruption on the tongue resembling geographic tongue; one patient had sterile conjunctivitis. Histologically, the spongiform pustule of Kogoj is common to lesions of both skin and mucosa. We suggest that generalized pustular psoriasis be considered one of the mucocutaneous syndromes.
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