Multimodal imaging of white preretinal lesions in atypical familial exudative vitreoretinopathy: Case report and literature review.

Purpose: To report a rare clinical finding of preretinal granules associated with atypical familial exudative vitreoretinopathy (FEVR) and perform a review of the literature. Observations: An asymptomatic 18-year-old male was referred for unilateral peripheral avascular retina evaluation in association with presumed FEVR. He was first noted to have white preretinal granules on fundus examination at five years of age. The lesions remained unchanged over the subsequent years. Genetic testing did not reveal a pathogenic or likely pathogenic variant in a known FEVR gene. A review of the literature revealed five other cases of FEVR with similar findings. Conclusions and Importance: Literature review suggests preretinal granules may present rarely in FEVR. Negative genetic screening of known FEVR genes in our patient with atypical FEVR suggests either a molecularly distinct etiology supporting the rarity of this association with FEVR or, alternatively, the presence of granules in developmental retinal vascular anomalies that are not specific to FEVR. Future study and genetic testing is necessary to better understand the cause of these preretinal granules and the clinical manifestations of FEVR.

The Magic Triangle in Oral Potentially Malignant Disorders: Vitamin D, Vitamin D Receptor, and Malignancy.

OPMDs (oral potentially malignant disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of various diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also suggest a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD-VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD and investigate their potential association and ramifications for clinical management of OPMDs.

Reactive and Nonreactive White Lesions of the Oral Mucosa.

White lesions in the oral cavity may be diverse in etiology and may present with significant clinical and sometimes histologic overlap between categories, making accurate diagnosis difficult at times. Although white lesions of immune and infectious etiology are covered in another article, this article discusses the differential diagnosis between developmental, reactive, idiopathic, premalignant, and malignant white lesions focusing on clinical features of each category.

The Correlation of Swedish Snus, Nicotine Pouches and Other Tobacco Products with Oral Mucosal Health and Salivary Biomarkers.

In society, tobacco products, such as e-cigarettes, and smokeless tobacco products, such as snus and nicotine pouches, are becoming more attractive. There is still a lack of information regarding the effects of these products on the oral mucosa and oral saliva biomarkers. The aim of this study is to evaluate oral mucosa and the presence of inflammatory biomarkers IL-6, IL-1, IL-8, TNF alpha and LRG-1 in saliva. Respondents were divided in four groups based on their tobacco product usage. Oral examination was carried out, saliva samples were taken, and the detection of IL-6, IL-8, IL-1, TNF alpha and LRG-1 levels in saliva was carried out. Out of the tobacco users, 30.8% were snus users, 48.7% were cigarette users and 20.5% were e-cigarette users. The control group was composed of respondents who did not use any tobacco products. E-cigarettes were used more by women, but snus was used more by men. Mucosal changes were seen in the group of snus users, and mucosal changes were only seen in men who had used 5-10 tobacco units per day for 5-10 years. Increased IL-6 levels in saliva were detected in respondents who also experienced mucosal changes. Mucosal changes were white, leathery and localized at the site where snus sachets were placed. Saliva, as an easily available biofluid, could be used as a first tool to detect potentially precancerous signs, but the LRG1 marker cannot be used as a prognostic marker.

Acquired White Oral Lesions with Specific Patterns: Oral Lichen Planus and Lupus Erythematosus.

BACKGROUND: Diagnosis of oral white lesions might be challenging. These lesions represent a wide spectrum of diseases with different etiology and prognosis. Oral white lesions can be categorized into two major groups, congenital and acquired, according to their development, and in four subgroups: lesions which can be scraped off or not and lesions with special pattern or not. OBJECTIVES: The aim of this manuscript is to review, from diagnosis to treatment, the current knowledge on oral white lesions with specific pattern. METHODS: A review on oral white lesions with specific pattern was conducted on PubMed and Scopus from inception to January 2021. RESULTS: Among acquired lesions with specific pattern two clinical entities are mostly represented: Oral lichenoid reactions and Lupus erythematosus. The etiology of both diseases is still not known but their pathogenesis is mainly immunological. At present the mucoscopic features of those disease have been described only in few case reports or case series. Immunomodulatory therapies are often the agents of choice for their treatment. CONCLUSIONS: The collaboration of dermatologists and dentists as a team is important for early diagnoses and effective treatments. Mucoscopy is a promising technique which may reveal important features for the differentiation of OLP and LE oral white lesions.

Potencial de transformación maligna de las lesiones blanquecinas bucales / Potential for malignant transformation of whitish oral lesions

Introducción: Las lesiones blanquecinas bucales con potencial maligno, son un grupo reconocible de enfermedades de las mucosas, que preceden a la aparición de cánceres invasivos de la cavidad bucal. Objetivo: Determinar el potencial de transformación maligna de las lesiones blanquecinas de la cavidad bucal. Métodos: Se realizó un estudio observacional, descriptivo y transversal, de enero del año 2016 hasta enero de 2020, de todos los pacientes que acudieron al servicio de Cirugía Maxilofacial, con lesiones blanquecinas bucales. Las variables utilizadas fueron: edad, sexo, factores de riesgo, tiempo de evolución, sitio de la lesión, diagnóstico histológico y potencial de transformación maligna. Se exploró asociación mediante ji cuadrado. Resultados: Se encontraron lesiones con potencial de transformación maligna en el 24 por ciento de los mayores de 50 años, en el 24,3 por ciento de los hombres y en el 40 por ciento de pacientes con queilitis actínicas. El 83,3 por ciento fueron leucoplasias y entre ellas, el 20 por ciento con potencial de transformación maligna. Conclusiones: La leucoplasia es el diagnóstico histológico más común. Las lesiones con potencial de transformación maligna aumentan con la edad, son mayores en los hombres y en pacientes con queilitis actínicas. Los sitios anatómicos en que más aparecen son: paladar blando y labio superior; entre los factores de riesgo de mayor asociación está la exposición al sol(AU)

Introduction: Potentially malignant whitish oral lesions are a recognizable group of mucosal diseases that precede the appearance of invasive cancers of the oral cavity. Objective: To determine the potential malignant transformation of whitish lesions in the oral cavity. Methods: An observational, descriptive and cross-sectional study was carried, from January 2016 to January 2020, of all patients who attended the Maxillofacial Surgery service with whitish oral lesions. The variables used were: age, sex, risk factors, time of evolution, and site of the lesion, histological diagnosis and potential for malignant transformation. To explore the association between categorical variables, the Chi square distribution was used. Results: Lesions with the potential for malignant transformation were found in 24 percent of those over 50 years of age, in 24,3 percent of men and in 40 percent of patients with actinic cheilitis. 83,3 percent were leukoplakia, and among them 20 percent with the potential for malignant transformation. Conclusions: Leukoplakia was the most common histological diagnosis. Lesions with the potential for malignant transformation increased with age, were greater in men and in actinic cheilitis patients. The anatomical sites in which they appeared most were on the soft palate and upper lip and among the risk factors with the greatest association was sun exposure(AU)

A randomized clinical study of the treatment of white lesions of the vulva with a fractional ultrapulsed CO2 laser.

BACKGROUND: White lesions of the vulva are a common vulvar disease of unclear etiology. Although a variety of treatments have been used to treat the disease in clinical practice, there is currently a lack of effective radical therapies. This study aimed to compare the feasibility and effectiveness of fractional ultrapulsed CO2 laser with that of high-intensity focused ultrasound in the treatment of white lesions of the vulva. METHODS: A total of 60 patients with pruritus vulvae who were treated at the Center for Diagnosis and Treatment of Cervical Diseases in our hospital between December, 2017, and December 2018 were enrolled in this study. The possibility of malignant lesions of the vulva was ruled out by histopathological diagnosis following colposcopic biopsy. The patients were randomly divided into two groups: a laser treatment group (group L, n=30) and a focused ultrasound treatment group (group U, n=30). The patients were monitored for changes in signs and symptoms during and after treatment, and the treatment outcomes of the two groups were compared. RESULTS: The local symptoms of pruritus were alleviated by both the fractional ultrapulsed CO2 laser and high-intensity focused ultrasound. The patients in group L had no significant adverse reactions during the operation and needed no special postoperative treatment. The total effective rate in group L was 96.7%. In group U, five patients felt mild burning during the operation, painful blisters arose on the skin of the ablated area, and long-lasting local edema was observed. Seven patients had subcutaneous nodules. The total effective rate in group U was 90.0%. CONCLUSIONS: Fractional ultrapulsed CO2 laser is a minimally invasive, effective, and safe treatment for white lesions of the vulva. It causes few complications and does not affect the daily and working life of patients. Therefore, it should be widely applied in clinical practice.

Incidental Finding of Oral White Lesions Due to Tobacco Chewing - A Case Report.

The diagnosis of oral white lesions might be quite challenging. White lesions are only 5% of all oral pathologies. Smokeless tobacco (ST), also known as tobacco chewing, spit tobacco, dip, plug, or chew, is one of the well-documented agents that causes white lesions. The use of ST is associated with a variety of oral cavity lesions, including tooth decay, periodontal disease, tooth loss, leukoplakia, keratosis, oral cancers such as carcinoma-in situ, verrucous carcinoma, and invasive squamous cell carcinoma. The prevalence and severity of lesions are dose related. Therefore, it can be best predicted by the amount, frequency, and duration of ST used. This case report highlights an unusual presentation of an adolescent child presenting in the orthodontic retention phase that was originally misdiagnosed as gingival recession due to treatment. A clinical examination of the oral cavity and careful history taken should be routinely performed in every patient presenting at a dental office.

White sponge nevus: A condition not always clinically suspected.

White sponge nevus (WSN) is an uncommon benign inherited disorder characterized by white and diffuse painless lesions in oral, esophageal, or genital mucosa. The lesions may develop at birth or later in childhood or adolescence, with careful clinical examination being sufficient for diagnosis in most cases. However, microscopic analysis may be necessary particularly in adults in which other whitish oral lesions may be clinically suspected. Dermatologists, dentists, and pathologists should consider WSN when evaluating multiple white oral lesions, thus preventing unnecessary treatments. Herein, we report four additional cases of WSN with emphasis on its clinical and histopathological features.

Remineralization of Demineralized Enamel and Dentine Using 3 Dentifrices-An InVitro Study.

Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each group was exposed to one test dentifrice [Colgate PreviDent (5000 ppm F), Colgate Winterfresh gel (1100 ppm F), Fluocaril Bi-Fluoré (2500 ppm F) and placebo (without fluoride)] three times daily for three minutes for 4 weeks. In between exposure to the test dentifrices, teeth were stored in a saliva storage solution. An Electrical Caries Monitor measured the electrical resistance at baseline and during the four-week test period at weekly intervals. The measurements were log transformed and Duncan's multiple range test applied. Remineralization was quantified using transversal microradiography. Results: Log mean (SD) electronic carries monitor (ECM) measurements in enamel at baseline and after 4 weeks of exposure to the test dentifrices were 4.07(1.53) and 3.87(0.90) (Placebo-Fluocaril), 4.11(1.86) and 4.64(1.43) (Colgate Winterfresh gel), 4.81(0.9) and 4.21(1.20) (Fluocaril Bi-Fluoré), and 4.60(0.88) and 3.76(0.9) (Colgate PreviDent). Corresponding measurements in dentine were 2.13(0.89) and 3.06(0.87) (Placebo-Fluocaril), 1.87(0.63) and 2.88(1.32) (Colgate Winterfresh gel), 2.47(1.20) and 1.65(0.60) (Fluocaril), and 2.16(0.00), and 2.34(1.07) for Colgate PreviDent. Lesion depth (µm) after microradiography in enamel was 100.1 (Placebo), 50.6 (Colgate Winterfresh gel), and 110.2 (Fluocaril, and 97.1 (Colgate PreviDent), and corresponding values in dentine were 169.7, 154.8, 183.7, and 153.5. The correlation of ECM and microradiographic parameters was negative (p < 0.05). Conclusion: Exposure of artificially demineralized enamel and root dentine to fluoridated dentifrices and saliva storage solution resulted in remineralization as follows: Colgate Winterfresh > Colgate PreviDent > Placebo-Fluocaril > Fluocaril Bi-Fluoré. Remineralization in teeth of the Placebo dentifrice group may be attributed to the presence of calcium and phosphate ions in the saliva storage solution.

White Sponge Nevus: Report of a Case and Review of the Literature.

White sponge nevus is a rare benign autosomal dominant disorder with variable penetrance. It is characterized by asymptomatic white plaques affecting mainly the oral mucosa. Careful clinical and histopathological examination is indicated to exclude other more serious conditions presenting as oral white lesions. Herein, we present a new case of oral white sponge nevus in a 17-year-old Iranian male with no familial background.

Evaluation of Different Laser-Supported Surgical Protocols for the Treatment of Oral Leukoplakia: A Long-Term Follow-Up.

PURPOSE: The aim of this study was to evaluate the long-term success rate of oral leukoplakia treatments by using different laser-supported surgical protocols. PATIENTS AND METHODS: Overall, 2347 diagnosed homogeneous oral leukoplakias were treated with CO2 laser and were included in this study. Different surgical protocols (P) were used: P1 (SV = superficial scanning) was a complete superficial vaporization of the leukoplakia by a scanning mode in two passages respecting an overlapping. Only the visible white area was treated in one surgical session independently of the lesion size. P2 (CR1x1) was a complete excision of the lesions until a tissular depth of 1 mm and 1 mm of surrounding healthy-like tissue were attained. The visible white area was treated in one surgical session independently of the lesion size. P3 (CR1x3) was a complete excision of the lesions until a minimum tissue depth of 1 mm and 3 mm of surrounding healthy-like tissue were obtained. The visible white area was treated in one surgical session independently of the lesion size. P4 (PR1x3) was similar to the third one, but for patient comfort, the large lesions of leukoplakias (lesion size higher than 20 mm), the complete surgical excision of the leukoplakia was performed in multiple sessions that were spaced by 1 month (partial surgical removal of 10 mm per session). All patients were recalled at 2 and 8 weeks after surgery, and then every 2 months during the first year, every 4 months during the second year, and once a year for the follow-up period of 6 years. A biopsy was done once a year during the follow-up period in the surgical site when needed. The control consisted of checking the nature and the aspect of the healed mucosa to exclude an eventual recurrence of leukoplakia. RESULTS: The percentage of permanent success after 6 years of follow-up was 5.7%, 69.7%, 97.8%, and 71.9%, respectively, for the first surgical protocol (SV), the second (CR 1 × 1), the third (CR 1 × 3), and the fourth (PR 1 × 3). The appearance of malignant transformation after laser treatment (during the follow-up period of 6 years) was 20%, 1%, and 0.2%, respectively, for the groups treated by the following protocols: 1 (SV), 2 (CR 1 × 1), and 4 (PR 1 × 3). Only in the third group CR1x3, no dysplasia or malignant transformation was noted. On the contrary, the appearance of malignant transformation in failed treated cases was 21.21% for the protocol 1 (SV), 3% for the protocol 2 (CR 1 × 1), and 0.6% for the protocol 4 (PR 1 × 3). CONCLUSIONS: The results of this long-term follow-up of treated patients with oral homogeneous leukoplakias pointed out that the surgical laser protocol respecting the complete excision of leukoplakias, in one session, by the removal of a minimum of 1 mm in lesion depth and 3 mm of surrounding healthy-like tissues (CR 1 × 3) offers significantly the highest success rate.

Expresión de E-cadherina y factor de crecimiento epidérmico en leucoplasias orales / Expression of E-cadherin and epidermal growth factor in oral leukoplakia

Introducción: se define a las leucoplasias orales como una placa blancaque no puede desprenderse por raspado y que no puede clasifi carse comoninguna otra lesión. Son lesiones con potencial maligno, relacionadascon la presencia de displasia epitelial. Estos cambios preneoplásicospueden ser evidenciados histológicamente como también a travésde técnicas que pongan en evidencia los diferentes cambios a nivelmolecular. La E-cadherina es una glicoproteína membranosa quedesempeña papeles importantes en el mantenimiento de la adhesióncélula-célula, la preservación de la polaridad del tejido epitelial y laintegridad estructural. Los factores de crecimiento epidérmico son unconjunto de moléculas de naturaleza proteica, biorreguladores, cuyafuncionalidad fundamental radica en el control del ciclo celular. Elobjetivo del presente trabajo es identifi car y comparar parámetros histológicosy moleculares predictores de riesgo de transformación malignaen leucoplasias orales. Material y métodos: El estudio correspondea un diseño observacional descriptivo. Se seleccionaron muestras de26 biopsias de leucoplasias orales, las cuales fueron evaluadas contécnica histológica de rutina y tinción con hematoxilina y eosina, luegosometidas a inmunomarcación con factor de crecimiento epidérmico yE-cadherina, donde se evaluó la intensidad de tinción y cambios en laexpresión de cada marcador, así como la localización en los diferentessubtipos celulares. Resultados: De las 26 leucoplasias observadas,16 mostraron histología con cambios hiperplásicos y 10 con cambiosdisplásicos leves a moderados. La expresión de E-cadherina no mostróalteraciones signifi cativas en leucoplasias sin displasia, sólo hubopérdida de expresión en aquellas leucoplasias con cambios displásicosde alto grado, en concordancia a los hallazgos histológicos...

Introduction: oral leukoplakia is defined as a white plaque thatcannot be removed by scraping and cannot be classifi ed as any otherdisease entity. They are potentially malignant lesions related to thepresence of epithelial dysplasia. These preneoplastic changes can bedetected histologically, as well as through techniques that demonstratediff erent changes at the molecular level. E-cadherin is a membraneglycoprotein that plays a major role in maintaining cell-cell adhesion,preserving structural integrity and the polarity of epithelial tissue.Epidermal growth factors are a group of bio-regulatory proteins,whose primary function is to control the cell cycle. The aim of thisstudy is to identify and compare the parameters for histological andmolecular markers for malignant transformation in oral leukoplakia.Material and methods: The study was observational and descriptive indesign. Samples were selected from 26 oral leukoplakia biopsies, whichwere routinely evaluated for histology and stained with hematoxylinand eosin, then subjected to immunostaining with epidermal growthfactor and E-cadherin, with the intensity of staining and changes inthe expression of each marker being evaluated. Results: Of the 26leukoplakia examined, 16 showed hyperplastic changes and 10 mildto moderate dysplastic changes. The expression of E-cadherin showedno signifi cant changes in non-dysplastic leukoplakia, while a lossof expression was found in only those leukoplakias with high-gradedysplastic changes, which was consistent with the histological fi ndings...

Clinical and cytological study of the oral mucosa of smoking and non-smoking qat chewers in Yemen.

OBJECTIVE: The study was conducted to investigate the role of qat and smoking habits on the prevalence of visible and cytological abnormalities in the oral mucosa among Yemenites. METHODS: We recruited 30 non-smoking and 30 smoking Yemenites chewing qat unilaterally for at least 5 years. We inspected oral cavities for the presence of lesions and took brush biopsies from the buccal mucosa/gingiva of the chewing/non-chewing region. RESULTS: All visible oral lesions were flat and homogeneous, and cytological changes were detected frequently. Among both non-smokers and smokers, white lesions and cytological changes were detected in 77% of all cases. On the chewing area, the proportion with white lesions ranged--depending on anatomical area and smoking status--between 47 and 93% and was significantly more frequent than on the non-chewing side (range 3-47%). The proportion of regions with changes was similar in non-smokers and smokers. Kappa statistics for "interobserver" agreement between visual inspection and cytological specimens of brush biopsies was at best fair (≤0.25). CONCLUSIONS: The high prevalence of visible lesions and cytological abnormalities among qat chewers was independent of smoking status. CLINICAL RELEVANCE: The moderate level of agreement between visual inspection and exfoliative cytology demonstrates the still challenging clinical management of chronic qat chewers, though brush biopsies including adjuvant techniques like DNA cytometry may support the clinical decision-making process in future.

Lesiones blancas de la cavidad bucal. Concordancia Diagnóstica / Diagnostic concordance of white lesions of oral cavity

Introducción: las lesiones bucales resultan un fuerte indicador del estado de salud del individuo, y dentro de estas, las lesiones de apariencia blanquecina están sujetas a errores diagnósticos dada su similitud y variada forma de presentación.Objetivo: determinar la concordancia existente entre el diagnóstico clínico e histopatológico de lesiones bucales blanquecinas, así como caracterizar dichas lesiones socio-demográficamente y distribuirlas topográficamente. Material y Métodos: se realizó un estudio descriptivo retrospectivo de corte transversal en una muestra de 52 pacientes del total con lesiones de apariencia blanquecina en la cavidad bucal sometidos a biopsia para confirmar diagnóstico en el Departamento de Cirugía de la Facultad de Estomatología Raúl González Sánchez, en el período comprendido de enero 2013 a diciembre 2013. Se tomaron datos sociodemográficos y diagnósticos de modelo de solicitud de biopsia, informe histopatológico y registro estadístico de la Institución. La información recogida fue sometida al estadígrafo Índice de Kappa para evaluar concordancia de diagnóstico clínico e histopatológico.Resultados: pacientes con edades entre 40 y 49 años resultaron los más afectados (28,85 por ciento). Predominaron lesiones blanquecinas en pacientes de piel blanca (59,62 por ciento) y femeninas (61,54 por ciento). Un 34,33 por ciento de las lesiones se ubicaron en la mucosa del carrillo. Clínicamente, 50 por ciento de las lesiones clasificaron como leucoplasia e histopatológicamente 42,31 por ciento. Existió muy buena concordancia entre ambos diagnósticos para leucoplasia (k=0,84) liquen plano (k=0,83). La concordancia total del grupo resultó buena (k=0,79). Conclusiones: la concordancia total de la muestra fue buena, aunque la concordancia diagnóstica de leucoplasia y liquen plano clasificó como muy buena(AU)

Introduction: the buccal lesions are a strong indicator of the state of the individual's health, and inside these the white lesions are subject to be misdiagnosed due to their similarity and varied presentation form. Objective: to determine the concordance between the clinical and histopathological diagnosis of buccal white lesions, as well as to characterize these lesions social-demographically and to distribute them topographically. Material and Methods: a cross sectional descriptive retrospective study was conducted in a sample of 52 patients of the total of patients with buccal white lesions to be biopsied in the Department of Surgery of Dentistry College Raúl González Sánchez in the period January 2013 to December 2013. The Sociodemographic and diagnostics data were obtained from the Biopsy request model and histopathological report .The information was subjected to kappa index to evaluate the concordance between clinical and histopathological diagnosis. Results: patients with ages between 40-49 were more affected (28,85 percent).White lesions prevailed in female( 61,54 percent) and white race people (59,62 percent). 34,33 percent was located in the cheek mucous. 50 percent was clinically diagnosed like leukoplakia and confirmed histologically in 42.31 percent. The concordance was very good in the diagnosis of leukoplakia (k=0,84) and lichen planus (K=0,83). The total concordance of the group was good (k=0,79). Conclusions: the total concordance of the studied sample was good, although the diagnostic concordance to leukoplakia and lichen planus were very good(AU)

Estimation of Circulating Immune Complexes in patients with Oral Leukoplakia and Oral Submucous Fibrosis: A Case Control Study.

PURPOSE OF THE STUDY: The present study was conducted to estimate the serum levels of Circulating Immune Complexes in patients with Oral Leukoplakia ,Oral sub mucous fibrosis and normal subjects and correlate these values with the clinical grades of the diseases. MATERIALS AND METHODS: The study consisted of 25 Oral Leukoplakia patients, 25 Oral sub mucous fibrosis patients and 25 Normal subjects. RESULTS: The mean serum levels of CIC showed a gradual increase from normal subjects to Oral Leukoplakia patients and showed a high values in Oral sub mucous fibrosis patients. The mean serum levels of CIC also showed a gradual increase from clinical grade I to grade IV of Oral sub mucous fibrosis. CONCLUSION: Serum levels of CIC may be taken as a prognostic marker for disease progression of patients with Oral Leukoplakia and Oral sub mucous fibrosis.

Prevalence of oral white lesions due to qat chewing among women in Yemen.

OBJECTIVES: To investigate oral mucosal white lesions due to qat chewing among Yemeni women and their possible confounders (tobacco, water-pipe). PATIENTS AND METHODS: In a cross-sectional hospital study, 162 healthy women were divided into 109 qat chewers and 53 non-qat chewers. Inclusion criteria were as follows: ≥20 years of age, chewing qat habitually ≥5 years on one side. Women were interviewed about tobacco/water-pipe use and examined for oral mucosal lesions. RESULTS: Among chewers, white lesions were recorded in 82/109 (75.2%) at the chewing site. Lesions on the opposite side were recorded among 6/109 (5.5%) and among 7/53 (13.2%) non-chewers. Lesions reported among chewers were correlated with the side of chewing and with longer duration of the habit. The difference in the prevalence of white lesions present between cases and controls was significant (P < 0.000). When white lesions were correlated with the durations of chewing and water-pipe and cigarette smoking, results in terms of chewing were highly significant (P = 0.000) and those in terms of water-pipe smoking and cigarette smoking were not significant. CONCLUSION: Habitual chewing of qat fibres by Yemeni women over decades caused mucosal white lesions recorded on the chewing side irrespective of additional noxae as tobacco and water-pipe smoking.

White lesions in the oral cavity: a clinicopathological study from a tertiary care dermatology centre in kerala, India.

CONTEXT: White lesions in the oral cavity may be benign, pre-malignant or malignant. There are no signs and symptoms which can reliably predict whether a leukoplakia will undergo malignant change or not. Many systemic conditions appear initially in the oral cavity and prompt diagnosis and management can help in minimizing disease progression and organ destruction. AIM: The aim of the paper was to study the clinical and histopathological patterns of white lesions in the oral cavity presented at the study setting and to study the factors associated with the histopathological patterns of the lesions. SETTINGS AND DESIGN: A hospital based cross-sectional study of patients with white lesions in the oral cavity attending the Department of Dermatology and Venereology, Medical College, Thiruvananthapuram was done. MATERIALS AND METHODS: After taking a detailed history, microscopic examination of Potassium hydroxide smear and an oral biopsy with histopathologial examination was done. RESULTS: Out of the 50 patients in the study, clinically the diagnoses made were Lichen planus (32 patients; 64%), Frictional Keratosis (4;8%), Dysplasia (2;4%), Oral Hairy Leukoplakia (1;2%), Pemphigus Vulgaris (2;4%), Cutaneous Lupus Erythematosus (1;2%), Oral Submucous fibrosis (3;6%) and Oral Candidiasis alone (5;10%). Out of the 45 patients who had undergone biopsy, 25 (55.6%) had Lichen planus, 9 (20%) had Frictional Keratosis and mild Dysplasia was found in 4 (8.9%) patients. CONCLUSION: The measure of agreement between the clinical and pathological diagnosis was only 32%. Older age, difficulty in opening the mouth, consumption of non-smoked tobacco, site of the lesion (gingival, floor of mouth or lingual vestibule) and presence of tenderness on the lesion were significantly associated with Dysplasia.

Is the 810-nm diode laser the best choice in oral soft tissue therapy?

OBJECTIVE: To evaluate the safety and efficacy of an 810-nm diode laser for treatment of benign oral soft tissue lesions. MATERIALS AND METHODS: Treatment with the 810-nm diode laser was applied to a group of eighteen patients with pathological frenulum and epulis fissuratum; five patients with oral lichen planus, oral leukoplakia, and mucous membrane pemphigoid; and four patients with pyogenic granuloma. RESULTS: Although the conventional surgery wound heals in a fairly short time, in the present study, the simple oral soft tissue lesions healed within two weeks, the white and vesiculobullous lesions healed completely within six weeks, and the pyogenic granuloma lesions healed within four weeks. Any complication was treated by using the 810-nm diode laser. CONCLUSIONS: Patient acceptance and satisfaction, without compromising health and function, have been found to be of a high degree in this present study. Thus, we can say that the use of the 810-nm diode laser may indeed be the best choice in oral soft tissue surgery.