Appearance Of Oral Lesions Research Articles

Pyodermatitis-pyostomatitis vegetans: a case report and systematic review focusing on oral involvement

BackgroundPyodermatitis-pyostomatitis vegetans (PPV) is a rare mucocutaneous disease characterized by multiple pustules and it is considered a marker for inflammatory bowel disease (IBD). The oral manifestations of this condition are referred to as pyostomatitis vegetans (PSV).PurposeTo investigate which features could help in establishing the diagnosis of PSV, with or without cutaneous lesions, based on information retrieved from all cases of PSV described in the literature. A case of PV from the authors was also included in the analysis.MethodsAn electronic search was undertaken, last updated in August 2022. Inclusion criteria included publications reporting cases of PSV, with the diagnosis confirmed by the pathological examination of oral or skin lesions, and presence of IBD.Results/ConclusionsSixty-two publications with 77 cases of PSV and an associated IBD were included. Features that are helpful in establishing the diagnosis of PSV are snail track appearance of oral lesions, an associated IBD (which is not always symptomatic), evidence of intraepithelial clefting on microscopic examination of oral lesions, and peripheral blood eosinophilia. A gold standard for the management of PSV does not exist and high-level evidence is limited. There is no established therapeutic protocol for PSV and management primarily consists of topical and/or systemic corticosteroids, antirheumatic drugs (sulfasalazine, mesalazine), monoclonal antibody (infliximab, adalimumab) immunosuppressives (azathioprine, methotrexate), antibiotics (dapsone), or a combination of these. The risk of recurrence of oral lesions is considerable when the medication dose is decreased or fully interrupted.

Oral Cancer Prediction Using a Probability Neural Network (PNN).

In India, usually, oral cancer is mostly identified at a progressive stage of malignancy. Hence, we are motivated to identify oral cancer in its early stages, which helps to increase the lifetime of the patient, but this early detection is also more challenging. The proposed research work uses a probabilistic neural network (PNN) for the prediction of oral malignancy. The recommended work uses PNN along with the discrete wavelet transform to predict the cancer cells accurately. The classification accuracy of the PNN model is 80%, and hence this technique is best for the prediction of oral cancer. Due to heterogeneity in the appearance of oral lesions, it is difficult to identify the cancer region. This research work explores the different computer vision techniques that help in the prediction of oral cancer. Oral screening is important in making a decision about oral lesions and also in avoiding delayed referrals, which reduces mortality rates.

Doctoral: A smartphone-based decision support tool for the early detection of oral potentially malignant disorders.

Oral potentially malignant disorders can be defined as mucosal lesions and conditions with an increased risk of malignant transformation. Oral potentially malignant disorders are a significant health burden, and they are often diagnosed late due to scant attention to routine dental practice and the low number of specialized oral medicine centres. This report summarizes the DoctOral experience, a research initiative, providing a free smartphone-based decision support tool for the general medical/dental practitioner; the tool is based on the clinical appearance of oral lesions. Captured, oral pictures can be immediately examined via interactive decision trees and constructed on the smartphone. Such decision trees are expressed in standard formats, and they are readily accessible for facilitating the completion of a hypothetical diagnostic path. Since October 2017 the DoctOral mobile app has been downloaded by 10K + users, achieving a score of 4.8 out of 5. DoctOral also supports an unfolding joint initiative, called DoctOralAI: this involves selecting reference images, with which to create an open-source model, and perform a Case-Based Reasoning method, both of which are combined with machine learning. The DoctOral mobile app has revolutionized oral pathology by providing dental students and professionals with an interactive platform for recognizing and diagnosing oral lesions.

Population-based cohort study to assess the gingival lesions in 1319 patients with lichen planus.

Oral lichen planus (OLP) is a chronic immune disease. In this paper, we evaluated the overall characters, clinical presentation, and outcome of gingival lesions in OLP Italian patients. A retrospective cohort study was accomplished: a total of 1319 charts were investigated, of whom 922 were female (69.9%): 617 patients (46.8%) manifested white lesions and 702 red ones (53.2%). While most patients had several oral sites of involvement, the gingiva was the unique location in 103 cases. Symptoms were reported in 480 patients (36.4%): 286 patients with erosive OLP, 103 with atrophic form, and 91 with a white form. Long-lasting surveillance showed that only 40 patients (3.03%) had a total clinical signs remission. Regarding OLP medical treatment provided, patients attending less frequently a dental office underwent more often a specific therapy. To the best of our knowledge, this is the biggest collections of patients with gingival OLP ever described; exclusive gingival lesions are, however, rare and unlikely to undergo a malignant transformation. Moreover, gum lesions seemed to anticipate the appearance of oral lesions and a higher rate of OLP therapy was observed in patients with less frequent dental check-ups and oral hygiene instructions.

Conservative treatment with mouthwashes followed by tongue photo biomodulation therapy in Covid-19: a case report

BackgroundOral manifestations of coronavirus disease 2019 (COVID-19), including ulcers, herpetiform lesions, macules, and petechiae, among others, are becoming increasingly recognized, but there is little guidance on their treatment. Reported cases have described treatment with various mouthwashes containing antivirals, antifungals, antibiotics, anesthetics, or steroids. Our case report is unique in that we provide guidance on the judicious use of these medications, followed by photobiomodulation therapy if the manifestations are treatment resistant.Case presentationWe describe a 30-year-old Caucasian woman who tested positive for COVID-19 after developing nasal congestion and cough. Ten days after testing positive, she developed a systemic rash on her extremities and torso. At the same time, she developed swelling of the tongue lasting 1 hour, with subsequent appearance of oral lesions that resembled geographic tongue. She also had an irritable sensation on her tongue and some mild loss of sense of taste. We opted for conservative therapy, including mouth rinses containing lidocaine to be used every 6 hours. The patient used the mouth rinse therapy for 1 month and experienced a 90% improvement in her oral lesions and tongue sensitivity. However, she had repeated flares every 3 weeks over a 6-month period, and the steroid mouthwash achieved incomplete resolution. After three sessions of photobiomodulation therapy, she had no further flares or tongue sensitivity and the lesions healed.ConclusionsThe implication of our report is that we promote the judicious use of topical antibiotics, antivirals, antifungals, and steroids for when they are indicated. We propose lidocaine-containing mouth rinses and steroid mouthwash as an initial, symptomatic treatment regimen for ‘COVID-19 tongue.’ If there is failure of resolution, we recommend photobiomodulation therapy.

The Reported Oral Manifestations of COVID 19 Viral infection: A Review Article

The new SARS-CoV-2 virus has become a worldwide emergency. It is recognized as a multiorgan disease and post-acute sequalae are seen in many systems. Many oral symptoms have been reported in relation to COVID-19. Cause- effect relationship between coronavirus and the appearance of such oral lesions still cannot be established. Immunosuppression state of positive cases could explain appearance of oral lesions. Oral hygiene is an aspect that should not be left aside, and it is of great importance to encourage the patient to reinforce hygiene techniques.

Major clinical findings of the oral hygiene relationship and increase in the predisposition to COVID-19: a systematic review

Introduction: The disease caused by the novel coronavirus 2019 (COVID-19) is caused by a newly identified virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus. In particular, poor oral hygiene, opportunistic infections, stress, immunosuppression, vasculitis, and a hyperinflammatory response secondary to COVID-19 are the most important predisposing factors for the appearance of oral lesions in patients with COVID-19. Objective: It was to highlight the main clinical studies on the relationship between hygiene and care in the oral cavity to reduce the chances of contamination with COVID-19, as well as to observe the interrelation between poor oral hygiene and the increased risk of this contamination. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from March 2022 to May 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 124 articles were found. In total, 42 articles were fully evaluated and 10 were included and evaluated in this study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 42 studies that were excluded with a high risk of bias (studies with small sample size). Also, 30 studies were excluded because they did not meet the GRADE. COVID-19 affects oral health most likely in patients with serious illness, which may be due to the disease itself, immune response, and lack of motivation for personal hygiene measures. Furthermore, the results indicated that gargling with mouthwashes composed of unique antiseptic agents may play a minor role in potentially reducing transmission rates, and therefore these findings are of utmost importance when considering alternative COVID-19 prevention strategies.

Clinical appearance of oral lesions in bronchial asthma patients using inhalation drug

Introduction: Inhalation therapy has become the first-line treatment for bronchial asthma patients. Studies have proved that not all of the inhaled drugs reach the target organ, but mostly are deposited in the mouth and cause local immunosuppressant and decrease saliva secretion. These conditions are closely linked to some adverse effects in the mouth. The purpose of this study was to describe the clinical appearance of oral lesion in bronchial asthma patients using inhalation drugs. Methods: This study was descriptive and conducted on 30 bronchial asthma patients that have been using inhalation drug for at least one year, free of other systemic diseases, not using denture and orthodontic appliances. Oral mucosa was examined, and any oral lesion was recorded. Results: The most number of oral lesions found in patients through clinical examinations were plaque (73.3%), followed by a fissure (36.7%), atrophy (30%), and the least oral lesions found were pigmentation (3.3%), bullae (3.3%), and petechiae (3.3%). The lesions found in patients using inhalation drugs in a range of up to 10 years were found more varyingly. Conclusion: Plaque, fissure, atrophy, pigmentation, bullae, and petechiae are oral lesions that are clinically found in bronchial asthma patients using inhalation drugs.

ASSOCIATION OF STRESS AND ORAL LESIONS

Evidence shows that psychological factors play an important role in the etiology of pathologic conditions that affects the oral cavity. Objective: To investigate the association between stressors and psychological factors with physical symptoms, including the appearance of oral lesions in graduation students of dentistry. Study Design: This is an observational clinical study, in which the evaluation was carried out through the inventory of stress symptoms for adults of LIPP-ISSL. Questionnaires were applied in 2 moments: 1- beginning of the semester, which was considered a less stressful moment, and 2- in the end of the same semester, which was considered a very stressful moment. Results: Of 72 students from a dentistry school aged between 18 and 40 years; 22 were male students were included. After statistical analysis, a significant association was found between the presence of oral lesions and presence of stressors factors evaluated at moment 2. Conclusion: This is a pilot study; therefore, it is necessary to carry out other studies to investigate this association taking into account other environmental factors that go beyond the scope of the graduation period. Support: FAPEMIG. Evidence shows that psychological factors play an important role in the etiology of pathologic conditions that affects the oral cavity. Objective: To investigate the association between stressors and psychological factors with physical symptoms, including the appearance of oral lesions in graduation students of dentistry. Study Design: This is an observational clinical study, in which the evaluation was carried out through the inventory of stress symptoms for adults of LIPP-ISSL. Questionnaires were applied in 2 moments: 1- beginning of the semester, which was considered a less stressful moment, and 2- in the end of the same semester, which was considered a very stressful moment. Results: Of 72 students from a dentistry school aged between 18 and 40 years; 22 were male students were included. After statistical analysis, a significant association was found between the presence of oral lesions and presence of stressors factors evaluated at moment 2. Conclusion: This is a pilot study; therefore, it is necessary to carry out other studies to investigate this association taking into account other environmental factors that go beyond the scope of the graduation period. Support: FAPEMIG.

CASE STUDY ON BETA BLOCKERS INDUCED PSORIASIS

Drug-induced Psoriasis is one among the common etiological factors of Psoriasis reported worldwide. Familiar drugs known to cause psoriasiform eruptions include Anti-malarials, Beta blockers, NSAIDs, Lithium. etc. Certain antihypertensives like ACE inhibitors, diuretics are also documented to have caused psoriatic episodes.
 A 57 y old South-Indian male patient with a history of Hypertension, Diabetes Mellitus, Atrial Fibrillation for 4 y; was on antihypertensive therapy for Hypertension and Atrial Fibrillation with proponolol for past 2 y and metoprolol initially. He was presented to the hospital two weeks after switching on to Metoprolol therapy for chief complaints of erythematous scaly lesions especially over both the extremities and paronydrial appearance of nails. Initially, he was on Propranolol therapy which was then shifted to Metoprolol due to an appearance of oral lesions in the mouth. Metoprolol was now discontinued and switched on to Atenolol. After 1-2 w of therapy with Atenolol, the lesions were found to disappear and no recurrence of psoriatic conditions were found.
 Proper reviewing of medical history for any allergic reactions and the optimization of drug therapy through Therapeutic Drug Monitoring could be initiated by Clinical Pharmacist in order to avoid such drug-induced flares.

Desmoglein Compensation Theory: An explanations for Early Appearance of Oral Lesions as Compared to Skin Lesions in Pemphigus Vulgaris

Pemphigus is a life-threatening autoimmune blistering disease targeting skin and mucous membranes. It is clinically characterized by flaccid blisters and erosions, while histologically shows intraepithelial acantholysis. The disruption of desmoglein-dependent cell adhesion by autoantibodies is the basic pathophysiology in blister formation of pemphigus. The clinical and histological spectrum of pemphigus is complex and differs in various variants of pemphigus. This review offers an answer to why the splits associated with pemphigus foliaceus occur in the superficial layer of the epidermis, while those of pemphigus vulgaris occur deep in the epidermis. With the help of desmoglein compensation theory, it logically explains why oral erosions develop in patients with pemphigus vulgaris, but not in patients with pemphigus foliaceus and why some patients with pemphigus vulgaris have only oral involvement, but others have extensive lesions on both skin and mucous membranes. Learning objective: After completing this article, readers shall be familiar with the clinical presentations, histologic findings, immunopathology of classical pemphigus and its variants. It discusses the desmoglein compensation theory of pathogenesis. along with the management of pemphigus.

Distribution of traumatic injuries after the installation of complete dentures in adult patients

AimDescribe the location of traumatic lesions of the oral mucosa that develop after the installation of complete dentures, as well as to quantify the number of post-operative controls that are required. A descriptive study was conducted by examining 84 patients who attended the dental center of Universidad de Los Andes, San Bernardo, during the period from July 2012 to July 2013. A sample of 120 edentulous patients was obtained. After the fabrication and installation of the complete dentures, at least 3 post-operative controls were performed and the location of oral lesions was recorded. Documentation of the association between the patient's clinical variables and the appearance of oral lesions during the first 3 controls was performed using a logistic regression. ResultsFor maxillary dentures, 5 post-operative visits were made and 6 controls for mandible dentures. In the upper jaw the anatomical areas of higher incidence of traumatic injuries were: canine fossa (23.9%), average bridle (23.1%), and distobuccal sulcus (20.1%). In the lower jaw, the highest number of lesions were recorded on the anterior lingual flank (16.5%), anterior and posterior lingual flank (13.4%), and distobuccal sulcus (12.8%). A significant association was observed between subjects who reported consumption of cholesterol-lowering medications and the development of traumatic lesions of the oral mucosa (OR: 0.25 and 95% CI: 0.055–0.939). The installation of complete dentures does not determine that the treatment has ended. Post-operative controls are needed to assess areas of erythema and ulceration.

Relationship of Oral Lesions and CD4 Count in Female HIV Patients in South Western Nigeria

ABSTRACT Background: Oral lesions have been reported to be early clinical features of HIV infection. Objective: The purpose of this study was to establish the prevalence of oral lesions in HIV Seropositive female patients and correlate the CD4 count with the appearance of oral lesions in the female patients attending Lagos University Teaching Hospital (LUTH) and University of Benin Teaching Hospital, Benin (UBTH). Methods: A prospective study was undertaken in 172 newly diagnosed adult HIV infected female patients (not on antiretroviral therapy), who attended the PEPFAR clinic at LUTH and the HIV Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria. They were assessed for oral lesions which were evaluated using EEC/WHO (2003) – Classification on the diagnostic criteria for oral lesions in HIV. Data were collected using an interviewer administered questionnaire. Following Oral examination undertaken, oral lesions were detected, recorded and Original Research Article

AIDS: An Epidemiological Study on Correlation between HIV- Related Oral Lesions and Plasma Levels of CD4, CD8 T Lymphocytes Counts and Ratio among 50 Patients

Aim: The aim of the study was to evaluate oral manifestations of HIV /AIDS patients and to correlate their occurrence with plasma levels of CD4+, CD8+ counts and CD4/CD8 ratio. Study Design: A descriptive cross-sectional study. Place and Duration: Odontology Unit, St-Antoine Hospital, a twoyear study. Methodology: In a descriptive cross-sectional study, 50 patients infected with human immunodeficiency virus (HIV) were assessed. The relationships between oral lesions and CD4+, CD8+ cell counts and CD4/CD8 ratio were evaluated. Results: The mean CD4+ counts and CD8+ counts were 167.12 cells/mm 3 and 979.66 cells/mm 3 and the mean CD4/CD8 ratio were 0.25. All patients displayed at least one oral manifestation. The most common identified oral lesion was pseudomembranous candidiasis, accounting for 76% Original Research Article Berberi et al.; BJMMR, 6(9): 859-866, 2015; Article no.BJMMR.2015.261 860 (38/50) followed by periodontal disease 34% (17/50), herpetic lesions, and hairy leukoplakia 10% for each (5/50), gingivitis 8% (4/50), oral ulceration 8% (4/50), Kaposi’s sarcoma 6% (3/50), and Non-Hodgkin lymphoma 2% (1/50). Conclusion: The CD4+ count was decreasing and the presence of oral lesions were increasing in this study. No relation was found between the presence of oral lesions and CD4/CD8 ratio. Progression to AIDS was characterized by increased prevalence of some oral lesions such as candidiasis, hairy leukoplakia and Kaposi’s sarcoma. The clinical appearance of oral lesions was more pronounced when CD4+ count was low.

Oral manifestations in human immunodeficiency virus infected children in highly active antiretroviral therapy era

Conducted a literature review to identify studies that reported on the oral manifestations in human immunodeficiency virus (HIV) infected children in highly active antiretrovial therapy (HAART) era. A search electronic data base were used and the terms used were 'oral lesions' and 'oral manifestations'. The studies of prevalence of oral manifestation in children with HIV worldwide, descriptive studies, case reports, studies on the association of oral lesions and levels of immune suppression, use of HAART and transmission of HIV were included. There have been substantial changes in the management of HIV disease, especially in the past decade because of the use of HAART. However, children are still being infected and present some peculiarities when compared with adults. Molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease need to be better understood as a consequence of improved anti-HIV strategies. Treatment with HAART improves the immune function and decreases mortality, morbidity, and opportunistic infections in HIV-infected persons. The frequency and severity of oral disease associated with HIV infection have reduced considerably, although the use of HAART may be associated with an increased appearance of oral lesions associated with human papillomavirus and potentially increase the risk of later oral squamous cell carcinoma.