RESUMEN
La leucoplasia verrucosa proliferativa (LVP) es de etiología multifactorial, en la actualidad aún no se encuentra un agente etiológico direccional, la alta tasa de transformación maligna a un carcinoma verrucoso es la principal preocupación en estos pacientes, con la presencia de una placa blanca irregular de características verrucoides, que se encuentra en diferentes sitios de la economía de la cavidad bucal. Hasta el momento, no se cuenta con un protocolo estandarizado de tratamiento; los retinoides y fármacos tópicos así como la criocirugía, la terapia láser y la cirugía convencional, han fracasado en la mayoría de los casos con una persistencia de la lesión o recurrencia. Presentamos una revisión de la literatura y el caso específico de una paciente femenina, de 70 años de edad, con una LVP en región de maxilar superior izquierdo y de aparición incipiente en maxilar derecho.
Proliferative verrucous leukoplakia (PVL) is of multifactorial etiology; at present there is still no directional etiologic agent; the high rate of malignant transformation to verrucous carcinoma is the main concern in these patients with the presence of a white plaque irregular verrucoid characteristics found in different sites of the economy of the oral cavity, so far no standardized treatment protocol is available for retinoids and topical drugs as well as cryosurgery, laser therapy and conventional surgery have failed. In most cases with a persistent lesion or recurrence, we present a review of the literature and the specific case of a 70-year-old female patient with a PVL in the region of the upper left jaw and incipient right jaw.
RESUMEN
INTRODUCTION: Actinic cheilitis (AC) is considered to be a pre-malignant lesion or an incipient and superficial form of lip squamous cell carcinoma. It is commonly found in individuals whose occupational activities are related to chronic sun exposure and the definitive diagnosis is performed with biopsy. Althoug Exfoliative cytology has been used as a screening procedure to evaluate cancer of the oral cavity no studies have proposed the use of exfoliative cytologic analysis to evaluate and diagnose AC. OBJECTIVE: The purpose of this study was to evaluate lower lip lesions on fishermen related to chronic solar exposure using clinical, cytologic and histopathologic analyses. PATIENTS AND METHODS: Smears taken from the vermilion of the lower lips of 125 fishermen and 30 control individuals were subjected to cytologic analysis. RESULTS: The harvested cells were sufficient for cytologic analysis in 83.2 percent of the samples. Sixteen fishermen exhibited prominent lower lip lesions that justified biopsy and histological studies. In total, 4 specimens were malignant (3.2 percent), and 12 displayed epithelial dysplasia, demonstrating that the prevalence of epithelial dysplasia and malignant lesions was high among the fishermen population. These conditions were strongly associated with infiltration and blurring of the vermilion margin of the lower lip. CONCLUSION: The cytologic analysis was not useful for detecting epithelial dysplasia or malignant alterations.