Prevalencia de lesiones en mucosa bucal y su relación con condición sistémica, edad y sexo / Prevalence of lesions in the oral mucosa and its relationship with systemic condition, age and gender

Este estudio tiene la finalidad de analizar la prevalencia de variantes de la normalidad y patología en la mucosa de la cavidad bucal por zona anatómica, de una población controlada en una clínica estomatológica universitaria de pregrado en el Estado de México. Se trata de un estudio transversal, descriptivo y observacional de 542 pacientes, de los cuales el 62.7% (340) pertenecen al sexo femenino y 37.3% (202) al masculino; la edad se distribuyó en un rango de dos a 85 años con una media de 28 años y fue categorizada en cinco grupos etarios: 2 a 12, 13 a 18, 19 a 35, 36 a 69 y > 70 años. En este estudio participaron una especialista en patología bucal, un especialista en odontopediatría y una pasante de la licenciatura de estomatología quien fungió como ayudante de investigación. Fueron identificadas 13 variantes de la normalidad y 52 lesiones en total, mismas que son reportadas por zona anatómica, por rangos de edad y por sexo. El número de condiciones y lesiones diagnosticadas por paciente varió de una a cinco en 87.27% y en el restante 12.73% no se detectó ninguna. Las variantes de la normalidad o condiciones más frecuentes fueron lengua fisurada con 12.17%, apéndice mucoso en frenillo vestibular con 11.25% y gránulos de Fordyce con 10.88%. Las lesiones más prevalentes por zona anatómica fueron: nevo intradérmico con 2.39% en labio externo superior e inferior; queilitis simple con 11.43% en la interfase de piel y mucosa de los labios (borde bermellón); úlcera traumática con 3.87% en mucosa labial; absceso de origen dental con 1.42 en encía; frenillo con inserción baja 1.84% en frenillos; úlcera traumática con 5.53% en mucosa bucal; candidiasis atrófica crónica con 5.53% en paladar; amígdalas hipertróficas con 8.11% en zona amigdalina; lengua pilosa con 1.66% en lengua; úlcera traumática con 3.69% en piso de boca; granuloma piógeno con 0.18% en proceso alveolar; y por último, hipertrofia de glándulas salivales labiales con 0.55% asociadas a presencia de aparatología ortodóntica. Finalmente se llevó a cabo una prueba de χ2 de Pearson para establecer correlación entre variables dependientes e independientes, encontrando significancia estadística de p < 0.000 entre lesiones de lengua y condición sistémica y edad en relación a lesiones de lengua, paladar y labios con p < 0.000 (AU)

The purpose of this study is to analyze the prevalence of variants of normality and pathology in the mucosa of the oral cavity by anatomical area in a controlled population in a university undergraduate stomatological clinic in the state of Mexico. This is a cross-sectional, descriptive and observational study of 542 patients, of which 62.7% (340) belonged to the female gender and 37.3% (202) to the male gender, the age was distributed in a range of two to 85 years with a mean of 28 years and was categorized in five age groups: 2 to 12, 13 to 18, 19 to 35, 36 to 69 and > 70 years. A specialist in oral pathology, a specialist in pediatric dentistry and an intern in stomatology who served as a research assistant participated in this study. Thirteen variants of normality and 52 lesions in total were identified and reported by anatomical area, age range and gender. The number of conditions and lesions diagnosed per patient ranged from one to five in 87.27% and none were detected in 12.73% of the population studied. The most frequent variants of normality or conditions were fissured tongue with 12.17%, mucous appendage in the vestibular frenulum with 11.25% and Fordyce granules with 10.88%. The most prevalent lesions by anatomical area were: intradermal nevus with 2.39% in upper and lower external lip; simple cheilitis with 11.43% in the interphase interface of skin and mucosa of the lips (vermilion border); traumatic ulcer with 3.87% in labial mucosa; abscess of dental origin with 1.42 in gingiva; frenulum with low insertion 1.84% in frenulum; traumatic ulcer with 5. 53% in buccal mucosa; chronic atrophic candidiasis with 5.53% in palate; hypertrophic tonsils with 8.11% in tonsillar area; hairy tongue with 1.66% in tongue; traumatic ulcer with 3.69% in floor of mouth; pyogenic granuloma with 0.18% in alveolar process and finally; hypertrophy of labial salivary glands with 0.55% associated with the presence of orthodontic appliances. Finally, a Pearson's χ2 test was carried out to establish correlation between dependent and independent variables, finding statistical significance of p < 0.000 between tongue lesions and systemic condition and age in relation to tongue, palate and lip lesions with a p < 0.000 (AU)

Epidemiology and pathological progression of erythematous lip lesions in captive sun bears (Helarctos malayanus).

This study investigates the occurrence of erythematous lip lesions in a captive sun bear population in Cambodia, including the progression of cheilitis to squamous cell carcinoma, and the presence of Ursid gammaherpesvirus 1. Visual assessment conducted in 2015 and 2016 recorded the prevalence and severity of lesions. Opportunistic sampling for disease testing was conducted on a subset of 39 sun bears, with histopathological examination of lip and tongue biopsies and PCR testing of oral swabs and tissue biopsies collected during health examinations. Lip lesions were similarly prevalent in 2015 (66.0%) and 2016 (68.3%). Degradation of lip lesion severity was seen between 2015 and 2016, and the odds of having lip lesions, having more severe lip lesions, and having lip lesion degradation over time, all increased with age. Cheilitis was found in all lip lesion biopsies, with histological confirmation of squamous cell carcinoma in 64.5% of cases. Single biopsies frequently showed progression from dysplasia to neoplasia. Eighteen of 31 sun bears (58.1%) had at least one sample positive for Ursid gammaherpesvirus 1. The virus was detected in sun bears with and without lip lesions, however due to case selection being strongly biased towards those showing lip lesions it was not possible to test for association between Ursid gammaherpesvirus 1 and lip squamous cell carcinoma. Given gammaherpesviruses can play a role in cancer development under certain conditions in other species, we believe further investigation into Ursid gammaherpesvirus 1 as one of a number of possible co-factors in the progression of lip lesions to squamous cell carcinoma is warranted. This study highlights the progressively neoplastic nature of this lip lesion syndrome in sun bears which has consequences for captive and re-release management. Similarly, the detection of Ursid gammaherpesvirus 1 should be considered in pre-release risk analyses, at least until data is available on the prevalence of the virus in wild sun bears.

A retrospective 11-year study on lip lesions attended at an oral diagnostic service

BACKGROUND: The objective of this study was to describe the upper and lower lip lesion occurrence in an oral diagnostic service. MATERIAL AND METHODS: Retrospective descriptive sectional study was performed. Clinical records were obtained from the archives of an Oral Diagnostic Service referral center between 2006 and 2016. Data such as gender, age, anatomical location, and diagnosis were collected and categorized. The collected data were submitted to a descriptive analysis and Pearson's chi-square test (p ≤ 0.05). RESULTS: A total of 587 patient records of lip lesions were analyzed. Most lesions were diagnosed in female (52.1%) and adults (56.9%) patients in the lower lip (76.2%). Among all lip lesions, the reactive/inflammatory lesions (n = 238; 40.5%) and oral potentially malignant disorders (n = 164; 28%) were the most frequent group lesions. Mucocele (n = 147; 25%), actinic cheilitis (n = 136; 23.1%) and vascular lesions (n = 51; 8.7%) were the most frequent lesion in the sample. Actinic cheilitis was significant in relation to gender (p < 0.001), all three most frequent lesions were significant in concerning to age group and anatomical site. CONCLUSIONS: Mucocele was the most common lower lip lesion in all age groups, followed by actinic cheilitis and vascular lesions, which mainly affected adults and the elderly

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Cutaneous effects associated with fluconazole in patients treated for coccidioidomycosis.

BACKGROUND: Fluconazole is the most commonly used antifungal treatment for various forms of coccidioidomycosis. Although we had anecdotally observed a high proportion of patients reporting cutaneous adverse effects associated with fluconazole treatment, this observation was not well described in the medical literature, and we were unsure of the additional effect of the arid desert environment of Arizona. METHODS: We performed a one-time, voluntary survey of patients with coccidioidomycosis and compared the responses of patients treated with fluconazole with those of untreated patients. RESULTS: From January 1, 2015, to August 22, 2017, 62 fluconazole-treated and 35 untreated patients with coccidioidomycosis provided consent and were enrolled in the study; demographics were similar between the two groups. Among the 62 fluconazole-treated patients, daily dosages ranged from 200 mg to 800 mg. However, most (44/62, 71%) took 400 mg daily, the typical dose for the treatment of coccidioidomycosis. The median fluconazole treatment duration at the time of study participation was 6 months. When compared with untreated patients, those taking fluconazole had more moderate to severe dry lips (74.2% [46/62] vs. 23.5% [8/34]; P < 0.001), dry skin (45.8% [27/59] vs. 22.9% [8/35]; P = 0.03), and alopecia (31.1% [19/61] vs. 11.4% [4/35]; P = 0.004). CONCLUSIONS: For the treatment of coccidioidomycosis, patients receiving fluconazole reported significantly more severe cutaneous effects, including dry lips, dry skin, and alopecia, than untreated patients. Our findings identify an association but do not prove causality.

Oral Thrombus: Report of 122 cases with clinically descriptive data

BACKGROUND: The aim of the present study was to assess the frequency and characterize clinic-pathologic aspects of thrombus occurring as a single lesion or in association with other oral pathologies. MATERIAL AND METHODS: 122 cases of thrombus from the oral cavity were retrieved. Information regarding site of the lesion, age, sex and clinical diagnosis or hypothesis and associated lesions were collected from the patients' records. RESULTS: The lesions occurred in a wide age range but the 5th decade was the most prevalent and female patients were more affected. The most frequent site for the lesion was the lip, followed by tongue, buccal mucosa, alveolar ridge, gingiva, floor of the mouth and vestibule. Thirty-five cases were associated with other vascular anomalies or actinic cheilitis. Microscopically, typical thrombus morphology was present. Organized thrombus presented neovascularization and fibroblasts, associated with hemorrhagic areas. CONCLUSIONS: Only 4 cases of oral thrombus have been described in the oral cavity. Given the limited number of cases reported, the importance of a thrombus in the oral cavity is not well established. This study contributes to establishing the profile of patients presenting oral thrombus, a lesion not rare but not well documented

A comparative analysis of oral and maxillofacial pathology over a 16-year period, in the north of Portugal.

OBJECTIVES: To determine the frequency and spectrum of oral and maxillofacial lesions biopsied in a hospital population in the northern region of Portugal. METHODS: We conducted descriptive analyses of pathology reports from biopsies of oral and maxillofacial lesions performed between 1990 and 2006, in Oporto Hospital Center. Information on gender and age of patient, location of the lesions and the histopathological diagnosis were analysed. RESULTS: The analyses revealed that 1,520 (47.7%) patients were male and 1,666 (52.3%) were female. They had a mean age ± standard deviation of 47.8 ± 18.6 years. The site most frequently biopsied was the labial mucosa (17.5%). A non-neoplastic diagnosis was established in 2,162 (63.3%) cases, potentially malignant disorders in 163 (5.1%) and neoplasms in 886 (27.6%) (403 benign and 483 malignant). The most commonly reported diagnosis was fibroepithelial polyp (n = 186; 15.9%), followed by squamous cell carcinoma (SCC) (n = 158; 13.6%). SCC was the lesion most commonly found in male patients (n = 279; 18.4%) whilst fibroepithelial polyp was the lesion most commonly found in female patients (n = 268; 16.1%). The most common lesion in patients 0-17 years of age was a follicular cyst (n = 25; 12.8%), whereas in patients 18-64 years of age it was a fibroepithelial polyp (n = 299; 13%). SCC was the most common type of lesion found in patients ≥ 65 years of age (n = 160; 24.6%). CONCLUSION: This large sample provides useful information about the incidence and distribution of oral biopsies over a period of 16 years, allowing valuable comparison with other countries. Non-neoplastic lesions were the types of lesion most commonly reported, with fibroepithelial polyp being most frequent. SCC was the second most common diagnosis.

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions.

The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.

Orolingual Angioedema During or After Thrombolysis for Cerebral Ischemia.

BACKGROUND AND PURPOSE: Orolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE. METHODS: We prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE. RESULTS: Of 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6-9.7; P=0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5-16.5; P=0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6-11.9; P=0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3-8.1; P=0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3-2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1-1.8), and death (adjOR, 1.1; 95% CI, 0.3-3.8). CONCLUSIONS: OLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.

Lichen planus of the lips: an intermediate disease between the skin and mucosa? Retrospective clinical study and review of the literature.

BACKGROUND: Lichen planus of the lips (LPL) is not frequently described in the literature. The objective of this study is to investigate the clinical outline, behavior, and prognosis of LPL. METHODS: Clinical data of patients with true oral lichen planus (LP) involving the lips, diagnosed and treated at our Oral Medicine Unit (University Federico II of Naples, Italy), have been collected and analyzed. Concurrently, a PubMed search was carried out from 1950 to March 2014 to assess epidemiological and clinical data about LPL. RESULTS: Our case series revealed 13 patients (female/male ratio 0.4) with a mean (± SD) age of 71.85 years (± 6.72). The lower/upper lip involvement ratio was 9, mainly with mixed clinical patterns (76.9%), generally including erosion and mild keratosis. In most cases, the lips were involved with other oral sites but displayed a better evolution of the lesions. The literature review showed 21 reports of LPL (35 patients, female/male ratio 0.4) with a mean (± SD) age of 45.35 years (± 16.19). CONCLUSIONS: In the literature, erosive (28.57%) lower lip lesions showed a clear predominance (lower/upper lip ratio 6.5). One case of malignant transformation was also reported. The prevalence of isolated LPL was clearly reported only in two studies, ranging from 0.51% to 8.9%. In our patients, lesions were mostly found at the inner border of the lower vermillion and presented a tendency for self-limitation, or to regression after treatment, like cutaneous lesions. The lip lesions were small and easy to overlook, and therefore the prevalence of these lesions may have been underestimated.

Incidence and recovery of neurosensory disturbances after bilateral sagittal split osteotomy in different age groups: a retrospective study of 263 patients.

This study aimed to investigate the incidence of neurosensory disturbance (NSD) after bilateral sagittal split osteotomy (BSSO) in different age groups and to assess the probability of sensory recovery in patients aged <19 years, 19-30 years, and >30 years. Hypoaesthesia of the lower lip was assessed subjectively and objectively immediately after BSSO and at 1 week and 1, 6, and 12 months after BSSO. Hypoaesthesia was considered permanent if it was present 1 year after BSSO. The frequency of NSD immediately after surgery was significantly higher in older patients. The cumulative incidence of recovery at 1 year was lower and the mean time to recovery was longer in the older patients, although these differences were not statistically significant. Older age was a significant risk factor for permanent hypoaesthesia, with an incidence of 4.8% per patient aged <19 years, 7.9% per patient aged 19-30 years, and 15.2% per patient aged >30 years. These findings show that the risk of NSD after BSSO is significantly higher in older patients. These results may aid surgeons in preoperative patient counselling and in deciding the optimal age at which to perform BSSO.

Accuracy of clinical diagnosis for the identification of potentially malignant disorders and malignant lip lesions

Abstract: The aim of this study was to assess the accuracy of clinical diagnosis for lip lesions based on sensitivity and specificity. The retrospective analysis focused on the detection of lesions caused by potentially malignant disorders (PMDs) and malignant lesions (n = 1195). All cases were classified as benign, PMD, and malignant lesions. Concordance between diagnoses based on clinical examination and those based on histopathological analysis was assessed, and accuracy for the identification of PMD and malignant lesions was calculated. Histopathological analysis revealed 44 lesion types; PMD and malignant lesions comprised 8.3% of all cases. Compared with histopathological analysis, clinical examination showed 97.4% accuracy for the identification of non-malignant and potentially malignant/malignant cases. Degrees of specific sensitivity ranged from 34% to 77% for different lesions, and were highest for autoimmune (77%) and reactive (72%) lesions. Positive and negative predictive values for the identification of PMD and malignant lesions were 81.9% and 98.9%, respectively. Clinical examination showed a high degree of accuracy for the detection of PMD and malignant lip lesions, indicating good reliability.

A 15-year retrospective study of 160 cases of benign lip lesions.

OBJECTIVE: This study aimed to describe the results of a retrospective analysis of a specific cohort of patients with benign lip lesions encountered in the last 15 years in the School of Medicine at Karadeniz Technical University. METHOD: A total of 312 patients were managed for lip lesions during the period 2000-2014. Data from 160 samples of benign lip biopsies were retrieved from the pathology laboratory records. RESULTS: The study group included 20 different histopathological types of lesions, with mucocele being the most frequent lesion (43.13 per cent). The other frequent lesions were chronic inflammatory infiltrate (11.25 per cent), intradermal naevus (5.63 per cent), pyogenic granuloma (5.63 per cent), fibroma (5 per cent) and papilloma (5 per cent). Mucocele was significantly more common in younger patients (p < 0.001). CONCLUSION: Knowledge of the epidemiology and distribution of oral mucosal lesions is essential to promote early diagnosis and treatment. Further epidemiological studies exploring the causal relationships and risk factors for lip lesions are necessary for a better understanding of lip diseases.

[Child care management in maxillofacial humanitarian mission]. / Prise en charge de l'enfant en mission humanitaire maxillofaciale.

Our practice in a humanitarian (or crisis) context differs from what we experience in daily practice. There are several reasons for this. First, the diseases encountered are sometimes unfamiliar, such as sequelae of noma, or the presentation of familiar diseases may be unusual, such as facial malformations seen at a late stage. Secondly, these missions take place in developing countries, and consequently, evaluation and anticipation of possible malnutrition should be considered, especially because facial diseases themselves may be responsible for nutritional problems. Lastly, conditions are often difficult, occurring in an unusual environment, and we sometimes have to face communication and equipment problems. The goal of our work, based on a 15-year experience (in Bamako and Mopti with the Association "Santé et Développement", and in Ouagadougou with the organization "Les enfants du noma") and the analysis of literature, is to point out these features and maybe to be helpful to others.

Use of submandibular gland flap for repairing defects after tumor resection in the infratemporal region.

OBJECTIVE: To investigate the application of submandibular gland flap with facial artery and vein pedicle, for repairing defects following tumor resection in the infratemporal region. PATIENTS AND METHODS: Fifteen patients, including eight males and seven females ranging in age from 21 to 73 years, underwent surgical resection of tumors in the infratemporal region. Tumors were exposed using the submandibular incision approach and completely resected after pulling and rotating the mandible laterally. Mandibular osteotomy was performed for larger tumors or those that were not completely exposed. After tumor resection, the submandibular gland flap was used to fill up the residual defect following tumor resection. RESULTS: The incisions healed well without exudation or infection (primary healing) postoperatively in all the patients. Long-term follow-up showed no tumor recurrence in all cases. Seven of the patients who underwent mandibular ramus osteotomy had numbness of the lower lip due to inferior alveolar nerve injury. No other complications were observed postoperatively. CONCLUSION: The submandibular gland flap with facial artery and vein pedicle is a reliable, effective, and easy approach for repairing the defects caused by tumor resection in the infratemporal region, and has great potential for application in the clinical setting.

Mucosal leishmaniasis of the lip: an emerging clinical form in Tunisia.

BACKGROUND: Mucosal leishmaniasis (ML), which mostly occurs in the New World, is mainly associated with Leishmania braziliensis. Primary lip ML is very rare in the Mediterranean basin and particulary in Tunisia despite the endemicity of both cutaneous and visceral leishmaniasis in this area. OBJECTIVES: To highlight a recent emergence of primary lip ML in Tunisia, to describe its epidemiological and clinical features and to identify the causative Leishmania species. METHODS: Epidemiological, clinical and therapeutic data of 10 cases presenting a ML of the lip were collected. Diagnosis confirmation of leishmaniasis was obtained by microscopic examination of Leishmania parasites in Giemsa stained smears of the lesion sampling and in cutaneous biopsies. Polymerase chain reaction (PCR) detecting Leishmania DNA directly from dermal scraping was also performed for diagnosis and species identification. RESULTS: Seven men and three women with lip ML were diagnosed during the last 6 years (2008-2013). The mean age was 29.7 years. Clinical presentation was characterized by an infiltrated and ulcerated plaque leading to macrocheilitis involving the upper lip in eight cases and the lower lip in two cases. Mean diagnosis delay was 6.9 months. PCR identified L. infantum in seven cases and L. major in two cases. Seven patients received intramuscular injections of meglumine antimoniate (MA) and three patients received both MA intralesional injections of MA and cryotherapy. A clinical remission was rapidly observed in all cases (on average in 2.2 months). CONCLUSIONS: Primary lip ML is emerging in Tunisia. Macrocheilitis of the upper lip is the main clinical presentation. PCR revealed more sensitive than direct examination in the diagnosis of such form (P < 0.01). Leishmania infantum was the most identified species (7 cases) while L major was involved in only two lesions. A benign local evolution and a rapid recovery were observed in all cases after MA treatment.

Prevalence of lip and perioral Ephelides in beach workers.

BACKGROUND: Ephelides are small hyperpigmented macules common in the skin, presenting as areas with increased melanin production. Ephelides are observed in genetically predisposed individuals, particularly fair-skinned people highly susceptible to sunburn. OBJECTIVES: This study aimed to determine the prevalence of lip and perioral ephelides in 362 beach workers in the city of Natal (Rio Grande do Norte) and to investigate potential associations with sociodemographic, occupational and general health. METHODS: For this purpose clinical tests were performed by calibrated examiners in the epidemiological area around the lips and the area bounded laterally by the nasolabial groove and at the bottom by the chin. A questionnaire was completed and assessed. The possible associations between sociodemographic variables, occupational and general health with the presence of lip and perioral ephelides were evaluated by chi-square test for a significance level of 5%. RESULTS: Approximately one third of the workers were affected by perioral ephelides (33.7%) and around a quarter of them by lip ephelides (24.0%). Gender was the only variable significantly associated with the presence of perioral ephelides (p = 0.002), unlike lip ephelides which proved to be significantly associated with habits (p = 0.036) and alcoholism (0.030). CONCLUSIONS: The prevalence of ephelides in lip and perioral region was high in the study population, with gender and certain habits associated with its occurrence.

Prevalence of lip and perioral Ephelides in beach workers / Prevalência de Éfelides labiais e periorais em trabalhadores de praias

Ephelides are small hyperpigmented macules common in the skin, presenting as areas with increased melanin production. Ephelides are observed in genetically predisposed individuals, particularly fair-skinned people highly susceptible to sunburn. This study aimed to determine the prevalence of lip and perioral ephelides in 362 beach workers in the city of Natal (Rio Grande do Norte) and to investigate potential associations with sociodemographic, occupational and general health. For this purpose clinical tests were performed by calibrated examiners in the epidemiological area around the lips and the area bounded laterally by the nasolabial groove and at the bottom by the chin. A questionnaire was completed and assessed. The possible associations between sociodemographic variables, occupational and general health with the presence of lip and perioral ephelides were evaluated by chi-square test for a significance level of 5%. Approximately one third of the workers were affected by perioral ephelides (33.7%) and around a quarter of them by lip ephelides (24.0%). Gender was the only variable significantly associated with the presence of perioral ephelides (p = 0.002), unlike lip ephelides which proved to be significantly associated with habits (p = 0.036) and alcoholism (0.030). The prevalence of ephelides in lip and perioral region was high in the study population, with gender and certain habits associated with its occurrence. .

Efélides são máculas hiperpigmentadas pequenas, comuns na pele, que constituem uma área com maior aumento da produção de melanina. São observadas em indivíduos geneticamente predispostos, de pele clara, com grande suscetibilidade a queimaduras solares. Esse estudo teve o propósito de verificar a prevalência de efélides labiais e periorais em 362 trabalhadores de praias do município de Natal/RN e investigar potenciais associações com variáveis sociodemográficas, ocupacionais e de saúde geral. Para tanto, foram realizados exames clínicos por examinadores calibrados, na área correspondente aos lábios e na área delimitada lateralmente pelo sulco nasolabial e inferiormente pelo mento, além de preenchimento de questionário validado. As possíveis associações das variáveis sociodemográficas, ocupacionais e de saúde geral com a presença de efélides labiais e periorais foram avaliadas pelo teste do qui-quadrado para um nível de significância de 5%. Aproximadamente um terço dos trabalhadores foi acometido por efélides perioral (33,7%) e um quarto por efélides labial (24,0%). O gênero foi a única variável que se mostrou associada significativamente com a presença de efélides periorais (p=0,002), ao contrário das efélides labiais que mostrou-se associada significativamente com hábito (p=0,036) e etilismo (0,030). Conclui-se que a prevalência de efélides em região perioral e labial foi elevada na população estudada e o gênero e hábitos ...

HPV oral lesions in HIV-infected patients: the impact of long-term HAART.

BACKGROUND: Since the introduction of highly active antiretroviral therapy (HAART), an increase in the frequency of human papillomavirus-associated oral lesions (HPV-OL) has been observed. Thus, the aim of this study was to determine the prevalence and factors associated with HPV-OL in Mexican HIV-infected patients, as well as its genotyping, in the HAART era. METHODS: In a cross-sectional study developed at an HIV/AIDS referral center in Mexico City, HIV-infected patients were consecutively included from 2004 to 2011. An oral exam was performed; lymphocyte CD4(+) count, HIV-viral load, CDC-stage, and HAART use were recorded. HPV-OL samples were taken for routine histopathological analysis (H-E) and HPV-DNA amplification/sequencing. Logistic regression models were performed and the interactions tested using the STATA software. RESULTS: Among 787 HIV patients, 55 (6.9%) showed HPV-OL. HPV-OLs were independently associated with age (≥40 years) and with a longer time of HAART use (≥12 months). The most frequent lesion was squamous cell papilloma in 22 (40%) cases, followed by multifocal epithelial hyperplasia in 15 (27.3%) cases. Labial mucosa was the most common site involved (56.4%). Of the sequences obtained, 65.4% corresponded to low risk and 11.5% to high risk. Mixed high- and low-risk infection were identified in 7.7% of the cases. CONCLUSIONS: Human papillomavirus-associated oral lesions were associated with older age and longer HAART use. All lesions were benign in nature and most of the HPV sequences corresponded to low-risk types. The rise of HPV-OLs in HIV patients on HAART may be related with the longer life expectancy of individuals with an impaired immune system rather than a direct effect of HAART.

Prevalência de lesões labiais em trabalhadores de praia e fatores associados / Prevalence and factors associated with orolabial lesions in beach workers / Prevalencia de lesiones labiales en trabajadores de playa y factores asociados

OBJETIVO: Analisar a prevalência de lesões labiais decorrentes da exposição solar e potenciais associações em trabalhadores de praia. MÉTODOS: Estudo transversal com 362 trabalhadores de cinco praias urbanas em Natal, RN, de agosto a dezembro de 2010. Os participantes responderam um questionário validado com dados pessoais, de ocupação e de saúde e passaram por exame clínico dos lábios feito por pesquisadores calibrados. As possíveis associações das variáveis sociodemográficas, ocupacionais e de saúde geral com a presença de lesões labiais foram avaliadas pelo teste do qui-quadrado para um nível de significância de 5%. A análise multivariada foi feita utilizando-se a regressão robusta de Poisson. RESULTADOS: Dos trabalhadores examinados, 27,1% apresentavam lesões labiais. Desses, 76,8% eram do sexo masculino; 61,6% tinham pele morena ou negra; 94,5% trabalhavam informalmente; e 85,4% trabalhavam expostos ao sol. A maioria (81,1%) relatou uso de algum tipo de fotoproteção: protetor solar (38,7%); protetor labial (15,3%); boné/chapéu (72,4%). Aproximadamente 28% eram fumantes e 48% consumiam álcool regularmente. A fotoproteção com uso de boné/chapéu foi associada à presença de lesões labiais decorrentes da exposição solar. CONCLUSÕES: Observou-se alta prevalência de lesões labiais nos indivíduos expostos ao sol, a qual foi associada ao uso de boné/chapéu como forma de fotoproteção.

OBJECTIVE: To assess the prevalence and factors associated with orolabial lesions caused by sun exposure in beach workers. METHODS: Cross-sectional study with 362 beach workers from five urban beaches in the city of Natal, northeastern Brazil, from August to December 2010. All subjects completed a validated questionnaire to collect personal, occupational, and health-related information and underwent an orolabial clinical examination by trained examiners. Potential associations between sociodemographic, occupational, and health-related variables and the presence of orolabial lesions were assessed using the chi-square test at a 5% significance level. The multivariate analysis was performed using Poisson regression. RESULTS: Of the 362 workers examined, 27.1% had orolabial lesions. Of these, 76.8% were males, 61.6% dark or black skinned, 94.5% informal workers, and 85.4% reported sun exposure. Most (81.1%) reported using sun protection methods including sunscreen (38.7%), lip balm (15.3%), and cap/hat (72.4%). Twenty-eight percent reported smoking and 48% regular drinking. Sun protection with cap/hat was associated with orolabial lesions caused by sun exposure. CONCLUSIONS: There was found a high prevalence of orolabial lesions in workers exposed to sunlight that was associated with the use of a cap/hat as a sun protection method.

OBJETIVO: Analizar la prevalencia de lesiones labiales productos de la exposición solar y potenciales asociaciones en trabajadores de playa. MÉTODOS: Estudio transversal con 362 trabajadores de cinco playas urbanas en Natal, RN, Brasil, de agosto a diciembre de 2010. Los participantes respondieron un cuestionario validado con datos personales, de ocupación y de salud y se evaluaron a través de exámenes clínicos realizados por investigadores calibrados. Las posibles asociaciones de las variables sociodemográficas, ocupacionales y de salud general con la presencia de lesiones labiales se evaluaron por medio de la prueba de Chi-cuadrado para un nivel de significancia de 5%. El análisis multivariado fue realizado utilizándose la regresión robusta de Poisson. RESULTADOS: De los trabajadores examinados, 27,1% presentaban lesiones labiales. De estos, 76,8% eran del sexo masculino; 61,6% tenían piel morena o negra; 94,5% trabajaban informalmente y 85,4%, expuestos al sol. La mayoría (81,1%) relató uso de algún tipo de fotoprotección: protector solar (38,7%); protector labial (15,3%); gorra/sombrero (72,4%). Aproximadamente 28% eran fumadores y 48% consumían alcohol regularmente. La fotoprotección con uso de gorra/sombrero fue asociada a la presencia de lesiones labiales productos de la exposición solar. CONCLUSIONES: Se observó alta prevalencia de lesiones labiales en los individuos expuestos al sol y esta se asoció al uso de gorra/sombrero como forma de fotoprotección.