Single ulcers on the tongue dorsum: differential diagnosis between paracoccidioidomycosis and squamous cell carcinoma.

BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a diferential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Iincisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.

Intraoral carcinosarcoma on the floor of the mouth mimicking a benign lesion.

Carcinosarcoma is a rare malignant disease with aggressive behaviour rarely producing oral manifestations. This article reports a case of an intraoral carcinosarcoma affecting a 71-year-old black male; the diagnosis was made by histopathological and immunohistochemical analyses. Computed tomography scanning showed metastatic masses in the lungs. The patient was underwent a chemotherapy protocol regimen, but died as a consequence of the disease within 10 months of diagnosis. Distinctive characteristics of this presentation were the location of the lesion (floor of the mouth) and its clinical features resembling a benign lesion. A brief review of intraoral carcinosarcoma cases in the literature is also presented.

The effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia.

AIM: This study evaluated the effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia. METHODS: Twelve patients with severe xerostomia were treated with acupuncture after radiation therapy. The baseline data were obtained preceding acupuncture treatment, and used as reference values. Acupuncture was performed in 12 sessions, 20 min each, twice a week, during a 6-week period. Clinical response was evaluated objectively by saliva collection measuring resting and stimulated whole salivary flow rates, and subjectively by a visual analogue scale patients' self-evaluation questionnaire. Statistical analyses were performed with a repeated-measures analysis of variance by using a mixed-effect modeling procedure. RESULTS: The results showed a statistically significant improvement for salivary flow rates on both objective and subjective evaluations (P<0.05). On objective evaluation there was an increase for resting salivary flow of 142.2% (mean=0.04 mL/min to 0.12 mL/min) and of 73.5% (mean=0.09 mL/min to 0.21 mL/min) for stimulated salivary flow. On subjective evaluation, visual analogue scale raised 36 points (mean=18.4 to 53.8) for sensation of more saliva production. CONCLUSION: According to the results of the present study, acupuncture showed a significant effect on saliva production, suggesting this therapy as a useful treatment for patients suffering from radiation-induced xerostomia.

Oral lichen planus. Clinical aspects and management in fifty-two Brazilian patients.

This study aimed to characterize the clinical profile of patients with oral lichen planus (OLP) and to evaluate the efficacy of topical, systemic and/or intralesional corticosteroids in the management of symptomatic cases. Fifty-two patients with OLP, 33 females and 19 males, aged from 17 to 75 years (mean 49.7 years) were studied. Information regarding the clinical forms, sites of involvement, patients' medical history and habits were recorded. Diagnosis of OLP was made using clinical criteria alone in 32 cases, while biopsy examination was required in the remaining 20. Symptomatic lesions were seen in 29 patients, who were treated with corticosteroid. Asymptomatic cases (23) were only clinically monitored. The forms of OLP found in this study were reticular (47%), atrophic (24%), erosive (21%) and plaque-like (8%). The buccal mucosa was the site predominantly affected. Systemic diseases were found in 17 patients (seven diabetic and ten with hypertension) but these data lacked statistical significance (p > 0.05) when compared with a control group of age and gender matched patients without any type of mucocutaneous disease. A habit of tobacco and/or alcohol use was reported by 11.5% of the patients, most of them with the reticular form of the disease. Topical corticosteroid therapy alone was effective in producing relief of symptoms in 18 of the 29 patients, although some relapses occurred after discontinuation. For lesions non-responsive to topical treatment, intralesional injection and/or short-term use of systemic corticosteroids were used.

Oral lichen planus. Clinical aspects and management in fifty-two Brazilian patients

This study aimed to characterize the clinical profile of patients with oral lichen planus (OLP) and to evaluate the efficacy of topical, systemic and/or intralesional corticosteroids in the management of symptomatic cases. Fifty-two patients with OLP, 33 females and 19 males, aged from 17 to 75 years (mean 49.7 years) were studied. Information regarding the clinical forms, sites of involvement, patients' medical history and habits were recorded. Diagnosis of OLP was made using clinical criteria alone in 32 cases, while biopsy examination was required in the remaining 20. Symptomatic lesions were seen in 29 patients, who were treated with corticosteroid. Asymptomatic cases (23) were only clinically monitored. The forms of OLP found in this study were reticular (47), atrophic (24), erosive (21) and plaque-like (8). The buccal mucosa was the site predominantly affected. Systemic diseases were found in 17 patients (seven diabetic and ten with hypertension) but these data lacked statistical significance (p > 0.05) when compared with a control group of age and gender matched patients without any type of mucocutaneous disease. A habit of tobacco and/or alcohol use was reported by 11.5 of the patients, most of them with the reticular form of the disease. Topical corticosteroid therapy alone was effective in producing relief of symptoms in 18 of the 29 patients, although some relapses occurred after discontinuation. For lesions non-responsive to topical treatment, intralesional injection and/or short-term use of systemic corticosteroids were used

Oral lichen planus. Clinical aspects and management in fifty-two Brazilian patients.

This study aimed to characterize the clinical profile of patients with oral lichen planus (OLP) and to evaluate the efficacy of topical, systemic and/or intralesional corticosteroids in the management of symptomatic cases. Fifty-two patients with OLP, 33 females and 19 males, aged from 17 to 75 years (mean 49.7 years) were studied. Information regarding the clinical forms, sites of involvement, patients' medical history and habits were recorded. Diagnosis of OLP was made using clinical criteria alone in 32 cases, while biopsy examination was required in the remaining 20. Symptomatic lesions were seen in 29 patients, who were treated with corticosteroid. Asymptomatic cases (23) were only clinically monitored. The forms of OLP found in this study were reticular (47%), atrophic (24%), erosive (21%) and plaque-like (8%). The buccal mucosa was the site predominantly affected. Systemic diseases were found in 17 patients (seven diabetic and ten with hypertension) but these data lacked statistical significance (p > 0.05) when compared with a control group of age and gender matched patients without any type of mucocutaneous disease. A habit of tobacco and/or alcohol use was reported by 11.5% of the patients, most of them with the reticular form of the disease. Topical corticosteroid therapy alone was effective in producing relief of symptoms in 18 of the 29 patients, although some relapses occurred after discontinuation. For lesions non-responsive to topical treatment, intralesional injection and/or short-term use of systemic corticosteroids were used.

Oral lichen planus. Clinical aspects and management in fifty-two Brazilian patients

This study aimed to characterize the clinical profile of patients with oral lichen planus (OLP) and to evaluate the efficacy of topical, systemic and/or intralesional corticosteroids in the management of symptomatic cases. Fifty-two patients with OLP, 33 females and 19 males, aged from 17 to 75 years (mean 49.7 years) were studied. Information regarding the clinical forms, sites of involvement, patients' medical history and habits were recorded. Diagnosis of OLP was made using clinical criteria alone in 32 cases, while biopsy examination was required in the remaining 20. Symptomatic lesions were seen in 29 patients, who were treated with corticosteroid. Asymptomatic cases (23) were only clinically monitored. The forms of OLP found in this study were reticular (47), atrophic (24), erosive (21) and plaque-like (8). The buccal mucosa was the site predominantly affected. Systemic diseases were found in 17 patients (seven diabetic and ten with hypertension) but these data lacked statistical significance (p > 0.05) when compared with a control group of age and gender matched patients without any type of mucocutaneous disease. A habit of tobacco and/or alcohol use was reported by 11.5 of the patients, most of them with the reticular form of the disease. Topical corticosteroid therapy alone was effective in producing relief of symptoms in 18 of the 29 patients, although some relapses occurred after discontinuation. For lesions non-responsive to topical treatment, intralesional injection and/or short-term use of systemic corticosteroids were used

Traumatic bone cyst: report of two cases and review of the literature.

Traumatic bone cysts usually are found in young individuals and most frequently have the radiographic appearance of well-circumscribed radiolucent lesions with a tendency to scallop between the roots of the teeth. Two well-documented cases of traumatic bone cysts are presented in which some differences related to their radiographic features were observed. The possible explanations for these differences are discussed and a brief review of the literature regarding the main characteristics of traumatic bone cyst lesions also is provided.

Natal teeth: review of the literature and report of an unusual case.

An unusual case of a newborn with 12 erupted teeth is presented. Epidemiological, etiological, and therapeutical aspects of this developmental disturbance of dentition is reviewed in order to establish guidelines for the dentist and neonatologist to manage this problem with minimal damage to the future teeth and the patient.

Periodontal aspects of the juvenile form of paracoccidioidomycosis.

Three cases of the juvenile form of paracoccidioidomycosis are reported. Emphasis has been given to the oral manifestations, particularly the periodontal involvement. The main periodontal findings were: generalized and progressive alveolar bone destruction leading to gingival recession with exposure of the tooth roots, and spontaneous tooth losses. The gingival mucosa was predominantly smooth, erythematous and slightly swollen. These aspects, although rare, may be the earliest signs of the disease and sometimes its only manifestations.