Topical Application of Dexamethasone-Loaded Core-Multishell Nanocarriers Against Oral Mucosal Inflammation.

Topical treatment of oral inflammatory diseases is challenging due to the intrinsic physicochemical barriers of the mucosa and the continuous flow of saliva, which dilute drugs and limit their bioavailability. Nanocarrier technology can be an innovative approach to circumvent these problems and thus improve the efficacy of topical drug delivery to the mucosa. Core-multishell (CMS) nanocarriers are putative delivery systems with high biocompatibility and the ability to adhere to and penetrate the oral mucosa. Ester-based CMS nanocarriers release the anti-inflammatory compound dexamethasone (Dx) more efficiently than a conventional cream. Mussel-inspired functionalization of a CMS nanocarrier with catechol further improves the adhesion of the nanocarrier and may enhance the efficacy of the loaded drugs. In the present study, the properties of the ester-based CMS 10-E-15-350 nanocarrier (CMS-NC) are further evaluated in comparison to the catechol-functionalized variant (CMS-C0.08). While the mucoadhesion of CMS-NC is inhibited by saliva, CMS-C0.08 exhibits better mucoadhesion in the presence of saliva. Due to the improved adhesion properties, CMS-C0.08 loaded with dexamethasone (Dx-CMS-C0.08) shows a better anti-inflammatory effect than Dx-CMS-NC when applied dynamically. These results highlight the superiority of CMS-C0.08 over CMS-NC as an innovative drug delivery system (DDS) for the treatment of oral mucosal diseases.

Oral Mucosal Lesions in Patients Attending Dermatology Outpatient Department of a Tertiary Care Center in Kathmandu: A Descriptive Cross-sectional Study.

INTRODUCTION: Oral mucosal lesions though mostly benign, may impair the quality of life of patients. Some may even progress to malignancies. Many physicians, including dermatologists, tend to skip oral examinations, missing many important diagnoses. Understanding the frequency and types of oral mucosal lesions in dermatological settings can help in early diagnosis, referral and adequate treatment. This study was done to determine demographic characteristics and clinical presentations of patients with oral mucosal lesions presenting to the out-patient department (OPD) of dermatology in Nepal Armed Police Force (APF) Hospital, Kathmandu. METHODS: This cross-sectional descriptive study was conducted after obtaining the ethical approval from the Institutional Review Committee of Nepal APF Hospital. Retrospective data of 264 patients presenting with oral mucosal lesions to the dermatology OPD were collected from 1st January 2021 to 31st December 2023 by using a pre-formed proforma. Data was entered in SPSS software and descriptive statistics were computed. RESULTS: Out of 13,832 cases, oral mucosal lesion was seen in 264 (1.90%) cases among which 153 (57.96%) cases were males with male female ratio of 1.37:1. Most common age group affected was 31-45 years 96 (36.36%). Buccal mucosa 86 (32.57%) was the commonest site involved followed by tongue 73 (27.65%). Aphthous ulcer 82 (31.06%) was the commonest lesion found followed by oral candidiasis 25 (9.46%) and oral lichen planus 24 (9.09%). CONCLUSIONS: Aphthous ulcer was the commonest oral mucosal lesion seen in patients visiting dermatology outpatient department of Nepal APF Hospital, with buccal mucosa being the commonest site affected.

Oral Erythema Multiforme: A Case Report and Review of Diagnostic, Therapeutic and Prognostic Challenges.

Erythema multiforme (EM) presents a distinct challenge in both diagnosis and management, particularly when its manifestations extend to the oral cavity. Classified into "minor" and "major" forms based on clinical presentation, EM defies gender bias and tends to affect individuals across different age groups. The complexity arises from its varied symptoms within the oral cavity, where it commonly manifests as painful, red erosive plaques known as target lesions, primarily observed on the lips and oral mucosa. These lesions may arise independently or be linked to underlying systemic or infectious conditions, complicating the diagnostic process. Here, we present a case study of a 55-year-old female patient grappling with EM, underscoring the importance of meticulous clinical examination, thorough investigations, tailored treatment strategies, and subsequent outcomes.

Prevalence and Patterns of Oral Mucosal Lesions Among Geriatric Patients in India: A Retrospective Study.

Introduction: Geriatric dentistry plays a pivotal role in addressing the oral health needs of the elderly population, who are prone to various age-related disorders affecting the oral mucosa. This study aims to investigate the prevalence of oral mucosal lesions among geriatric patients in India, considering factors, such as age, gender, and systemic diseases. Methodology: A hospital-based retrospective study was conducted, analyzing medical and clinical examination records of 354 geriatric patients attending a dental college/hospital between 2022 and 2023. Data on demographics, systemic diseases, oral habits, and denture usage were collected, and oral mucosal lesions were classified according to the World Health Organization (WHO) criteria. Results: Among the 354 subjects examined, oral mucosal lesions were observed in 54.66% of cases. Leukoplakia (19.49%) and lichen planus (17.80%) were the most prevalent lesions, followed by malignancy (12.99%) and denture stomatitis (9.04%). The prevalence varied across age-groups, with higher rates observed in individuals aged 60-70 years. Conclusion: The study highlights the significant burden of oral mucosal lesions among geriatric patients in India, underscoring the need for targeted preventive strategies and comprehensive oral healthcare interventions tailored to the specific needs of elderly individuals.

Clinical Correlation of Types and Forms of Smokeless Forms of Quid (Tobacco and Arecanut) and Occurrence of Oro Mucosal Lesions: A Cross-Sectional Study.

Aim: The aim of the study was to assess the prevalence of quid-induced oral mucosal lesion (QIOML) among the population in Jodhpur, western Rajasthan, and to ascertain if they are associated with chewing tobacco, arecanut, or both tobacco and arecanut. Materials and Methods: The study design was cross-sectional. All the subjects reporting to the out patient department at Vyas Dental College were screened, and 1209 quid users (using processed, unprocessed, and both processed and unprocessed forms of tobacco and arecanut) were identified and included. Results: Among 1209 (18.8%) chewers, 949 (78.49%) chewers were reported to have QIOML and the majority of QIOML occurred in the subjects chewing both tobacco and arecanut in processed forms. Conclusion: Further studies should be done to find out the actual composition of the processed form of quid along with its concentration and its role in the occurrence of QIOML.

Retrospective Research of Cases of Oral Mucosal Diseases: Diagnosis and Management Trends.

Objective: The purpose of this retrospective study was to look into patterns in the diagnosis and treatment of oral mucosal disorders over a 12-year period in a tertiary care environment. Methods: A comprehensive review of medical records from a Tertiary Care Center was conducted, encompassing 2010-2022. Data on patient demographics, clinical presentations, diagnostic methods, treatment modalities, and outcomes were systematically analyzed. Descriptive statistics and trend analyses were employed to discern patterns and changes over time. Results: A total of 500 cases were included in the research, with a mean age of 42.5 years. Aphthous ulcers, oral lichen planus, and candidiasis were the predominant diseases, collectively constituting 58% of cases. Diagnostic modalities varied, including biopsy and imaging. Treatment modalities ranged from topical agents to surgical procedures, tailored to specific diagnoses. The prevalence of squamous cell carcinoma was noteworthy at 8%. Conclusion: This research provides insights into the evolving landscape of oral mucosal disease diagnosis and treatment in tertiary care. Identified trends emphasize the importance of individualized care, advancements in diagnostic techniques, and ongoing research collaboration. Addressing challenges identified in this research is crucial for enhancing patient outcomes and shaping future research directions.

Preparation and characterization of mussel-inspired chitosan/polydopamine films and their feasibility for oral mucosa application.

Oral mucosal lesions (OML), which represent a major public health issue worldwide, include any pathological changes in the oral mucosa, such as ulcers, pigmentation, and swelling. Due to its humid and dynamic complex environment, designing oral mucosal preparations poses significant challenges. Drawing inspiration from mussels, this study employed an eco-friendly one-pot strategy for the preparation of chitosan/polydopamine (CS/PDA) films. We demonstrated that CS-induced polymerization of dopamine monomers under acidic conditions, which might be attributed to the large number of hydrogen bonding sites of CS chains. PDA markedly enhances properties of the CS film and exhibits concentration dependence. At the concentration of 1 wt% PDA, the lap-shear strength and tensile strength of CS/PDA films reached 5.01 ± 0.24 kpa and 4.20 ± 0.78 kpa, respectively, indicating that the mucosal adhesion ability was significantly improved. In comparison with the single CS film, the swelling rate of CS/PDA film decreased by about 30 %. Rheological results also showed that the storage modulus returned to 93 % after cyclic large strain, while the single CS film only recovered to 73 %. Moreover, these films demonstrated good biocompatibility and enhanced oral ulcer healing in rats, providing a new and practical option for the local treatment of OML.

Unusual oral manifestation of Kindler syndrome: a case report and review of literature.

Kindler syndrome (KS) is a rare autosomal recessive genodermatosis characterized by congenital acral blistering, that typically presents in infancy and is followed by the development of characteristic poikilodermatous pigmentation and photosensitivity in later life. These clinical manifestations arise from mutations in the FERMT-1 (Fermitin family homologue 1) that encodes kindlin-1, a protein localized to focal adhesions in keratinocytes. Kindlin-1 plays a crucial role in integrin receptor activation, which is essential for cell adhesion and migration. Most KS cases exhibit reduced or absent kindlin-1 expression, leading to defective integrin activation and impaired cell adhesion and migration processes. This impaired cell adhesion ultimately results in the blistering phenotype observed in KS. Oral manifestations of KS are frequently under-reported and misdiagnosed, potentially leading to delayed or incorrect treatment. Furthermore, diabetes mellitus (DM) can further exacerbate the severity of KS due to impaired epidermal barrier function and compromised periodontal health. This co-morbidity creates a synergistic effect. Periodontal infection, often exacerbated by DM through a caspase-3-dependent mechanism, can cause apoptosis of epithelial cells and fibroblasts. This enhanced apoptosis and loss of epithelial barrier function due to DM further hinder tissue repair processes. Consequently, both cutaneous and oral complications associated with KS become more severe in diabetic patients. We report a unique case of a diabetic adolescent with KS presenting with a massive oral pyogenic granuloma and extensive periodontal destruction with a comprehensive review of the literature exploring the current understanding of oral manifestations in KS, emphasizing their under-diagnosis and potential for exacerbation by DM. This case emphasizes the need for increased awareness of oral manifestations in KS, especially in diabetic patients. Early diagnosis and a multidisciplinary approach are crucial for optimal management of cutaneous and oral complications associated with KS.

Vascularized characteristics and functional regeneration of three-dimensional cell reconstruction of oral mucosa equivalents based on vascular homeostasis phenotypic modification.

Our prior research has effectively developed tissue-engineered vascularized oral mucosa equivalents (VOME); however, challenges such as low repeatability and stability, as well as the inability to accurately replicate the complexity of real blood vessels, were encountered. Therefore, this study aimed to screen the VOME and native oral mucosa vascular homeostasis phenotypes by tandem mass tag-tagged proteomics associated with laser capture microdissection and human angiogenesis antibody array technology. Then, lentiviruses were constructed and stably transfected with vascular endothelial-like cells (VELCs) to detect angiogenic capacity. HE, EdU Apollo tracer staining, immunofluorescence staining, scanning electron microscopy, biomechanical testing, and a small animal ultrasound imaging system were used to analyze the characteristics of vascularization homeostasis and monitor functional regeneration of the vascularized homeostatic phenotypic oral mucosal equivalents (VHPOME). The results showed that PGAM1, COL5A1, ANG, and RNH1 are potential specific angiogenesis phenotypes. High expression of PGAM1, COL5A1, and ANG and/or low expression of RNH1 can promote the angiogenesis of VOME. ANG/shRNH1 has the most significant tube-like structure-formation ability. The expression of PGAM1, COL5A1, and ANG in the VHPOME group was higher than that of the control group, and the expression of RNH1 was lower than that of the control group. COL5A1/ANG can significantly improve the mechanical properties. The blood flow signal was most significant in the ANG/shRNH1 group. PGAM1, COL5A1, ANG, shRNH1, PGAM1/ANG, COL5A1/ANG, PGAM1/shRNH1, PGAM1/shRNH1, COL5A1/shRNH1, and ANG/shRNH1 may be the targets for establishing vascularization homeostasis and functional regeneration of oral mucosal equivalent genes (groups), and ANG/shRNH1 has the most significant effect.

The application of the "perinephric fat wrapping" technique with oral mucosal graft for the management of ureter repair and reconstruction.

OBJECTIVE: The management of long-segment ureteral stenosis has posed a significant challenge for urologists. Ureteroplasty with oral mucosal graft has emerged as an effective approach for treating long-segment ureteral stenosis and defects. A key step in replacement repair surgery involves suturing the surrounding tissue with an adequate blood supply around the reconstructed ureter. The current study aims to evaluate the potential practical application of the "perinephric fat wrapping" technique in laparoscopic ureteroplasty with oral mucosal graft. METHODS: Between July 2018 and February 2023, 26 patients with ureteral stenosis underwent laparoscopic ureteroplasty with oral mucosal graft at the Second Affiliated Hospital of Anhui Medical University. We used traditional omental wrapping technique (OW group) or perinephric fat wrapping technique (PFW group) to enhance ureter repair. Perioperative and follow-up data for both groups were collected retrospectively and compared. RESULTS: There were 10 patients in OW group, including 4 males and 6 females, with BMI of 23.5±2.8 kg/m2 and stenosis length of 3.6±1.6 cm. There were 16 patients in the PFW group, including 10 males and 6 females, with a BMI of 26.1±3.3 kg/m2 and a median stenosis length of 2.3 cm (range, 1.2~6.0 cm). The operation of both groups was successfully completed, and no serious complications occurred during the operation. The mean operating time (OT) in the OW group was 200.6±41.9 min, the estimated amount of blood loss (EBL) was 25 ml (range, 10~30ml), and the median length of postoperative hospital stay (LHS) was 7.5 days (range 4.0~14.0 days). In the PFW group, the mean operating time (OT) was 211.9±38.3 min, the estimated blood loss (EBL) was 25 ml (range, 5~150ml), and the postoperative hospital stay (LHS) was 6.8±2.0 d. There was no significant difference between the two groups in the above indexes. Postoperative anal exhaust time was 1.0 d (range, 1.0~2.5d) in the PFW group and 1.9±0.5 d in the OW group, with significant difference between the two groups (P=0.009). The mean follow-up time was 36.8±15.9 months, and there was no significant difference between OW group and PFW group in the curative effect of operation. CONCLUSION: Perinephric fat wrapping technique not only avoids the potential effects of using omentum on abdominal organs, it is also as safe and effective as omentum wrapping technique in repairing and reconstructing the ureter using oral mucosal grafts.

A molybdenum sulfide based nitric oxide controlled release oral gel for rapid healing of oral mucosal ulcers.

Oral mucosal ulcer is the most prevalent oral mucosal lesion, affecting over 25 % of general population. The current treatment regimens lack efficacy in addressing challenges such as wound bleeding, bacterial infection and inflammation on a continuous basis. Hence, a multi-functional oral gel (termed MPCST) with a long-acting duration is designed. It is based on a tannic acid-thioctic acid (TATA) supramolecular hydrogel which absorbs tissue exudate while exhibiting robust tissue adhesion properties. To form MPCST, TATA is loaded with MPCS, which are composed of polydopamine (PDA)-coated molybdenum disulfide (MoS2) nanoflakes (MoS2@PDA) with high photothermal conversion efficiency, nitric oxide (NO) precursor nitroprusside (SNP) and cerium oxide (CeO2) with high reactive oxygen species (ROS) scavenging rate. Upon exposure to 808 nm near-infrared (NIR) irradiation, MPCS rapidly heats up and releases NO to promote angiogenesis, while exhibiting strong ROS scavenging, antibacterial (including oral common Streptococcus mutans), and anti-inflammatory properties. Animal experiments show that the MPCST oral gel, composed of MPCS and TATA hydrogel, exhibits superior therapeutic efficacy compared to the commonly used dexamethasone patch.

Effects of Green Tea Extract Epigallocatechin-3-Gallate on Oral Diseases: A Narrative Review.

OBJECTIVES: Oral diseases are among the most prevalent diseases globally. Accumulating new evidence suggests considerable benefits of epigallocatechin-3-gallate (EGCG) for oral health. This review aims to explore the role and application of EGCG in main oral diseases. METHODS: This narrative review thoroughly examines and summarizes the most recent literature available in scientific databases (PubMed, Web of Science, Scopus, and Google Scholar) reporting advances in the role and application of EGCG within the dental field. The major keywords used included "EGCG", "green tea extract", "oral health", "caries", "pulpitis", "periapical disease", "periodontal disease", "oral mucosa", "salivary gland", and "oral cancer". CONCLUSIONS: EGCG prevents and manages various oral diseases through its antibacterial, anti-inflammatory, antioxidant, and antitumor properties. Compared to traditional treatments, EGCG generally exhibits lower tissue irritation and positive synergistic effects when combined with other therapies. Novel delivery systems or chemical modifications can significantly enhance EGCG's bioavailability, prolong its action, and reduce toxicity, which are current hotspots in developing new materials. CLINICAL SIGNIFICANCE: this review provides an exhaustive overview of the biological activities of EGCG to major oral diseases, alongside an exploration of applications and limitations, which serves as a reference for preventing and managing oral ailments.

A Bilayer Polyurethane Patch with Sustained Growth Factor Release and Antibacteria for Re-epithelization of Large-Scale Oral Mucosal Defects.

In the field of oral and maxillofacial surgery, extensive oral soft-tissue injuries occur repeatedly in clinical practice; however, effective restorative materials are lacking. In this study, a biodegradable waterborne polyurethane patch featuring a mucosa bionic bilayer structure is presented. This patch consists of a porous scaffold layer that faces the lesion, incorporating a polydopamine coating to achieve sustained release of epidermal growth factors (EGFs) for mucosal defect reconstruction. Additionally, there is a dense barrier layer toward the oral cavity loaded with silver nanoparticles, which prevents bacteria from entering the wound and simultaneously acts as a physical barrier. This patch can sustainably release EGF in vitro for 2 weeks, thereby facilitating the proliferation and migration of HaCaT and L929 cells, while effectively killing common oral cavity bacteria. In a rabbit buccal mucosal full-thickness defect model, the patch demonstrates better efficacy than the clinical benchmark, decellularized extracellular matrix (dECM). It effectively reduces wound inflammation and significantly upregulates gene expression associated with epithelialization by activating the EGF/epidermal growth factor receptor (EGFR) pathway. These mechanisms promote the proliferation, differentiation, and migration of epithelial/keratinocyte cells, ultimately expediting mucosal defect healing and wound closure.

Diagnostic Utility of Cytomorphometric Evaluation of Exfoliated Oral Mucosal Cells in Type II Diabetes Mellitus: A Systematic Review and Meta-analysis.

Diabetes Mellitus (DM) is the sixth leading cause of mortality and morbidity in the world. Early diagnosis and periodic monitoring are mandatory to prevent complications. The custom of noninvasive exfoliative cytology diagnostic technique is the need of the hour in diabetes, where the invasive methods lose viability. The purpose of this meta-analysis is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of type II diabetes. A thorough search was made by using PubMed, Google Scholar, and Cochrane Library databases. Original research articles, that evaluated cytomorphometric parameters (nuclear area, cytoplasmic area, cytoplasmic nuclear ratio) in type II diabetes patients were included in this review. Risk of bias was analysed for each study using Joanna Briggs Institute and Review Manager was used for meta-analysis. All nine subgroups included for qualitative and quantitative data synthesis revealed that there was a significant increase in nuclear area and a decrease in cytoplasmic nuclear ratio in diabetic patients as compared to non-diabetics. Random-effects model also confirmed cytologically altered (nuclear area and cytoplasmic nuclear ratio) parameters to have a significantly increased risk of association with diabetes. Furthermore, these morphometry parameters were also associated with glycemic control and there was no gender disparity among them. Mounting evidence authenticate that cytomorphometric analysis of oral mucosal cells using exfoliative cytology might be aid as an adjunct non-invasive diagnostic tool for type II diabetes.

Assessment of Quality of Life in Patients with Chronic Oral Mucosal Diseases Using the Indonesian Version of the Chronic Oral Mucosal Disease Questionnaire-15 (COMDQ-15).

INTRODUCTION: Chronic oral mucosal diseases (COMDs) can significantly impair the quality of life (QoL) of affected individuals. Monitoring the overall disease's impact and the efficacy of treatments requires the use of the Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15) as a standardized instrument for measuring QoL in these patients. OBJECTIVE: This study aimed to assess QoL in patients with COMDs using an Indonesian version of the COMDQ-15. METHODS: Seventy patients diagnosed with recurrent aphthous stomatitis (RAS), oral lichen planus, autoimmune blistering diseases (ABD), and cheilitis were included. Levels of QoL among different groups of disease were compared. Various potential factors influencing QoL were evaluated. Bivariate analysis was performed to identify factors associated with overall and specific aspects of QoL. RESULTS: The mean total COMDQ-15 score was 20.83 ± 10.07. The highest scores were in the physical discomfort domain (8.76 ± 4.65), while the lowest was in the medication and treatment domain (2.13 ± 1.99). Physical discomfort was significantly associated with gender, major RAS, and cheilitis. Social and emotional aspects were significantly associated with age and ABD, while patient support was linked to employment status, RAS types, and cheilitis. CONCLUSIONS: The Indonesian version of the COMDQ-15 is a valid and reliable tool for assessing QoL in patients with COMDs.

Early intervention with oral mucosal barrier Protective agents in chronic oral graft-versus-host disease: a retrospective cohort study.

BACKGROUND: Preventing the progression of chronic oral graft-versus-host disease (cGVHD) is essential for maintaining oral health, improving quality of life, minimizing functional impairment, reducing systemic complications, and addressing treatment challenges. PURPOSE: To evaluate the effectiveness of early intervention with oral mucosal barrier protective agents in preventing the progression of cGVHD and its impact on oral health, quality of life, and treatment response. METHODS: This retrospective cohort study included 75 participants, with 34 in the non-oral mucosal barrier protective agent group and 41 in the oral mucosal barrier protective agent group. Baseline characteristics, oral mucosal health parameters, quality of life assessments, and curative effect data were collected and compared between the two study groups. RESULTS: The group receiving oral mucosal barrier protectants (n = 41) exhibited significantly lower severity of oral mucositis compared to the group without such protectants (n = 34) (2.12 ± 0.48 vs. 2.56 ± 0.63, P = 0.001) and the incidence of complications was significantly lower in the group receiving oral mucosal barrier protectants (P < 0.05). Additionally, the quality of life assessment showed marked improvements in somatization, emotional management, and social reintegration in the oral mucosal barrier protectant group compared to the group without these protectants (P < 0.05). Furthermore, the assessment of treatment efficacy revealed significantly higher rates of both complete and partial responses in the oral mucosal barrier protectant group, along with a notable reduction in disease progression compared to the group without these protectants (P < 0.001). CONCLUSION: Early intervention with oral mucosal barrier protective agents was associated with improved oral health parameters, enhanced quality of life, and a more favorable treatment response in the context of cGVHD.

Prevalence of Dental Abnormalities, Soft Tissue Pathologies and Occlusion Disorders in Patients with High BMI: A Cross-sectional Study.

PURPOSE: The relationship between body mass index (BMI) and oral disorders remains unclear. This study examined the prevalence and types of dental abnormalities and oral mucosal lesions among female students with obesity attending a Taif University sports centre. MATERIALS AND METHODS: This non-interventional cross-sectional study enrolled female students with high BMI from a university sports facility using a convivence sampling method. The participants were divided into three BMI groups. Data were collected using an interview and by clinical oral examination. Prevalence and oral disorder types and possible mechanisms linking BMI and dental development were evaluated. RESULTS: Ultimately, 86 female students with obesity were analysed. The mean BMI was 42.8 kg/m2, indicating high obesity levels. A weak although statistically significant correlation was observed between age and BMI (r=0.27), indicating that older students had higher BMI. A statistically significant association was observed between BMI and dental abnormalities (p0.05). The dental abnormality prevalence increased with BMI, ranging from 37.5% to 40.7% in the ≤40 and >45 kg/m2 groups, respectively. Most participants (66.3%) had oral mucosal lesions, with the highest prevalence among participants in the 40-45 kg/m2 group (71.4%). CONCLUSION: A statistically significant relationship was observed between BMI and dental abnormalities; obesity may negatively affect oral health.

Herpes Simplex Virus (HSV)-Induced Erythema Multiforme: A Rare Case Report.

A polymorphous recurrent eruption mostly composed of macules, bullae, papules, and target lesions, which are often distributed symmetrically and can spread to distant extremities, and oral mucosae are the features associated with erythema multiforme (EM). Herpes simplex virus (HSV) is a common condition that is associated with EM and manifests in late adulthood. It shows recurrence and is usually diagnosed clinically. Following is a case of HSV-associated EM. A 45-year-old patient visited the outpatient department with complaints of oral ulceration and associated pain and burning sensation. The patient also reported that similar ulcers were seen two months prior to her visit, which resolved on their own and the recurrence was seen two days prior to the visit. The recurrence occurred with more severity of pain and inflammation as compared to previous ulcers. The patient was kept on a combination therapy of antivirals, steroids, silymarin, and multivitamins for four visits with a tapering dose of steroids. Post-treatment, there was no recurrence till date and the patient is able to perform mastication as well as deglutition without any pain or burning sensation.

Epidemiological Trends and Clinicopathological Characteristics of Oral Leukoplakia: A Retrospective Analysis From a Single Institution in Chennai, Tamil Nadu, India.

Background India has a high prevalence of oral potentially malignant disorders and malignant transformation. Cases of oral leukoplakia are not commonly encountered, and only a small cohort of patients undergo biopsies for the same. This study aims to assess the various etiological factors causing leukoplakia, the clinical features, histopathological findings, and treatment received by the patients who were histopathologically diagnosed with oral leukoplakia. Methodology Oral leukoplakia cases were included in this study from total biopsy samples received in the oral pathology department. Details were collected from the Dental Information Archival Software of our institution. The period analyzed was from January 1, 2021, to December 31, 2023. Relevant clinical and histopathological details were retrieved and tabulated. Statistical analysis (chi-square test) was used to assess the association between the clinicopathological parameters using SPSS software version 21.0 (IBM Corp., Armonk, NY, USA) with a significance level set at a p-value <0.05. Results A total of 76 oral leukoplakia cases were retrieved from 2,600 biopsy samples. The prevalence of oral leukoplakia was 3.1% to 3.4% for the three years. Leukoplakia was commonly observed in those aged 51 to 60 years (33%). Overall, 21% of the patients with leukoplakia showed severe epithelial dysplasia, 22% showed mild epithelial dysplasia, and 39% showed moderate epithelial dysplasia. Moreover, 30% of the patients presented with leukoplakia and oral submucous fibrosis and showed varying degrees of epithelial dysplasia. Finally, 45% of the patients were managed conservatively using pharmacotherapy. Conclusions Severe epithelial dysplasia was commonly associated with oral leukoplakia. Oral submucous fibrosis was also found to be associated with leukoplakia and showed epithelial dysplasia. None of our proliferative verrucous leukoplakia cases showed any association with oral submucous fibrosis. Surgical management was the preferred treatment.