ABSTRACT
Familiarity with common oral conditions allows clinicians to observe and treat patients in the primary care setting or refer to a dentist, oral surgeon, otolaryngologist, or other specialist. Recurrent aphthous stomatitis (canker sores) is the most common ulcerative condition of the oral cavity. Recurrent herpes simplex labialis and stomatitis also commonly cause oral ulcers. Corticosteroids, immunocompromise, antibiotics, and dentures can predispose patients to oral candidiasis. Benign migratory glossitis (geographic tongue) occurs in up to 3% of the population but generally lacks symptoms, although some people experience food sensitivity or a burning sensation. Hairy tongue is associated with a low fiber diet, tobacco and alcohol use, and poor oral hygiene in older male patients. Generally, hairy tongue is asymptomatic except for an unattractive appearance or halitosis. Tobacco and alcohol use can cause mucosal changes resulting in leukoplakia and erythroplakia. These can represent precancerous changes and increase the risk of squamous cell carcinoma. Mandibular and maxillary tori are common bony cortical outgrowths that require no treatment in the absence of repeat trauma from chewing or interference with dentures. Oral lichen planus occurs in up to 2% of individuals and can present as lacy reticulations or oral erosions and ulcerations. Traumatic buccal mucosal fibromas and labial mucoceles from biting can be excised.
Subject(s)
Glossitis, Benign Migratory , Mouth Diseases , Oral Ulcer , Stomatitis, Aphthous , Tongue, Hairy , Aged , Glossitis, Benign Migratory/pathology , Humans , Male , Mouth Diseases/diagnosis , Mouth Diseases/etiology , Mouth Diseases/therapy , Mouth Mucosa/pathology , Oral Ulcer/diagnosis , Oral Ulcer/etiology , Stomatitis, Aphthous/complications , Stomatitis, Aphthous/etiology , Tongue, Hairy/complications , Tongue, Hairy/pathologySubject(s)
Tongue, Hairy/therapy , Adult , Aged , Conservative Treatment/methods , Female , Humans , Male , Patient Dropouts , Photography , Risk Factors , Tongue, Hairy/etiology , Tongue, Hairy/pathologyABSTRACT
Excluding human papillomavirus (HPV)-driven conditions, oral papillary lesions consist of a variety of reactive and neoplastic conditions and, on occasion, can herald internal malignancy or be part of a syndrome. The objectives of this paper are to review the clinical and histopathological features of the most commonly encountered non-HPV papillary conditions of the oral mucosa. These include normal anatomic structures (retrocuspid papillae, lingual tonsils), reactive lesions (hairy tongue, inflammatory papillary hyperplasia), neoplastic lesions (giant cell fibroma), lesions of unknown pathogenesis (verruciform xanthoma, spongiotic gingival hyperplasia) and others associated with syndromes (for instance Cowden syndrome) or representing paraneoplastic conditions (malignant acanthosis nigricans). Common questions regarding differential diagnosis, management, and diagnostic pitfalls are addressed, stressing the importance of clinico-pathologic correlation and collaboration.
Subject(s)
Mouth Diseases/pathology , Mouth Mucosa/pathology , Mouth Neoplasms/pathology , Acanthosis Nigricans/pathology , Fibroma/pathology , Hamartoma Syndrome, Multiple/pathology , Humans , Tongue, Hairy/pathology , Xanthomatosis/pathologySubject(s)
Tongue, Hairy/pathology , Child , Humans , Male , Tongue, Hairy/etiology , Tongue, Hairy/therapySubject(s)
Tongue, Hairy/pathology , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Candida glabrata/isolation & purification , Candidiasis, Oral/complications , Combined Modality Therapy , Gastrectomy , Humans , Hyperpigmentation/etiology , Hyperpigmentation/pathology , Male , Oral Hygiene , Oxonic Acid/administration & dosage , Oxonic Acid/adverse effects , Postoperative Complications/chemically induced , Postoperative Complications/etiology , Postoperative Complications/pathology , Pyridines/administration & dosage , Pyridines/adverse effects , Smoking/adverse effects , Stomach Neoplasms/drug therapy , Stomach Neoplasms/surgery , Tegafur/administration & dosage , Tegafur/adverse effects , Tongue, Hairy/chemically induced , Tongue, Hairy/etiologyABSTRACT
At the outpatient clinic, an 8-month-old girl presented with a black hairy tongue. Since 2,5 weeks she used antibiotics because of osteomyelitis in her right humerus. There was no proper oral hygiene. She had no other complaints or abnormalities. The diagnosis 'lingua villosa nigra' was made. This is a benign, self-limiting disorder.
Subject(s)
Tongue, Hairy/pathology , Anti-Bacterial Agents/therapeutic use , Female , Humans , Infant , Oral Hygiene , Osteomyelitis/drug therapyABSTRACT
La lengua negra vellosa es una patología benigna relativamente frecuente, caracterizada por una coloración pardo-negruzca de la superficie lingual asociada a hipertrofia de papilas filiformes dando aspecto de vellosidades. Los factores de riesgo son amplios y de exposición cotidiana (antibióticos, alcohol, tabaco, higiene dental deficiente). Entre sus diagnósticos diferenciales es útil recordar aquellos asociados con neoplasias o inmunocompromiso (acantosis nigricans oral, leucoplasia vellosa, etc.). Su diagnóstico es clínico; sin embargo, cuando las causas o historia no son claras, la exploración clínica es atípica o hay refractariedad sistemática a los tratamientos habituales, se debe plantear un estudio ampliado (AU)
Black hairy tongue is a relatively common benign disease, characterized by brown-black discoloration and hypertrophic tongue surface, giving aspect of villi. Risk factors are broad and from daily exposure (antibiotics, alcohol, tobacco, poor dental hygiene). Among its differential diagnoses it is useful to recall those associated with malignancies or immunocompromise (oral acanthosis nigricans, hairy leukoplakia, etc.). Diagnosis is clinical, but when the causes are unclear, history or clinical examination is atypical, or treatment is refractory, it should be considered an extended study (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Tongue, Hairy/diagnosis , Tongue, Hairy/pathology , Tretinoin/therapeutic useSubject(s)
Tongue Diseases/pathology , Tongue/anatomy & histology , Ankyloglossia , Diagnosis, Differential , Glossitis, Benign Migratory/diagnosis , Glossitis, Benign Migratory/drug therapy , Glossitis, Benign Migratory/etiology , Glossitis, Benign Migratory/pathology , Humans , Immunosuppressive Agents/therapeutic use , Lingual Thyroid/diagnosis , Lingual Thyroid/pathology , Melanoma/diagnosis , Melanosis/diagnosis , Melanosis/etiology , Melanosis/pathology , Mouth Abnormalities/diagnosis , Mouth Abnormalities/pathology , Mouth Abnormalities/surgery , Peutz-Jeghers Syndrome/diagnosis , Peutz-Jeghers Syndrome/pathology , Psoriasis/complications , Smoking/adverse effects , Tongue/blood supply , Tongue/pathology , Tongue Diseases/diagnosis , Tongue Diseases/etiology , Tongue Neoplasms/diagnosis , Tongue, Fissured/diagnosis , Tongue, Fissured/etiology , Tongue, Fissured/pathology , Tongue, Hairy/diagnosis , Tongue, Hairy/etiology , Tongue, Hairy/pathology , Varicose Veins/diagnosis , Varicose Veins/pathologySubject(s)
Anti-Bacterial Agents/adverse effects , Anti-Ulcer Agents/adverse effects , Lansoprazole/adverse effects , Metronidazole/adverse effects , Tongue, Hairy , Tongue , Anti-Bacterial Agents/therapeutic use , Anti-Ulcer Agents/therapeutic use , Child , Drug Therapy, Combination , Female , Helicobacter Infections/drug therapy , Helicobacter pylori , Humans , Lansoprazole/therapeutic use , Metronidazole/therapeutic use , Tongue/drug effects , Tongue/pathology , Tongue, Hairy/chemically induced , Tongue, Hairy/pathologySubject(s)
Tongue, Hairy , Female , Humans , Infant , Tongue, Hairy/drug therapy , Tongue, Hairy/pathologySubject(s)
Anti-Bacterial Agents/adverse effects , Candidiasis, Oral/complications , Doxycycline/adverse effects , Pigmentation Disorders/etiology , Tongue Diseases/etiology , Tongue/pathology , Adult , Candida albicans/isolation & purification , Humans , Male , Pigmentation Disorders/pathology , Tongue Diseases/pathology , Tongue, Hairy/etiology , Tongue, Hairy/pathologyABSTRACT
The purpose of this study was to determine whether there are any differences in the appearance of tongue-surface structure in different kinds of collagen diseases, because red tongue is well known to be a very important feature of suspected Sjögren's syndrome (Sjs). To clarify some features of the filiform papillae on the dorsal surfaces of the tongues of patients with speculated Sjs, we observed a total of 565 individuals with primary Sjs (n = 24, M/F = 0/24), secondary Sjs (n = 16, M/F = 1/15), possible Sjs (n = 96, M/F = 21/75), collagen diseases (CD) (n = 55, M/F = 15/40; 15 SSc, 10 SLE 10, two MCTD, six dermatomyositis, and 22 others), various cutaneous disorders (n = 324, M/F = 118/206), and healthy controls (HC) (n = 50, M/F = 32/18) by using a dermoscope. The average ages of the patients with Sjs, CD (non-Sjs), cutaneous disorders (non-Sjs/CD), and HC were 56.4 14.8, 55.1 116.4, 51.1 121.2, and 37.1 110.6 years of age, respectively. The filiform papillae were classified into four patterns by their structural characteristics: normal papillae (no abnormality with clear cornified tips) (pattern I, n = 162), slightly rounded papillae with unclear cornified tips (pattern II, n = 239), rounded papillae without cornified tips (pattern III, n = 86), and completely flattened papillae (pattern IV, n = 28). Their patterns were reversely related to the volume of salivary fluid (gum test) (P = 0.046) and the degree of furor coating of the tongue (P = 0.051). Pattern IV is predominant in definitive Sjs (primary and secondary Sjs) (n = 15; 53.6%) with positive anti-SS-A or -B antibody (n = 8) with a specificity of 53.6% and a sensitivity of 36.6%. The present dermoscopic finding that the completely flattened pattern (IV) is predominant in definite Sjs patients may indicate a useful marker for suspicion of Sjs.
