ABSTRACT
The pigmentation is the physiological or pathological accumulation of a pigment in a tissue. Physiological pigmentation in gingiva which is a part of masticatory mucous membranes depends on the activity of the melanocytes. These non keratinocytic cells include the melanosoma where an endogenous pigment, the melanin, is synthesized. Quantitative or qualitative disruption of mucous pigmentation leads to the apparition of pigmented lesions. When melanocytes are directly concerned, the lesions can be of intrinsic origin, such as oral mucosa melanoma, the nevus, pigmented oral lichen planus etc. Pigmented lesions can be also of extrinsic origin caused by medicaments, dental materials, tobacco etc. In this article, gingival pigmentations are described to allow practitioner to elaborate a differential and positive diagnosis of gingival pigmented lesions and to facilitate an early detection of these lesions particularly the gingival melanoma.
Subject(s)
Gingiva/anatomy & histology , Gingival Diseases/diagnosis , Hyperpigmentation/diagnosis , Pigmentation/physiology , Diagnosis, Differential , Gingival Neoplasms/diagnosis , Humans , Melanoma/diagnosis , Nevus/diagnosisABSTRACT
Lichen planus (LP) is a chronic inflammatory disease of uncertain etiology. When the gingiva is affected, the LP can appear under several clinical forms. The diagnosis of the gingival lichen planus is based on the anamnesis, the clinical observation and the histological analysis. Various medicamentous and non medicamentous treatments are used to treat gingival LP with random results, due to the lack of knowledge on the etiology and the recidiving character of the lesions. The risk of malignant transformation of gingival LP is weak but it depends on clinical forms, justifying a periodic follow-up of all patients.
Subject(s)
Gingival Diseases/pathology , Lichen Planus, Oral/pathology , Antifungal Agents/therapeutic use , Cell Transformation, Neoplastic , Diagnosis, Differential , Gingival Diseases/drug therapy , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Lichen Planus, Oral/drug therapy , Vitamin A/therapeutic useABSTRACT
The desquamative gingivitis is the clinical term given to the gingival manifestation of mucocutaneous diseases. It is characterized by an erythematous, glazed, friable and hemorrhagic gingiva, which can be accompanied by pains. Except the gingiva, the lesions can be localised on other oral mucous membranes or on the skin. The three principal diseases at the origin of the desquamative gingivitis are by order of frequency: the cicatricial pemphigoïd, erosive lichen planus and pemphigus. The knowledge of the clinical, histological and immunohistochemical characteristics of these three affections is essential for the diagnosis and the suitable treatment of the desquamative gingivitis.
Subject(s)
Gingivitis/pathology , Gingivitis/diagnosis , Gingivitis/etiology , Hemidesmosomes/pathology , Humans , Lichen Planus/complications , Pemphigoid, Benign Mucous Membrane/complications , Pemphigus/complicationsABSTRACT
Au cours de l'annee 1992; le service de parasitologie de l'I.P.C.I. a effectue 1435 examens pour la recherche du paludisme. 269 resultats positifs ont ete obtenus; soit 18;74 pour cent de paludisme confirme contre 1166 resultats negatifs. 429 sujets; soit 29;89 pour cent ont recu un traitement antipaludique avant l'examen; 645 sujets; soit 44;94 pour cent n'ont recu aucun traitement prealable et pour 361 sujets; soit 25;15 pour cent aucune indication n'est donnee sur la prise du medicament. Parmi les patients qui ont consomme des medicaments; 17;01 pour cent avaient encore une goutte epaisse positive et chez les malades non traites 20;15 pour cent sont positifs. Lorsqu'on considere les produits consommes; sept specialites viennent largement en tete avec un pour centage d'utilisation de 84;71 pour cent. Par odre decroissant; ce sont: la Nivaquine; La Flavoquine; l'Halfan; l'Arsiquinoforme; le Quinimax; le Quiniforme et le Fansidar. Dans la presque totalite des cas de resultats positifs apres la prise de medicaments (89;88 pour cent) les doses sont infracuratives. 10 malades (2;73 pour cent); bien qu'ayant suivi le protocole therapeutique conseille pour le medicament choisi ont une goutte epaisse positive. Les auteurs ont conclu que l'inadaptation des doses etait le fait de la forte proportion d'automedication. L'echec therapeutique chez les 10 malades pourrait s'expliquer par l'existence de la chimioresistance dont celle a la chloroquine est deja reconnue
