[Assessment of severity of oral lichen planus using a new clinical index]. / Schweregradbestimmung des oralen Lichen planus mit einem neuen klinischen Index.

AIM: The goal of this study was to develop a clinical index to assess therapy of oral lichen planus (OLP) to be used in comparing the efficacy of two topical glucocorticoids. The clinical severity of non-gingival and gingival lichen planus and their severity from the patients' view were evaluated. DESCRIPTION OF THE INDEX: A clinical index for assessing the severity of oral lichen planus is described with which the clinical forms as well as all the varying combinations of forms can be addressed separately. The clinical classification of OLP into six variants according to Andreasen [1] is the basis of the index. The index provides information about the severity of the disease in single regions and in the patient as a whole. The index is subdivided into a basic index as well as supplementary indices, which are optional. The clinical forms and size of OLP are recorded using the basic index, while various form-specific features such as the intensity of whitish pattern or mucosal erythema can be assessed additionally using the supplementary indices. Non-gingival and gingival lichen planus are assigned with their own indices. An index of subjective symptoms consisting of a visual analogue scale and verbal scales is available for describing patient discomfort. There is also a short form of the index (study-region index/one-region index), whereby only a single selected region is assessed. CONCLUSION: The index presented here is available as a new method of assessing OLP severity, offering both basic and advanced information for use especially in scientific studies of oral lichen planus.

[Shammah-associated oral leukoplakia-like lesions]. / Shammah-assoziierte leukoplakieartige Veränderungen.

CASE REPORT: Shammah is a chewing tobacco, commonly used in Northern Africa. Leukoplakia-like lesions and oral cancer may be induced. In a 73-year-old male patient from Algeria leukoplakia-like lesions were observed in the anterior mandibular vestibulum and lower lip. The patient has been using shammah for 39 years. During the day three portions of shammah wrapped in a piece of paper tissue are prepared and rest in situ for 4-5 h. Due to its high alkalinity, shammah induces lesions resembling a burn. FINDINGS: Clinically, a white homogeneous lesion was seen in the vestibulum and mucosa of the lower lip. The white lesions could not be wiped off. Gingival recessions were seen in the lower front teeth. Root surfaces showed black-brown discoloration. A brush biopsy did not reveal epithelial atypia. The oral cavity showed signs of denture stomatitis and erythematous candidiasis. Microbiologically, Candida albicans was demonstrated. CONCLUSION: Due to the possibility of oral cancer in association with this habit, leukoplakia-like lesions have to be followed up diligently. Since chewing tobacco is a rare habit in Germany, changes as observed in the present case report may only rarely be observed. Due to migration it seems likely that in the future oral habits may be observed which are atypical for Western Europe. This phenomenon has also been addressed as transcultural dentistry.

[Detection of TP53-mutations in brush biopsies from oral leukoplakias]. / Nachweis von TP53-Mutationen mittels Exfoliativzytologie (brush biopsy) oraler Leukoplakien.

OBJECTIVE: The aim of this study was to determine the prevalence of mutations of the tumour suppressor gene TP53 in oral leukoplakias. MATERIAL AND METHOD: Brush biopsy specimens of 43 oral leukoplakias, 26 oral squamous cell carcinomas (OSCC) for reference, and the oral mucosa of 4 clinically normal volunteers were collected. DNA of the critical exons 5-8 was analysed by temperature gradient gel electrophoresis (TGGE). RESULTS: The prevalence of mutations was 57.7% in OSCC, 39.5% in leukoplakias and 0% in controls. The highest frequency of mutations was found in exon 5 (46.2%) in OSCC and in exon 6 (23.3%) in leukoplakia. More than one mutation was detected in 26.9% of OSCC and 7% of leukoplakia specimens. At least one mutation was found in 37.5% of T1 OSCC and 100% of T4 OSCC specimens and in 37.1% of the L1 leukoplakia and 100% of L3 leukoplakia specimens. CONCLUSIONS: TP53 mutations could be a useful prognostic indicator in precancerous oral lesions. Although the brush biopsy technique appears simple clinically, further investigations are necessary to specify the implications of genetic analysis.

[Focal palmoplantar and oral mucosa hyperkeratosis syndrome]. / Fokales palmoplantares und orales Mukosa-Hyperkeratose-Syndrom.

CASE REPORT: Four members of a family in three generations are presented who were affected by a rare syndrome (mucosa hyperkeratosis syndrome). This syndrome is characterized by autosomal-dominant inheritance, white lesions of the gingiva, and palmoplantar hyperkeratosis. The four affected members of the family revealed an abnormal keratinization of the gingiva and palmoplantar epidermis. Biopsies of plantar and gingival lesions histologically showed acanthosis and hyperkeratotic cornification of the epithelium. Electron microscopy demonstrated the features of epidermolytic hyperkeratosis. DISCUSSION: From the differential diagnostic point of view, the mucosa hyperkeratosis syndrome has to be distinguished from the Jadassohn-Lewandowsky syndrome and the Howel-Evans' syndrome, which is associated with esophageal carcinoma.

[Risk of oral piercing]. / Risiken des oralen Piercings.

Oral and facial piercing with different kinds of body art are being observed more frequently in medical and dental practices. Principally, piercing is not a new form of body art and is traditional in different geographical areas. Various materials are used. Besides tongue and lip piercing, different locations of the face such as the eyebrows and the nose are anatomical areas of piercing. The aim of this article is to demonstrate different forms of oral piercing, illustrated by own observations. The piercing procedure is briefly described. Piercing is usually performed without local anaesthesia and stepwise. In a literature review, the possible risks and complications are summarised. Postprocedural complications are oedema, haemorrhage and infection. Other complications are foreign body granulomas or allergies, particularly against nickel. Dentists, and oral- and maxillofacial surgeons should be in a position to advise patients with oral or facial piercings or those who plan to have this type of body art performed.

[The clinical picture of lichen ruber of the oral mucosa]. / Das Krankheitsbild des Lichen ruber der Mundschleimhaut.

A comprehensive discussion of our current understanding of lichen ruber of the oral cavity is given. The diagnostic and therapeutic experience gained in our clinic is communicated with particular emphasis being placed on the wide range of clinical pictures and on differential diagnosis. A treatment strategy is presented to illustrate our therapeutic approach.

[Leukoplakia-like epidermal nevus of the mouth mucosa. Case report]. / Leukoplakischer epidermaler Nävus der Mundschleimhaut. Fallbericht.

We report on a nevus of the oral mucosa, which became present in the age of 30 of a male patient. By microscopic examination we did not find any vacuolation of the spinous layer of the epithelium. So this nevus has been considered quite different from the typical white sponge nevus, and we prefer to name it leucoplakial nevus of the oral mucosa.

[On the clinical aspects and ultrastructure of bullous pemphigoid (parapemphigus) of the oral mucous membrane (author's transl)]. / Beitrag zur Klinik und Ultrastruktur des bullösen Pemphigoids (Parapemphigus) der Mundschleimhaut.

Bullous changes in the oral mucosa are often the first signs of a general dermatological disease. Successful diagnosis of such diseases is largely dependent upon the use of complex laboratory methods. Clinical and ultrastructural changes are described and discussed with particular reference to a case of parapemphigus. Atypical intracellular vacuolation and marked acantholysis observed in electron micrographs is interpreted as a secondary phenomenon of direct blistering.

Remote measurement of smoke plume transmittance using lidar.

A van-mounted ruby lidar system has been developed for the remote single-ended measurement of smoke plume transmittance at ranges of 150-500 m. The measurement of transmittance is obtained by comparing the clear air lidar return from the near side of the plume with that from the far side. The lidar system performance has been tested using synthetic targets of known transmittance, and its accuracy limitation has been found to be photomultiplier tube afterpulsing. Results from these target tests as well as field tests using real power plant smoke plumes where comparison telephotometer measurements were made are discussed in terms of accuracy for the determination of plume transmittance.