RESUMO
OBJECTIVE: To assess the oral shedding and viremia of Epstein-Barr virus (EBV) in HIV-positive patients and their relationship with oral hairy leukoplakia (OHL). METHODOLOGY: A total of 94 HIV-positive patients were included in the study, in which blood and saliva samples were collected for EBV quantification. Data on gender, age, time of HIV seropositivity, combined antiretroviral therapy (cART), CD4+ T-cell counts, and HIV viral load were collected. OHL diagnosis was based on histopathological examination and EBV in situ hybridization. RESULTS: The EBV load in the 94 HIV-positive patients was higher in saliva than in blood (2.4 and 1.6, respectively), and there was a positive correlation between EBV oral shedding and viremia (p = 0.001). Twenty (21.27%) patients had OHL and also a higher EBV load in saliva (mean log10 = 3.11) compared to those who had no OHL (p = 0.045). Presence of OHL was only associated with age (p = 0.030). CONCLUSION: In HIV-positive patients, the presence of OHL was associated with EBV oral shedding but not with viremia, regardless of the amount of circulating CD4+ T cells.
Assuntos
Infecções por Vírus Epstein-Barr , Infecções por HIV , Humanos , Leucoplasia Pilosa/diagnóstico , Herpesvirus Humano 4 , Infecções por Vírus Epstein-Barr/complicações , Viremia/complicações , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Leucoplasia Oral/complicaçõesRESUMO
O câncer de mucosa oral é um problema de saúde pública, com maior incidência em homens acima de 50 anos. Uma das manifestações clínicas mais precoces do câncer da mucosa oral são as lesões leucoqueratósica. O aspecto clínico não homogêneo e o tamanho maior de 200mm2, em mucosa não queratinizada como a do assoalho da boca e ventre da língua, são aspectos que implicam na possibilidade de evolução da lesão. A dificuldade do diagnóstico das lesões precoces está na seleção do local a ser biopsiado principalmente frente a lesões extensas e heterogêneas. O objetivo desta pesquisa é avaliar se a utilização do exame clínico juntamente com os métodos auxiliares de diagnóstico das lesões leucoqueratósica da mucosa oral (VELscope®, Azul de toluidina e Solução de lugol) contribui para uma maior precisão do diagnóstico de displasias nestas lesões quando comparado ao histopatológico. E, identificar os padrões morfológicos destas lesões quando avaliadas por meio da microscopia confocal reflectante. Foram selecionados 30 pacientes, maiores de 18 anos, portadores de lesão clínica compatível com leucoplasia oral triados no ambulatório da disciplina de Estomatologia Clínica da Faculdade de Odontologia da Universidade de São Paulo e que precisavam ser submetidos à biópsia para o estabelecimento do diagnóstico final. Foram realizados os testes de Azul de Toluidina, Solução de Lugol, VELscope®, microscopia confocal reflectante e posteriormente, a biópsia incisional para obtenção do diagnóstico final. Os pacientes incluídos possuíam média de idade 60,66 anos, sendo 70% (21/30) do gênero feminino e 30% (9/30) do gênero masculino. O tabagismo foi relatado por 16,7% (5/30) dos pacientes, sendo 60% (3/5) homens. A associação do tabagismo e etilismo foi relatada em 10% (3/30) dos pacientes, o tabagismo isoladamente por 6,6% (2/30) e o de etilismo por 3,3%(1/30)...
Cancer of the oral mucosa is a public health problem, with higher incidence in men above 50 years. One of the earliest manifestations of cancer of the oral mucosa lesions are leukokeratosis. The inhomogeneous clinical aspect and the larger size of 200mm2 in non-keratinized mucosa as the floor of the mouth and constipation of the tongue, are aspects that imply the possibility of evolution of the lesion. The difficulty of diagnosis of early lesions is in the selection of the site to be biopsied primarily against large and heterogeneous lesions. The objective of this research is to evaluate the use of clinical examination along with diagnostic aids leucoqueratósica of oral lesions (VELscope ®, Toluidine blue and Lugol solution) methods contributes to greater accuracy of diagnosis of dysplasia in these lesions when compared the histopathological. And identify the morphological patterns of these lesions when evaluated by reflectance confocal microscopy. 30 patients older than 18 years, with clinical lesion compatible with oral leukoplakia screened in the outpatient discipline of Clinical Dentistry, Faculty of Dentistry, University of São Paulo and that needed to be biopsied to establish the final diagnosis were selected. Tests toluidine blue, Lugol's solution, VELscope ®, reflectance confocal microscopy (RCM) and subsequently, incisional biopsy to obtain the final diagnosis were performed. Patients enrolled had a mean age 60.66 years, 70% (21/30) were female and 30% (9/30) were male. Smoking was reported by 16.7% (5/30) of patients, 60% (3/5) homens.A association of smoking and alcohol use was reported in 10% (3/30) of patients, smoking alone by 6.6% (2/30) and of alcoholism by 3.3% (1/30)...
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Bucal/métodos , Epitélio , Leucoplasia Oral/classificação , Leucoplasia Oral/complicações , Leucoplasia Oral/diagnóstico , Odontodisplasia/complicações , Odontodisplasia/diagnósticoRESUMO
OBJECTIVE: Our purpose was to carry out an epidemiological study to assess the prevalence of oral mucosal conditions in Brazilian patients with chronic hepatitis C. METHODS: A cross-sectional survey was carried out on 215 patients with chronic hepatitis C who were examined for oral mucosal conditions, including oral mucosal lesions and variations of normality. RESULTS: The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent (207 patients). Oral mucosal lesions were present in 147 patients (68.4 percent), whereas variations of normality were observed in 173 patients (80.5 percent). The most common lesions included cheek biting in 42 cases (19.5 percent), candidiasis in 39 cases (18.1 percent), and leukoplakia in 28 cases (13.0 percent). The association of oral lichen planus with hepatitis C virus (HCV) infection proved to be statistically significant (P = 0.002). The most frequent variations of normality included Fordyce's spots in 96 cases (44.7 percent), lingual varicosities in 67 cases (31.2 percent), and fissured tongue in 60 cases (27.9 percent). CONCLUSION: The prevalence of patients with chronic hepatitis C presenting oral mucosal conditions was 96.3 percent. Despite this high prevalence, only the association between oral lichen planus and hepatitis C showed statistical significance. Considering that HCV infection may be associated with extrahepatic disorders, such as oral manifestations, efforts should be made to clarify the possible relation between oral conditions and HCV infection. This may be helpful in the earlier diagnosis of the infection mainly in asymptomatic patients.
Assuntos
Hepatite C Crônica/complicações , Líquen Plano Bucal/complicações , Adolescente , Adulto , Idoso , Mordeduras Humanas/complicações , Candidíase Bucal/complicações , Bochecha/lesões , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Leucoplasia Oral/complicações , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Adulto JovemRESUMO
AIM: To determine the prevalence of oral lesions in a HIV+ group of patients, related to CD4 cell count and viral load in a Venezuelan population. MATERIALS AND METHODS: In the present study, we evaluated 75 HIV+ adult patients, attended at the Center of Infectious Diseases, at the Faculty of Dentistry, Central University of Venezuela. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by flow cytometry, as well as viral load by RT-PCR (Amplicor HIV-RNA, TM test 1.5, Roche). RESULTS: 85% (64/75) of HIV/AIDS patients showed associated HIV lesions. Oral Candidiasis constituted the most common lesion representing a 61% (39/64), followed by Oral Hairy Leukoplakia 53% (34/64); Oral Leukoplakia 34% (22/64), Melanic Hyperpigmentation 38% (18/64); Papilloma 13 (6/64), Lineal Gingival Erythema 8% (5/64); Aphtous Recurrent Stomatitis 5% (4/64) and Kaposi's Sarcoma 5% (3/64). Only one case of the following lesions were represented by Non Hodgkin Lymphoma, Multifocal Epithelial Hyperplasia, Recurrent Herpes, Histoplasmosis and Molluscum Contagiosum. The patients with a viral load of 30.000 copies/mm3 exhibited oral lesions related with HIV, independent of CD4 cell count, although patients with CD4+ levels of 200 cel/mm3 were more susceptible to develop these lesions. CONCLUSIONS: The most common oral lesion was Oral Candidiasis followed by Oral Hairy Leukoplakia, Oral Leukoplakia and Melanic Hyperpigmentation. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+ cell count.
Assuntos
Infecções por HIV/complicações , Doenças da Boca/complicações , Adulto , Contagem de Linfócito CD4 , Candidíase Bucal/complicações , Candidíase Bucal/epidemiologia , Eritema/complicações , Eritema/epidemiologia , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/isolamento & purificação , Humanos , Leucoplasia Oral/complicações , Leucoplasia Oral/epidemiologia , Masculino , Melanose/complicações , Melanose/epidemiologia , Pessoa de Meia-Idade , Doenças da Boca/epidemiologia , Neoplasias Bucais/complicações , Neoplasias Bucais/epidemiologia , Papiloma/complicações , Papiloma/epidemiologia , Prevalência , Sarcoma de Kaposi/complicações , Sarcoma de Kaposi/epidemiologia , Estomatite Aftosa/complicações , Estomatite Aftosa/epidemiologia , Venezuela/epidemiologia , Carga ViralRESUMO
El carcinoma escamocelular bucal es una patología que se presenta con baja frecuencia en la consulta estomatológica. El propósito del estudio fue hacer la descripción de las características clínicas y epidemiológicas de los casos diagnosticados en el Hospital Universitario San Vicente de Paúl entre los años 1990 y 1996. Se analizaron las historias clínicas y los formatos de archivo del Departamento de Patología del Hospital y de la Facultad de Odontología de la Universidad de Antioquia. Se encontraron 228 casos, de los cuales el mayor porcentaje correspondía a hombres de sesenta años y más; la lengua fue el sitio más frecuentemente afectado (30 por ciento), seguida del suelo de boca (20,7 por ciento) y del paladar (17,7 por ciento). El tabaquismo fue un antecedente presente en el 67 por ciento de los casos y el consumo de alcohol en el 29,8 por ciento. Se detectó una lesión premaligna previa al desarrollo del cáncer en 56 casos, donde las leucoplasias fue la más común. Los estadios de cáncer que más se presentaron fueron el IV y el III con 55,1 y 19,8 por ciento respectivamente; la radioterapia en el 46,1 por ciento de los casos y la cirugía en el 39,6 por ciento fueron los tratamientos que más se realizaron. Se concluye que en la población estudiada el carcinoma escamocelular bucal se diagnostica principalmente en mayores de edad y en estadios avanzados, esto disminuye las probabilidades de éxito de los tratamientos curativos y a su vez desmejora la calidad de vida de los pacientes; es necesario conocer el comportamiento clínico, las manifestaciones, las características de los estadios iniciales y los posibles factores de riesgo asociados, con el fin de realizar el diagnóstico temprano y el control precoz de esta neoplasia.
Assuntos
Carcinoma de Células Escamosas , Carcinoma/epidemiologia , Leucoplasia Oral/complicações , Neoplasias BucaisRESUMO
An undesirable effect of fixed orthodontic appliances is irritation of the oral mucosa. Lesions are common, but they usually heal quickly because of the fast metabolism of oral mucosa cells. Alterations accompanying some injuries are temporary, but some are irreversible because of attrition. White sponge nevus constitutes a special situation, and little information about it is available in the orthodontic literature. This report presents a patient with white sponge nevus who received orthodontic treatment over a 40-month period. The condition was also noted in a sibling. Because of the similarity between white sponge nevus and other diseases, including some that are malignant, a thorough clinical history and differential diagnosis are essential.
Assuntos
Hamartoma/complicações , Leucoplasia Oral/complicações , Má Oclusão Classe II de Angle/complicações , Má Oclusão Classe II de Angle/terapia , Doenças da Boca/complicações , Ortodontia Corretiva , Adolescente , Feminino , Hamartoma/patologia , Humanos , Leucoplasia Oral/patologia , Doenças da Boca/patologia , Mucosa Bucal/patologia , Ortodontia Corretiva/efeitos adversos , Estomatite/etiologia , Resultado do TratamentoRESUMO
Se describe el caso de un paciente femenino de 74 años que cursó con leucoplasia verrucosa proliferativa de 12 años de evolución. Inició con lesión leucoplásica con aumento de tamaño y número de afectó la totalidad de la cavidad bucal. Mejoró con tratamiento a base de criocirugía; pero posteriormente desarrolló carcinoma epidermoide en el fondo de saco anterosuperior bilateral, área donde asentaba una prótesis total. La leucoplasia verrucosa proliferativa es una forma de leucoplasia oral altamente agresiva de evolución lenta y progresiva, multifocal, persistente y resistente a todo tipo de tratamiento con un alto índice de recurrencia y malignización
Assuntos
Humanos , Feminino , Idoso , Leucoplasia Oral/complicações , Leucoplasia Oral/patologia , Carcinoma de Células EscamosasRESUMO
One hundred and twenty-five HIV-infected patients, of whom 49 (39%) were at early stages of the infection (CDC-II & III) and 76 (61%) in CDC IV, were prospectively examined. In 100 (80%) one or more oral mucosal lesions were observed; candidiasis (51%) and hairy leukoplakia (43%) were the commonest. Erythematous candidiasis was more often seen (35%) than the pseudomembranous type (16%), and appeared with the higher values at early than later stages. The prevalence of hairy leukoplakia, oral hyperpigmentation and xerostomia were incremented in groups CDC-IV. Pseudomembranous candidiasis and exfoliative cheilitis increased significantly with severity of disease. Our study demonstrates that oral alterations associated to HIV are a frequent finding, both at early (76%) and late (83%) stages of the infection in Mexican patients.
Assuntos
Infecções por HIV/epidemiologia , Doenças da Boca/epidemiologia , Adolescente , Adulto , Idoso , Candidíase Bucal/complicações , Candidíase Bucal/epidemiologia , Feminino , Infecções por HIV/complicações , Soropositividade para HIV , Herpesvirus Humano 4 , Humanos , Leucoplasia Oral/complicações , Leucoplasia Oral/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Doenças da Boca/complicações , Neoplasias Bucais/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Sarcoma de Kaposi/epidemiologia , Neoplasias da Língua/complicações , Neoplasias da Língua/epidemiologia , Infecções Tumorais por Vírus/complicações , Infecções Tumorais por Vírus/epidemiologiaRESUMO
In 1981 AIDS acquired a lot importance, observing opportunist infections, not common malignant lesion and abnormalities in the immune system which develops in mysterious ways in healthy persons apparently or without pathologic background. The medical and scientific community respond immediately with intensive research to find the cause, prevention and treatment. The Journal American Medical Society is one of the principal sources to inform about AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças da Boca/complicações , Neoplasias Bucais/etiologia , Candidíase Bucal/complicações , Humanos , Leucoplasia Oral/complicações , Sarcoma de Kaposi/etiologia , Estomatite Herpética/complicaçõesRESUMO
AIDS is currently one of the most important and concerning diseases for dentists, both general and specialized. This review of the literature makes emphasis on the main biological, epidemiological, diagnostic and prognostic aspects of oral hairy leucoplakia which every dental care professionist should know, as well as the importance of those conditions in the evolutionary course of this disease.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Leucoplasia Oral , HIV , Herpesvirus Humano 4 , Humanos , Leucoplasia Oral/complicações , PrognósticoRESUMO
Oral hairy leukoplakia (OHL) is a new lesion that appears specifically on the lateral borders of the tongue. It has basically been detected in immunosuppressed male homosexuals and it is associated with the later development of the acquired immunodeficiency syndrome (AIDS) or HIV infection. Epstein-Barr virus has been suggested to be the possible etiological agent. A review of the existing literature pointing out definition, clinical, histopathologic and ultrastructural features, prognostic and treatment is made. Moreover the characteristics of the individuals suffering from it are equally studied. The role of the dentist at detecting the lesion, as well as the importance of its definitive diagnostic are emphasized, in virtue of the effects that may have a bearing on patients.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Leucoplasia Oral/complicações , Adulto , Feminino , Herpesvirus Humano 4/isolamento & purificação , Humanos , MasculinoRESUMO
AIDS is a systemic infection that in many steps of its evolution presents various oral lesions and clinical conditions. This fact raises a problem for the dentist who are working on heterogeneous populations of healthy and infected people as well as on AIDS patients: to receive a continuous update about the disease. Apart from the risks of exposure inherent to his personal relation with HIV-infected or AIDS patients, the dentist is one of the health careworkers who must and ought recognize the oral signs of the disease when they appear in the mouth. For this reason this paper describes recent data on oral findings in AIDS: fungal, viral and bacterial infections, neoplasms and other manifestations of unknown or rare etiology. The most precocious clinical or pathological characteristics of these oral diseases suggesting HIV-infection or its results, are also stressed when described. Some doubts are possessed here about the meaning of outstanding oral AIDS lesions as "hairy leukoplakia". On the other way diagnostic methods which can help to recognize this lesion are also commented.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Doenças da Boca/complicações , Candidíase Bucal/complicações , Humanos , Leucoplasia Oral/complicações , Neoplasias Bucais/etiologia , Infecções Oportunistas/complicações , Sarcoma de Kaposi/etiologiaRESUMO
At present HL: should be considered a marker of immunodeficiency, though not necessarily associated with HIV infection. In eight patients with HL it was confirmed that this lesion, in male homosexuals, in a precursor and marker of AIDS. The diagnosis of HL warrant all efforts to protect the immune system and avoid progression to AIDS.