Epidemiologic survey of pemphigus vulgaris with oral manifestations in northern Greece: retrospective study of 129 patients.

OBJECTIVE: To evaluate the epidemiology of pemphigus vulgaris (PV) in a Greek population and to compare it with other countries. MATERIALS AND METHODS: A retrospective study was conducted based on the records of 129 patients (41 males and 88 females) with PV who visited the Department of the Oral Medicine and Maxillofacial Pathology, Aristotle University of Thessaloniki, Greece and the State Hospital for Skin and Venereal Diseases of Thessaloniki, Greece, between 1985 and 2004. A group of 73 individuals was used as controls. RESULTS: The average annual incidence was found to be eight patients per year. The male to female ratio was 1 : 2.25. The difference in the age of onset between the two genders was statistically significant in marginal levels (P = 0.05). In addition, 86.1% of the patients showed oral lesions only, 13.3% oral and skin lesions and 1.3% manifested oral, skin, and ocular lesions. Twenty-eight of the 88 females were in the premenopausal period-of-life. Additionally, 19 males were farmers who had daily contact with organophosphoric pesticides. Co-existing pathologic conditions were present in 75 of the 129 patients, and of these 75 patients six (8%) were diabetics, 15 (20%) presented with hypertension, two (2.6%) faced problems from their thyroid gland, and 10 (13.3%) of the patients complained of allergic reactions. CONCLUSIONS: The results of this study demonstrated a relatively high incidence of PV in northern Greece compared with that in other countries. The disease most frequently occurred in the sixth decade-of-life and the majority of the patients manifested oral lesions. Further epidemiological studies are needed to elucidate whether this region is constituted from population groups with high susceptibility to PV.

Detection of pemphigus desmoglein 1 and desmoglein 3 autoantibodies and pemphigoid BP180 autoantibodies in saliva and comparison with serum values.

Although there is much literature on the detection of pemphigus and pemphigoid autoantibodies by enzyme-linked immunosorbent assay (ELISA) in serum, nothing is known about their presence in saliva. The aim of this study was to evaluate the salivary levels of these autoantibodies in pemphigus and pemphigoid patients. Autoantibodies against desmoglein3, desmoglein1, and BP180 were assayed, by ELISA, in serum and saliva samples of patients and healthy controls. The titres of autoantibodies against Dsg1/3 found in both serum and saliva of pemphigus patients showed a statistically significant correlation, suggesting that saliva may be a useful biological material for diagnostic purposes, in monitoring disease activity, as well as for the early detection of relapses. By contrast, the titres of autoantibodies against BP180 in the serum and saliva of bullous pemphigoid patients were not statistically related, and further study of the usefulness of the BP180 ELISA for saliva in this disease is needed. In addition, based on our results, the BP180 ELISA with a recombinant NC16a epitope failed to detect the autoantibodies against BP180 in the serum and saliva of mucous membrane pemphigoid patients.

Oral findings in patients with obstructive sleep apnea syndrome.

OBJECTIVE: To evaluate the role of dental parameters that may contribute in increasing apneic activity in patients with obstructive sleep apnea syndrome (OSAS). METHOD AND MATERIALS: A total of 152 subjects (121 males and 31 females ) were examined from October 1999 until September 2001, for sleep disorder symptoms. All patients underwent polysomnography. Any abnormal or unusual features that could inhibit the upper airway of the oral cavity were evaluated by an oral pathologist. RESULTS: Statistical analysis of the independent structural variables and the respiratory disturbance index proved to be significant only in the cases of retropositioned or narrow hard palate with a vertically positioned soft palate, the type of breathing (oral breathing), and the enlarged uvula. CONCLUSION: The oral soft tissues seem to be more closely associated with OSAS. Therefore, the diagnosis of the structural features of the oral cavity by the clinician is useful to predict apneic activity.

Candidal overgrowth in diabetic patients: potential predisposing factors.

This study was designed to investigate the potential factors that influence the prevalence of the oral carriage of Candida species in patients with type II diabetes mellitus. One hundred and twenty-eight diabetic patients (68 males and 60 females, mean age 54 +/- 7 years) were sequentially enrolled along with 84 (44 males and 40 females mean age 52 +/- 8 years) healthy subjects. Samples were obtained by swabbing the oral mucosa of all participants. Yeast isolates were identified by germ tube test, with API 32 ID system, and by chlamydospore production on 'cornmeal' Tween-80 agar. Candida spp. was recovered from the oral cavity of 64% of the diabetic group, in contrast to 40% of the control group. Candida albicans was the most frequently isolated species in both groups. Potential etiologic factors such as xerostomia, dentures, age, gender and diabetes on oral carriage of Candida spp. were evaluated. The oral carriage of Candida spp. was significantly higher in 'diabetic' patients compared with the healthy subjects but it seems that parameters such as xerostomia, dentures, age, gender and glycemic control cannot be directly associated with Candida growth in the oral cavity in the presence of diabetes.

Encephalocraniocutaneous lipomatosis accompanied by maxillary compound odontoma and juvenile angiofibroma: report of a case.

BACKGROUND: Encephalocraniocutaneous lipomatosis (ECCL) is a rare neurocutaneous syndrome characterized by congenital cutaneous, ocular, and neurologic abnormalities, which may be pronounced in the head and neck. CASE: In this article we present a well-documented case of a six-year-old boy with ECCL associated with oral manifestations. In this case, typical features such as large lipomatous brown pigmented plaques of the top of the skull with overlying alopecia, ptotic eyelid with decreased function, bulbar conjunctiva lipodermoid, microcalcifications and atrophy of cerebral parenchyma, and the widening of the frontal subarachnoid space and the fissure of Sylvius were accompanied by intraoral lesions, maxillary compound odontoma, and juvenile extranasopharyngeal angiofibroma of the gingiva. CONCLUSIONS: Although cases of odontomas have already been described and angiofibromas are a quite common extraoral finding, to our knowledge this is the first case of intraoral evaluation of both extranasopharyngeal juvenile angiofibroma and maxillary compound odontoma in ECCL syndrome.

Diagnosis of a maxillary brown tumor associated with hyperparathyroidism secondary to chronic renal failure--a case report.

Brown tumor associated with hyperparathyroidism secondary to chronic renal failure has been increasingly documented of late. This intraosseous giant cell lesion is indistinguishable from a central giant cell granuloma and is considered as an unusual local complication of renal osteodystrophy. This report presents a case of a maxillary brown tumor in an uremic, non-hemodialysis patient with secondary hyperparathyroidism. The radiographic, biochemical, and histopathological examinations are reported and the possible pathogenesis is also discussed.

Comparison of salivary IgA and systemic IgA and IgG antibodies to Saccharomyces cerevisiae in HIV-infected subjects.

Our objective was to investigate the concentrations of IgA and IgG antibodies to Saccharomyces cerevisiae in whole saliva and serum samples from HIV-infected patients and to compare them with the corresponding antibody values of healthy controls. A cross-sectional design was used. The test group consisted of 23 HIV-infected male individuals, aged 20-41 years old, free of any other systemic disease. Twenty healthy subjects aged 27-43 years old served as controls. Whole unstimulated saliva and blood were collected from all subjects. IgA concentrations in saliva and IgA and IgG concentrations in serum were measured by solid-phase enzyme-linked immunosorbent assay. Salivary antibody concentrations were calculated by reference to a pooled standard saliva obtained from 10 healthy males with high levels of anti-S. cerevisiae antibody activity. Total IgA and IgG concentrations were measured by nephelometry / tholocymetry assay. No significant difference was observed in salivary specific IgA and serum specific IgG levels to S. cerevisiae, while serum specific IgA were significantly lower in HIV infected patients compared to control group. Opportunistic infections due to S. cerevisiae, although rare, cannot be dismissed. This yeast can show a potential virulence in debilitated patients, therefore, further extensive investigation should be considered.