An Atypical Case of Mucocutaneous Blastomycosis in the Greater Toronto Area.

Blastomycosis is an uncommon infection caused by Blastomyces dermatitidis. While management is fairly straightforward, diagnosis can be quite challenging. We describe a case of a healthy 37-year-old man who presented with progressive mucocutaneous lesions, without lung or other systemic involvement. Treatment with itraconazole resulted in complete resolution of signs and symptoms. This case showcases the variety of blastomycosis clinical presentation and the importance of blastomycosis in the differential diagnosis of verrucous and papillomatous mucocutaneous lesions.

Oral soft-tissue biopsy: an overview.

Proper management of an oral mucosal lesion begins with diagnosis, and the gold standard for diagnosing disease, oral or otherwise, is tissue biopsy. The oral environment, which is moist and confined, poses challenges for collecting a viable tissue sample that will be suitable for diagnosis. These challenges are further compounded by the myriad of biopsy techniques and devices now available. In addition, certain oral subsites are subject to diagnostic pitfalls that necessitate modifications of technique. This article provides an overview of the oral soft-tissue biopsy and highlights some potential pitfalls.

Oral melanosis after tyrosine kinase inhibition with Imatinib for chronic myelogenous leukemia: report of a case and review of the literature.

Dermatologic manifestations from therapy with imatinib are well known and frequently include hypopigmentation, and less commonly, hyperpigmentation. There have been few reports of oral hyperpigmentation. We present a case of palatal melanosis related to imatinib therapy for chronic myelogenous leukemia. This case is reported to add to the sparse literature concerning mucosal reactions related to this medication.

Congenital melanocytic nevus of the oral mucosa: report of a rare pigmented lesion and review of the literature.

Oral pigmented lesions are uncommon and congenital melanocytic nevi are especially rare. We report a case of a patient with multiple congenital melanocytic nevi including a palatal lesion. This is reported to add to the scant literature that exists on this subject. Prognosis and management are discussed.

Death, dying and bereavement: a survey of dental practitioners.

The dentist's role following the death of a patient in his/her practice has received little attention in the literature. This study determined the prevalence of death within a dental practice. It also investigated methods by which dentists supported grieving survivors, and how frequently dentists received formal bereavement education in dental school. A perceived need for training in death and dying was also investigated. A survey was mailed to 200 randomly selected general dental practitioners in Ontario, Canada. It was found that (1) the vast majority of respondents (86%) had experienced the death of a patient within the past 12 months; (2) support methods included sending sympathy cards (79.3%), sending flowers (34.5%), attending the funeral or wake (23%), or visiting/calling survivors (11.5%); (3) only 4% of respondents reported receiving formal bereavement education during dental school; and (4) 61% believed bereavement education should be included in the dental school curricula. While the majority of dentists in this study provided bereavement support and believed they could effectively comfort grieving persons, these dentists experienced significant stress when dealing with issues of death and bereavement. The stress may be explained by inadequate education and exposure to the issues of death and dying.

Trigeminal neuralgia caused by intracranial epidermoid tumour: report of a case.

Trigeminal neuralgia is a recognized complication in patients with intracranial tumours affecting the trigeminal nerve. This case report describes an epidermoid tumour at the cerebellopontine angle in a middle-aged man with otherwise classical unilateral trigeminal neuralgia. The case highlights the difficulties of diagnosis and the importance of a multidisciplinary approach when trigeminal neuralgia occurs concurrently with a brain tumour.

Oncocytic lipoadenoma of the parotid gland with sebaceous differentiation. Study of its keratin profile.

Oncocytic lipoadenomas of salivary gland are extremely rare tumors with only two previously reported cases. In this paper, we describe an additional example of oncocytic lipoadenoma showing sebaceous differentiation, a hitherto unreported occurrence. The tumor was encapsulated and measured 3 x 2.5 x 2 cm. Microscopically, the tumor comprised a mixture of oncocytes with "light" and "dark" cells intimately associated with mature adipose tissue. The oncocytes were positive for low molecular keratin, epithelial membrane antigen (EMA), and keratin 7, with only a small subgroup of cells expressing high-molecular-weight keratin, keratin 5/6, keratin 19, and p63. Terminally differentiated sebaceous cells were positive for EMA and keratin 14 only. Calponin and actins were negative, indicating a lack of myoepithelial cells in the tumor. The keratin profile and p63 expression of this oncocytic lipoadenoma suggest the presence of a dual cell population somewhat similar to the dual cell population described in some ultrastructural studies of pure salivary gland oncocytomas and may represent partial basal-cell differentiation. The presence and nature of a dual cell population in oncocytic neoplasms of salivary glands merit further investigation to confirm these observations.