RESUMEN
This study is a cross-sectional report of oral mucosal lesions in 23785 patients more than 15 years of age who requested elective dental care in a dental school. Among the patients examined, the general lesion rate was 356.60 lesions per 1000 patients. Sixty-eight entities were identified, the lesions being more common among males. White, red, and ulcerated lesions were seen to predominate, associated mostly with chronic irritative causative factors. The prevalence rates of individual oral mucosal lesions ranged from 0.55 to 105.36 per 1000 patients examined. Age and sex assessment showed some differences in the type and presentation rates of the lesions. These and other epidemiological aspects are discussed.
Asunto(s)
Enfermedades de la Boca/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Métodos Epidemiológicos , Femenino , Humanos , Leucoedema Bucal/epidemiología , Leucoedema Bucal/patología , Masculino , México/epidemiología , Persona de Mediana Edad , Morbilidad , Enfermedades de la Boca/etiología , Enfermedades de la Boca/patología , Mucosa Bucal/patología , Distribución por Sexo , Fumar/efectos adversosRESUMEN
Purpose of the present investigation was to study the association between the betel quid chewing (BQC) habits, the oral yeast flora and oral lesions in female Padaung of northern Thailand. Oral swabs were taken from the tongue and palate of 50 Padaung women with and 50 control individuals without BQC habit. The spectrum of oral Candida species in both groups was determined microbiologically. In addition, oral mucosal lesions were registered in both groups. Mean age of BQ chewers was 35.4 years, of non-chewers was 19.2 years. Candida parapsilosis was the most common Candida spp. isolated both in BQ chewers (46%) and non-chewers (44%). Candida albicans was revealed in 24% of BQ chewers and 18% of non-chewers. There was no significant difference in carriage of Candida spp. isolated between both groups. Forty-four per cent of BQ chewers revealed betel chewers mucosa, 10% showed leukoedema. Isolated populations such as the Padaung may reveal different patterns of candidal flora, in this case a predominance of Candida parapsilosis.
Asunto(s)
Areca , Candida/aislamiento & purificación , Candidiasis Bucal/microbiología , Portador Sano/microbiología , Enfermedades de la Boca/epidemiología , Boca/microbiología , Adolescente , Adulto , Candidiasis Bucal/complicaciones , Candidiasis Bucal/epidemiología , Portador Sano/epidemiología , Niño , Femenino , Humanos , Leucoedema Bucal/epidemiología , Leucoedema Bucal/patología , Masticación , Persona de Mediana Edad , Boca/patología , Enfermedades de la Boca/complicaciones , Enfermedades de la Boca/patología , Mucosa Bucal/microbiología , Mucosa Bucal/patología , Hueso Paladar/microbiología , Hueso Paladar/patología , Tailandia , Lengua/microbiología , Lengua/patologíaRESUMEN
Among the most important factors in a thorough clinical examination is the dentist's ability to recognize and make distinctions among normal oral structures, variations of normal structures, and pathologic entities. The practitioner's diagnostic acumen is essential to this process and is a skill gained and refined by clinical experience and continuing education. In this introductory article, the authors describe normal entities, anomalies, and benign soft tissue lesions of interest to the clinician. For presentation, these structures are organized according to their location within the oral cavity.
Asunto(s)
Enfermedades de la Boca/patología , Mucosa Bucal/patología , Exostosis/patología , Humanos , Leucoedema Bucal/patología , Labio/patología , Úlceras Bucales/patología , Enfermedades de la Lengua/patología , Várices/patologíaRESUMEN
La patología blanca de la mucosa oral comprende una constelación de enfermedades cuyos cuadros clínicos se asemejan mucho entre sí y se caracterizan por la presentación de una lesión de aspecto blanquesino en la cavidad bucal. Con el fin de remarcar las diferencias entre cada afección, sus diversas evoluciones y pronósticos y alertar sobre aquellas con tendencia cancerígena y pronóstico más ominoso es que se realiza este trabajo. Es también nuestro interés señalar que no debemos olvidar a la cavidad bucal en el examen dermatológico de rutina (AU)
Asunto(s)
Humanos , Disqueratosis Congénita/diagnóstico , Enfermedad de Fox-Fordyce/diagnóstico , Leucoplasia Vellosa/diagnóstico , Nevo/diagnóstico , Mucosa Bucal/patología , Glositis Migratoria Benigna/diagnóstico , Candidiasis Bucal/diagnóstico , Sífilis/diagnóstico , Glositis Migratoria Benigna/patología , Enfermedad de Fox-Fordyce/patología , Candidiasis Bucal/patología , Leucoplasia Vellosa/patología , Sífilis/patología , Sarampión/diagnóstico , Sarampión/patología , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/patología , Estomatitis/diagnóstico , Estomatitis/etiología , Psoriasis/diagnóstico , Psoriasis/patología , Hiperplasia Epitelial Focal/diagnóstico , Hiperplasia Epitelial Focal/patología , Leucoplasia Bucal/diagnóstico , Leucoplasia Bucal/patología , Papiloma/diagnóstico , Papiloma/patología , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Leucoedema Bucal/diagnóstico , Leucoedema Bucal/patología , Enfermedades de la Boca , Diagnóstico DiferencialRESUMEN
La patología blanca de la mucosa oral comprende una constelación de enfermedades cuyos cuadros clínicos se asemejan mucho entre sí y se caracterizan por la presentación de una lesión de aspecto blanquesino en la cavidad bucal. Con el fin de remarcar las diferencias entre cada afección, sus diversas evoluciones y pronósticos y alertar sobre aquellas con tendencia cancerígena y pronóstico más ominoso es que se realiza este trabajo. Es también nuestro interés señalar que no debemos olvidar a la cavidad bucal en el examen dermatológico de rutina
Asunto(s)
Humanos , Candidiasis Bucal/diagnóstico , Disqueratosis Congénita/diagnóstico , Enfermedad de Fox-Fordyce/diagnóstico , Glositis Migratoria Benigna/diagnóstico , Leucoplasia Vellosa/diagnóstico , Mucosa Bucal/patología , Nevo/diagnóstico , Sífilis/diagnóstico , Candidiasis Bucal/patología , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Diagnóstico Diferencial , Hiperplasia Epitelial Focal/diagnóstico , Hiperplasia Epitelial Focal/patología , Enfermedad de Fox-Fordyce/patología , Glositis Migratoria Benigna/patología , Leucoedema Bucal/diagnóstico , Leucoedema Bucal/patología , Leucoplasia Vellosa/patología , Leucoplasia Bucal/diagnóstico , Leucoplasia Bucal/patología , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/patología , Enfermedades de la Boca , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Papiloma/diagnóstico , Papiloma/patología , Psoriasis/diagnóstico , Psoriasis/patología , Sarampión/diagnóstico , Sarampión/patología , Sífilis/patología , Estomatitis/diagnóstico , Estomatitis/etiologíaRESUMEN
Betel chewer's mucosa (BCM) was first described and defined in 1971. Its clinical appearance is characterised by a brownish-red discolouration of the oral mucosa with an irregular epithelial surface that has a tendency to desquamate or peel off. The buccal mucosa is most frequently affected. The prevalence of BCM varies between 0.2% and 60% in different studies from South and Southeast Asia. Women are more frequently affected than men. Betel chewer's mucosa may be found together with other oral mucosal lesions such as leukoedema, leukoplakia and ulceration. The histological features are characteristic. The epithelium is often hyperplastic, and brownish amorphous material derived from the betel quid may be demonstrated not only on the epithelial surface but also intra- and inter-cellularly. Ballooning of epithelial cells may occur. The etiology is traumatic and possibly chemical. Betel chewer's mucosa is most likely not precancerous. Differential diagnoses include cheek biting, with which it has a number of similarities, and other predominantly white lesions that may have taken up stains from tobacco and other substances. The natural history of BCM should be studied in more detail and its association with other oral mucosal diseases, particularly of a precancerous nature, should be the aim of further investigations.
Asunto(s)
Areca , Enfermedades de la Boca/patología , Plantas Medicinales , Diagnóstico Diferencial , Células Epiteliales/patología , Epitelio/patología , Femenino , Humanos , Hiperplasia , Leucoedema Bucal/patología , Leucoplasia Bucal/patología , Masculino , Enfermedades de la Boca/etiología , Mucosa Bucal/patología , Neoplasias de la Boca/patología , Úlceras Bucales/patología , Lesiones Precancerosas/patología , Factores SexualesRESUMEN
The purpose of this investigation, which has been performed as two studies, was to evaluate the association between the daily exposure to nicotine (measured as cigarette smoking machine yields) and the actual uptake of nicotine by cigarette smokers, as well as the association between oral mucosal changes and the exposure to cigarette smoke. In Study 1, consumption data, soft tissue changes and nicotine intake were measured in 47 habitual smokers using cigarettes with tar and nicotine yields within the ranges 9.3-12.2 and 0.72-1.16 mg per cigarette, respectively. The subjects were divided into three groups based on daily cigarette consumption; group averages (standard deviation) were 10.8 (2.2), 17.9 (1.9) and 28.4 (6.1) cigarettes per day. The group averages of tar deliveries from their usual brands of cigarettes were 11.1, 11.0 and 10.5 mg per cigarette, and group averages of nicotine deliveries were 1.05, 1.05 and 1.06 mg per cigarette, respectively. In Study 2, the same data were measured in a group of 77 habitual smokers with an average individual consumption of 11-21 cigarettes per day. The participants in Study 2 were divided into three groups according to tar delivery from their usual brands to cigarettes, with group averages of tar being 6.4 (1.2), 11.0 (1.2) and 16.0 (1.1) mg per cigarette, and of nicotine being 0.70 (0.12), 1.05 (0.12) and 1.34 (0.08) mg per cigarette, respectively. The average consumption of all three groups was within the range 17.1 to 17.9 cigarettes per day. The daily exposures to nicotine and tar were measured as the smoking machine yields multiplied by the number of cigarettes smoked per day. Nicotine uptake was determined by monitoring nicotine and its seven main metabolites in 24-h urine samples. In Study 1 there were significant differences between the three groups in the total amount of nicotine and metabolites excreted in the 24-h urine. The average nicotine uptake was 14.9, 24.4 and 35.4 mg per day, respectively. In Study 2, the 24-h excretion of nicotine and metabolites was about the same in all three groups and averaged 24.5 mg per day. The nicotine uptake was significantly correlated to the number of cigarettes smoked per day but not to the smoking machine yields of tar and nicotine per cigarette. The average prevalences for each of the different oral mucosal lesions (leukoedema, smoker's palate and hairy tongue) were found to increase with increasing consumption and nicotine uptake (Study 1); they were also independent of tar and nicotine yields from the cigarettes smoked (Study 2). These results indicate that the actual uptake of nicotine by smokers could not be estimated from the smoking machine yields. Reduction in exposure to smoke components may best be accomplished if smokers are encouraged to smoke fewer lower-yield cigarettes and to avoid smoking more of each cigarette.
Asunto(s)
Enfermedades de la Boca/etiología , Mucosa Bucal/metabolismo , Nicotiana/química , Nicotina/análisis , Plantas Tóxicas , Fumar/metabolismo , Adulto , Cotinina/análogos & derivados , Cotinina/orina , Óxidos N-Cíclicos/orina , Exposición a Riesgos Ambientales , Glucuronatos/orina , Humanos , Leucoedema Bucal/etiología , Leucoedema Bucal/patología , Leucoplasia Bucal/etiología , Leucoplasia Bucal/patología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Mucosa Bucal/patología , Nicotina/análogos & derivados , Nicotina/farmacocinética , Nicotina/orina , Prevalencia , Fumar/efectos adversos , Breas/análisis , Factores de Tiempo , Lengua Vellosa/etiología , Lengua Vellosa/patologíaRESUMEN
The purpose of this study was to investigate the uptake and metabolism of nicotine by smokeless (oral) tobacco users and to find out if the less pronounced clinical changes in the oral mucosa in users of portion-bag packed oral moist snuff (snus) compared with the changes in the mucosa of loose snus users are correlated to exposure and uptake of tobacco constituents. 54 habitual users of smokeless tobacco were selected for the study: 22 loose snus users, 23 users of portion-bag packed snus and 9 users of chewing tobacco. In accordance with previous findings, less pronounced clinical changes in the oral mucosa were recorded in portion-bag users compared with loose snus users. The clinical findings observed in the oral mucosa of users of chewing tobacco were leukoedema and slight clinical "snus changes". The average intake of nicotine (measured as nicotine equivalents excreted during 24 h) for snus users was 35 mg, and was 50% higher for users of chewing tobacco. The average steady-state saliva cotinine concentration was about 300 ng/ml for both categories of snus users, which is similar to that found in smokers, while the average concentration found in users of chewing tobacco was 50% higher. There was a good correlation between saliva cotinine concentration and the 24 h intake of nicotine. The average excretion profile of nicotine was similar in all three groups of smokeless tobacco users, being on average: nicotine 8%, nicotine-GlcA 3%, cotinine 8%, cotinine-GlcA 9%, 3'-hydroxycotinine 42%, 3'hydroxycotinine-GlcA 19%, nicotine-N'-oxide 9% and cotinine-N-oxide 3%.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Mucosa Bucal/patología , Nicotina/farmacocinética , Plantas Tóxicas , Tabaco sin Humo , Adulto , Cotinina/análogos & derivados , Cotinina/análisis , Cotinina/orina , Glucuronatos/análisis , Glucuronatos/orina , Ácido Glucurónico , Humanos , Leucoedema Bucal/patología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patología , Mucosa Bucal/metabolismo , Nicotina/análisis , Nicotina/metabolismo , Nicotina/orina , Nitrosaminas/análisis , Saliva/química , Suecia , Tabaco sin Humo/químicaRESUMEN
Oral hairy leukoplakia (OHL) is a disorder of the tongue associated with Epstein-Barr virus (EBV). OHL is seen mainly in HIV infection but is also rarely seen in the course of iatrogenic immunosuppression, especially in kidney transplantation; OHL is even more rarely seen in immunocompetent hosts. Lesions that clinically and histologically mimicked OHL but were not associated with EBV were recently characterized as pseudo hairy leukoplakia. We present such a case that occurred in a renal allograft recipient; light and electron microscopy, immunohistochemistry, and in situ hybridization were used to examine the patient for the presence of EBV and human papillomavirus. Two independent treatments with topical retinoid and oral amoxicillin resulted in complete remission. Pseudo hairy leukoplakia may correspond, at least in some cases, to the conditions known as leukoedema and white sponge nevus; the distinction of these diseases from OHL is of importance because OHL is a hallmark of severe immunosuppression.
Asunto(s)
Trasplante de Riñón , Leucoplasia Vellosa/patología , Enfermedades de la Lengua/patología , Citoplasma/ultraestructura , Diagnóstico Diferencial , Femenino , Hamartoma/patología , Humanos , Queratinocitos/patología , Leucoedema Bucal/patología , Persona de Mediana Edad , Trasplante HomólogoRESUMEN
Leukoedema, a grayish-white lesion of the oral mucosa in humans, was once thought to be a probable precursor to leukoplakia. Clinical examination differentiates leukoedema from leukoplakia, lichen planus, white sponge nevus, and pathomimia morsicatio buccarum. Prevalence rates vary greatly in different countries and in different ethnic groups. For many years, leukoedema was alleged to occur only in adult populations until Martin and Crump found this lesion in children and youth. There is a definite predilection for this lesion in black Americans. Although the etiology is unknown, it has been suggested that leukoedema develops in areas of local irritation. This article reviews the literature related to the prevalence of leukoedema and correlates the independent findings, which might pertain to its etiology.
Asunto(s)
Leucoedema Bucal , Negro o Afroamericano , Humanos , Leucoedema Bucal/epidemiología , Leucoedema Bucal/etiología , Leucoedema Bucal/patologíaRESUMEN
A 4-month-old developed rapidly enlarging, white plaques up to several centimeters in diameter in areas where occlusive tape had been applied, almost all on the sites of venous or arterial punctures. Microscopy demonstrated the features of miliaria profunda, with sweat duct occlusion and evidence of extravasation of sweat into the dermis. This clinical entity has not been described previously, and we suggest the name giant centrifugal miliaria profunda.
Asunto(s)
Miliaria/patología , Humanos , Lactante , Leucoedema Bucal/etiología , Leucoedema Bucal/patología , Masculino , Miliaria/etiología , Piel/patologíaRESUMEN
One thousand, nine-hundred and ninety-six Cape Coloured high school pupils (655 females and 1,341 males, 14-18 years old) were examined to determine the prevalence of leukoedema and to investigate its relationship with smoking. Results were contradictory. Only in some subgroups was it found that the proportion of smokers with leukoedema was significantly larger than non-smokers with leukoedema; that those with leukoedema consumed significantly more tobacco than those without leukoedema, and that there was a corresponding increase in smoking and leukoedema with age. An analysis of the relationship between smoking, the sex, and leukoedema showed a relationship between sex and leukoedema, but that leukoedema was independent of smoking. Also the prevalence of the condition in smokers and ex-smokers was not significantly different. No correlation existed with the type of smoking and between the severity of the lesion and the amount of tobacco consumed. It is concluded that smoking does not cause the lesion but may aggravate it and that its etiology must be multifactorial.
Asunto(s)
Leucoedema Bucal/etiología , Enfermedades de la Boca/etiología , Fumar , Adolescente , Mejilla , Etnicidad , Femenino , Humanos , Leucoedema Bucal/epidemiología , Leucoedema Bucal/patología , Masculino , Mucosa Bucal/patología , Sudáfrica/etnología , EstudiantesRESUMEN
Electron microscopic, histochemical and light-microscopic studies were carried out on biopsy specimens of 12 cases of leukoedema and on the desquamated epithelial cells of a further 50 examples. For comparison, similar observations were made of 4 examples of healthy cheek mucosa and 29 cases of a variety of pathological conditions of the oral mucosa. Only in leukoedema were a series of structures encountered which consisted of an aggregation of ribosomes and electron dense masses, or a network of electron-dense material, or an electron-dense network with a central dense core or a solid body with a few central cavities. Histochemical stains and RNA extraction studies showed that they are probably abnormal forms of keratohyalin granules and that ribosomes is an important component of their composition.
Asunto(s)
Gránulos Citoplasmáticos/ultraestructura , Hialina , Queratinas , Leucoedema Bucal/patología , Enfermedades de la Boca/patología , Humanos , Microscopía Electrónica de Rastreo , Mucosa Bucal/ultraestructura , ARN Ribosómico , Ribosomas/ultraestructuraRESUMEN
The ultrastructural features of 12 cases of leukoedema were investigated and compared with clinically normal buccal mucosa. Histochemistry was undertaken to try to resolve some of the observed ultrastructural changes. The characteristic "intracellular edema" of the epithelial cells in leukoedema is due to vacuolation in the cytoplasm of cells. Abnormal mitochondria were observed in these cells. The vacuoles contained a granular material somewhat like clumped glycogen granules, but histochemistry failed to identify this material as glycogen. Towards the surface of the epithelium, the vacuolated cells collapsed into a compact layer of flattened cells. The outer cells of this layer abruptly swelled again to form the characteristic superficial layer of "ballooning" cells of leukoedema. The latter cells were not vacuolated but contained remnants of organelles, membraned vesicles with remnants of organelles, keratohyalin granules and structures apparently related to keratohyalin granules. We propose that the vacuolation represents a limited reversible form of cellular degeneration resulting from cell damage and that impeded mitochondrial function may be the cause of the vacuolation. The superficial "ballooning" cells are degenerated cells. The flattening of the vacuolated cells into a compact layer and the presence of keratohyalin granules and keratohyalin-like structures in the superficial cells are regarded as features of an aborted form of keratinization.