Variations of oral anatomy and common oral lesions

Abstract Several topics related to the oral cavity are briefly addressed in this article, from anatomical variations that, when recognized, avoid unnecessary investigations, to diseases that affect exclusively the mouth, mucocutaneous diseases, as well as oral manifestations of systemic diseases. A complete clinical examination comprises the examination of the mouth, and this approach facilitates clinical practice, shortening the path to diagnosis in the outpatient clinic as well as with in-hospital patients. The objective of this article is to encourage the examination of the oral cavity as a useful tool in medical practice, helping to recognize diseases in this location.

Recurrent aphthous stomatitis in 18-year-old adolescents - Prevalence and associated factors: a population-based study

Abstract: Background: Recurrent aphthous stomatitis is a painful disorder of unknown etiology. It is among the most common oral mucosal lesions with high prevalence among young adults. Objectives: To conduct a population-based study with 18-year-old army recruiters to assess its prevalence and associated factors in male adolescents. Methods: Interview during clinical examination in the army. Results: In this group (2,427 interviewed adolescents) there was a RAS prevalence of 24.9%. Smoking, herpes labialis and socioeconomic status correlated with the outcome. Study Limitations: only male adolescents were interviewed. Conclusions: Our results showed high prevalence of RAS; association with higher economic level and herpes simplex was found. Protective effect of smoking was confirmed.

Acute generalized exanthematous pustulosis associated with spider bite

Abstract: Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications.

Acne scars in 18-year-old male adolescents: a population-based study of prevalence and associated factors

Abstract: Background: Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. Objectives: To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. Methods: A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. Results: A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. Conclusions: There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.

Pretibial mucinosis in an euthyroid patient

Abstract A case of exuberant pretibial mucinosis in a patient with normal thyroid function is reported. A review of literature on possible etiologies other than thyroid disease for the accumulation of mucin in the pretibial area is presented. In the patient described, it is possible that vascular insufficiency is involved. However, this is not the only factor responsible for the accumulation of mucin, since there are still unidentified causes and many patients with vascular diseases do not develop similar injuries.

Infantile generalized hypertrichosis caused by topical minoxidil

Abstract Rare cases of hypertrichosis have been associated with topically applied minoxidil. We present the first reported case in the Brazilian literature of generalized hypertrichosis affecting a 5-year-old child, following use of minoxidil 5%, 20 drops a day, for hair loss. The laboratory investigation excluded hyperandrogenism and thyroid dysfunction. Topical minoxidil should be used with caution in children.

HTLV-1-associated infective dermatitis and probable HTLV-1- associated myelopathy in an adolescent female

Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (ID) is a chronic, severe and recurrent eczema occurring during childhood in patients vertically infected with HTLV-1. HTLV-1-associated myelopathy/tropical spastic paraparesia (HAM/ TSP) is slow and progressive. We report the case of an adolescent female from a non-endemic area for HTLV-1 who presents ID and, most likely, associated HAM/TSP.

Síndrome de Laugier-Hunziker / Laugier-Hunziker syndrome

A Síndrome de Laugier-Hunziker é uma doença adquirida, caracterizada por hiperpigmentação macular da mucosa oral e lábios, frequentemente associada à melanoníquia longitudinal. Não está associada a manifestações sistêmicas ou a malignidades, e o seu conhecimento é importante no diagnóstico diferencial das hiperpigmentações mucocutâneas, achado frequente na prática clínica. Relatamos um caso de uma paciente de 56 anos, cujo diagnóstico foi feito com base nos achados clínicos e histopatológicos e pela ausência de pólipos à colonoscopia (AU)

The Laugier-Hunziker syndrome is an acquired disorder characterized by macular hyperpigmentation of the oral mucosa and lips, often associated with longitudinal melanonychia. It is not associated with systemic manifestations or malignancies and knowledge of it is important in the differential diagnosis of mucocutaneous hyperpigmentation, a common finding in clinical practice. We report a case of a 56 year-old patient, whose diagnosis was based on clinical and histopathological findings and the absence of polyps at colonoscopy (AU)

Dissatisfaction and acne vulgaris in male adolescents and associated factors

BACKGROUND: Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES: To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS: A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS: A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION: This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction. .

Tattoos on 18-year-old male adolescents - Characteristics and associated factors / Tatuagens em Adolescentes Masculinos de 18 anos - Caracteristicas e fatores associados

BACKGROUND: Prevalence of tattoos is around 10-26% in men and 10-22% in women, and can involve negative effects such as: regret, removal attempts, physical and biological changes of the skin and association with some viral diseases. OBJECTIVE: to determine the prevalence, characteristics and factors associated with tattoos in recruiters joining the military. METHODS: the recruiters were examined by dermatologists that documented the presence or absence of tattoos, as well as their sizes, colors, designs and patterns, and whether they needed a parent's consent to get a tattoo. RESULTS: 1,968 recruiters were examined and the prevalence of tattoos was 10.82% (213), 141 (66.20%) had a single tattoo, 44 (20.66%) two tattoos, 15 (7.04%) three tattoos, 9 (4.23%) four tattoos, and 4 (1.88%) had more than four. Of the total sample, 168 (80.77%) reported getting the first tattoo before the age of 18. 158 (74.53%) were monochromatic. In relation to size, 108 (50.70%) had tattoos of up to 10 cm, 75 (35.21%) had tattoos measuring between 11-20cm, while 30 had ones over 21cm (14.09%). CONCLUSIONS: The population studied had a high prevalence of tattoos for their age, the percentage of complex (large and polychromatic) tattoos was also high. .

FUNDAMENTOS: Estima-se que a prevalência de tatuagens seja por volta de 10-26% em homens e 10-22% em mulheres, e estas trazem como consequência desdobramentos como: arrependimento, tentativas de remoção, alterações físicas e biológicas da pele e associação com soro positividade para doenças virais. OBJETIVOS: determinar a prevalência, características e fatores associados a tatuagens em alistandos do exército. MÉTODOS: Os alistandos foram entrevistados e examinados por dermatologistas, os quais anotaram a presença ou não de tatuagem , seus tamanhos, suas cores, padrões de desenhos e se havia permissão dos responsáveis para sua execução. RESULTADOS: Foram examinados 1.968 alistandos e a prevalência de tatuagens foi de 10,82% (213), 141 (66,20%) tinham tatuagem única, 44 (20,66%) tinham duas tatuagens, 15 (7,04%) tinham três tatuagens, 9 (4,23%) tinham quatro tatuagens e 4 (1,88%) tinham mais que quatro tatuagens; 168 (80.77%) informaram ter feito a primeira tatuagem antes de completar 18 anos de idade. 158 (74,53%) eram monocromáticas. Em relação ao tamanho no seu maior eixo temos que 108 (50,70%) tinham tatuagens com até 10 cm, 75 (35,21%) tinham entre 11 e 20 cm e com mais de 21 centimetros 30 (14,09%). CONCLUSÕES: a população estudada apresenta uma prevalência alta de tatuagens para a idade, e o percentual de tatuagens complexas (grandes e policromáticas) também é alto. .

Papilite lingual transitória ? relato de caso / Transient lingual papillitis ? case report

com essa afecção.Descrição do caso: Um homem de 34 anos apresentava desde a infância surtos de lesões papulosas dolorosas na língua. O exame anatomopatológico de uma das lesões demonstrou papilite crônica.Conclusões: Papilite lingual transitória é uma doença inflamatória dolorosa das papilas fungiformes, que tem seu início na infância e evolui em surtos, podendo ser acompanhada de dor ou desconforto. Embora seja frequente, é um distúrbio pouco estudado.

Aims: To describe a case of transient lingual papillitis in order to familiarize health professionals with this condition.Case description: A man of 34 years of age had since childhood bouts of painful papular lesions on the tongue. The anatomopathological examination of one lesion showed chronic papillitis.Conclusions: Transient lingual papillitis is a painful inflammatory disease of the fungiform papillae, which has its onset in childhood, progresses in spurts, and may be accompanied by pain or discomfort. Although it is common, is an understudied condition.

Case for diagnosis / Caso para diagnóstico

Chilblains are an inflammatory skin condition that develops following exposure to the cold. They consist of pruritic and/or painful erythematous-to-violaceous acral lesions and are the result of an abnormal vascular response to exposure to the cold. This benign condition is common in southern Brazil, particularly in Rio Grande do Sul where climatic conditions, together with cultural and economic aspects, facilitate the development of these sores.

Eritema pérnio é uma condição inflamatória da pele que ocorre após exposição ao frio e se manifesta com lesões eritêmato-violáceas, pruriginosas e dolorosas nas extremidades. Ocorre devido a uma resposta vascular alterada à exposição ao frio. Esta condição benigna é frequente na região sul do Brasil, especialmente no Rio Grande do Sul, onde as características clínicas, associadas a aspectos culturais e econômicos, promovem o desenvolvimento do eritema pérnio.

Caso para diagnóstico / Case for diagnosis

O eritema elevatum diutinum é vasculite cutânea rara. Caracteriza-se por pápulas e nódulos eritêmato-acastanhados, que podem coalescer formando placas. A região extensora dos membros é a mais acometida, e lesões antigas apresentam aspecto xantomatoso. O exame histopatológico apresenta infiltrado neutrofílico perivascular com depósito dérmico de fibrina, edema endotelial e leucocitoclasia. Apresenta-se um caso de eritema elevatum diutinum sem doença secundária associada.

Erythema elevatum diutinum is a rare presentation of cutaneous vasculitis. Typical lesions are papules, plaques, and nodules that may coalesce and later turn to yellow-brown color. The extensor surface of the extremities is the most involved area and older lesions may present xanthomatous appearance. Light microscopy of acute lesions shows neutrophilic, perivascular infiltrate with dermal fibrin deposits, endothelial expansion, and leukocytoclasis. We present a case of erythema elevatum diutinum without associated disease.

Síndrome de Netherton com 20 anos de acompanhamento / Netherton's Syndrome with a 20-year follow-up

A síndrome de Netherton é doença cutânea autossômica recessiva caracterizada por eritrodermia congênita, anormalidade específica dos pêlos denominada tricorrexe invaginada e manifestações atópicas. Os autores relatam acompanhamento de mais de 20 anos de paciente com essa doença e a melhora importante do cabelo com o uso de Acitretina.

Netherton's syndrome is a recessive autosomal skin disease, characterized by congenital erythroderma, hair anomalies such as trichorrhexis invaginata, and atopic manifestations. The case of a female patient with a 20-year follow-up is described, with an important improvement of hair alterations after use of oral acitretine.

Micose Fungóide hipopigmentar com 20 anos de evolução / Hypopigmented mycosis fungoides with 20 years evolution

A micose fungóide hipopigmentar é uma forma rara de linfoma cutâneo de células T, em que lesões hipopigmentadas ocorrem na ausência de lesões clássicas dessa neoplasia. Na literatura latino-americana existem apenas três casos; relata-se aqui o caso de um homem negro, de 29 anos com lesões há 20 anos O tratamento é semelhante ao de outros tipos de linfomas T cutâneos, sendo o psoraleno mais ultravioleta A (Puva) e a mostarda nitrogenada tópica os mais relatados

Lesões sobre cicatrizes: uma das manifestações da sarcoidose / Infiltration of old scars: a manifestation of sarcoidosis

Relata-se o caso de uma paciente de 41 anos, negra, que apresentou infiltração de cicatrizes pré-existentes na face, decorrentes de acidente automobilístico havia dez anos. O exame histológico de biópsia de pele evidenciou granuloma não caseoso sugestivo de sarcoidose e a tomografia de tórax demonstrou linfoadenomegalia mediastinal. Não foi realizado tratamento e a paciente apresentou regressão espontânea das lesões.