Oral Mucosal Lesions Research Articles

Simultaneous determination of areca nut- and tobacco-specific alkaloids in saliva by LC-MS/MS: Distribution and transformation of alkaloids in oral cavity

Areca nut and tobacco are frequently used in combination. Cigarette smoking and betel quid (BQ) chewing habits impose greater oral cancer risk than either habit alone. Saliva is a better noninvasive diagnostic material as it is in direct contact with oral mucosa and cancerous lesions. This study describes the application of isotope-dilution LC-MS/MS for simultaneous quantitation of five areca nut-specific alkaloids (ASAs) and three tobacco-specific alkaloids (TSAs) in human saliva. With this method, we demonstrate that the distribution of ASAs vary significantly in smokers who chew BQ habitually, due to the hydrolysis of ASAs and metabolic activity in the oral cavity. The alkaline condition formed due to slaked lime in BQ, plays an important role in the distribution of ASAs and TSAs, by catalyzing the hydrolysis of ester forms of ASAs to their respective carboxylic acid forms besides facilitating the TSA (i.e., nicotine) absorption in the oral cavity. Moreover, our results reveal that oral mucosa rather than saliva contributes to the metabolism of ASAs at oral cavity. Less than 2.1% of ASAs were metabolized by saliva, as determined by in vitro test. Our findings may provide a better insight into the pathobiology of oral carcinogenesis due to BQ chewing.

The spectrum of non-characteristic oral manifestations in COVID-19 - a scoping brief commentary.

Virus-induced oral abnormalities, occurring especially in severe COVID-19 cases of hospitalized patients, have various characteristics and clinical features being, either directly or indirectly, related to SARS-CoV-2 infection. Deregulation of the immune system as a result of SARS-CoV-2 infection may lead to the impairment of the normal defense pathway in the SARS-CoV-2 positive patients. This scoping mini-review is aimed to critically appraise the existing evidence concerning the potential link between COVID-19 condition and abnormal manifestations within oral cavity, affecting oral mucosa, salivary glands and sensory elements. COVID-induced oral mucosa manifestations, with various clinical aspects, are likely to occur as coinfections and secondary symptoms, as immune system imbalance is per se a causative factor of secondary manifestations. Oral mucosal lesions related to SARS-CoV-2 infection do not seem to demonstrate gender predilection, with the average reported age around 50 years of age. They include mainly white and erythematous plaques, ulcers, blisters, petechiae. The affected intraoral areas were mainly: tongue, palate, lips, gingiva, and buccal mucosa. The "aggressive" therapies utilized to treat COVID-19, including drug interactions may aggravate or initiate OMLs pathologies. Neglected oral hygiene or partial or complete abandonment of oral hygiene during intensive hospitalization constitutes an independent factor promoting a wide range of oral pathologies. In addition, stress factor indirectly impairs functioning of the immune system. Oral mucosa lesions occurring in COVID-19 cases present with a wide variation of non-characteristic features. These intraoral, soft tissues abnormalities seem to be reversible and transient. A potential impact of severe oral pathologies to systemic health resulting from SARS-CoV-2 infection, along with associated poor oral hygiene should not be ignored, predominantly in seriously ill patients hospitalized in intensive care units. Med Pr. 2021;72(6):685-92.

Assessment of Oral Health Care Needs among Fishermen Living in North Chennai, India – A Cross Sectional Study

Introduction: Studies conducted among fishermen shows that there was a high prevalence rate in Oral mucosal lesions. However, data on oral health care needs among fisherman is scarce. Hence this was undertaken to obtain a data that can be used to plan programmes for the prevention and treatment of such oral mucosal lesions in the fishermen.
 Materials and Methods: A study was carried out among 71 fishermen after obtaining clearance from the institutional ethical committee and concerned authorities. A self administered questionnaire is distributed among the study group comprising questions relating to personal history and deleterious habits. Clinical examination was carried out using mouth mirror, explorer and under proper illumination. Oral health examination was done using WHO Basic Oral health Assessment proforma, 2013. Data collected and analysed statistically using SPSS software.
 Results: Among the 71 fishermen, 56(78.9%) were males and 15 (21.1 %) were females. In the study population, 44(62%) were tobacco chewers, 39(54.9%) were snuff users, 24(33.8%) were alcohol consumers and 19(26.8%) were smokers. Smokeless tobacco (41.5%) was the most common deleterious habit after which by alcohol consumption (33.8%) and smoking (26.8%).The prevalence of oral mucosal lesions was 20.8%.It was found that statistically significant association existed between the deleterious habits and leukoplakia.
 Conclusion: According to the our study, the prevalence of oral mucosal lesions was 20.8% among the fishermen who had a clear association with deleterious habits such as tobacco chewing, smoking, alcohol consumption and snuff.

European recommendations for management of immune checkpoint inhibitors-derived dermatologic adverse events. The EADV task force 'Dermatology for cancer patients' position statement.

The introduction of immune checkpoint inhibitors (ICIs) opened a new era in oncologic therapy. The favourable profile of ICIs in terms of efficacy and safety can be overshadowed by the development of immune-related adverse events (irAEs). Dermatologic irAEs (dirAEs) appear in about 40% of patients undergoing immunotherapy and mainly include maculopapular, psoriasiform, lichenoid and eczematous rashes, auto-immune bullous disorders, pigmentary disorders, pruritus, oral mucosal lesions, hair and nail changes, as well as a few rare and potentially life-threatening toxicities. The EADV task force Dermatology for Cancer Patients merged the clinical experience of the so-far published data, incorporated the quantitative and qualitative characteristics of each specific dirAEs, and released dermatology-derived, phenotype-specific treatment recommendations for cutaneous toxicities (including levels of evidence and grades of recommendation). The basic principle of management is that the interventions should be tailored to serve the equilibrium between patients' relief from the symptoms and signs of skin toxicity and the preservation of an unimpeded oncologic treatment.

Disseminated Kaposi sarcoma with osseous metastases in patients with HIV infection. Case report

Background. Kaposi sarcoma is a low-grade vascular tumor affecting blood and lymphatic vessels associated with the human herpes virus type 8 (HHV-8). As a rule, the skin of the lower extremities is involved in the process first of all, and then other organs and lymph nodes are involved. There are 4 various types of the disease with different clinical picture: the classic, the endemic, the epidemic and immunosuppression subtype. The epidemic subtype is the most common and has the most aggressive course, with specific lesions of a multiple kind, including the skin, mucous membrane layers, the lymph nodes, the gastrointestinal tract, the lungs and the spleen. Osseous metastases are extremely rare.
 Aim. Show the case of Kaposi sarcoma with osseous metastases in patient with the human immunodeficiency virus (HIV) infection.
 Results. We observed a 43-year-old patient with HIV infection and stage 4b Kaposi sarcoma against the background of the irregular antiretroviral therapy in the progression stages. The duration of the anamnesis was 32 months. The clinical debut of the cancer process was noted with skin lesions on the shoulder. Histological and immunohistochemical analysis of skin biopsies showed the morphological picture of Kaposi sarcoma. HHV-8 was expressed in tumor cells. During the endoscopic examination the lesions of oral mucosa, stomach and proximal colon were confirmed morphologically, and spiral computed tomography of the chest revealed the lesions in the lungs. On this point, the patients received oxaliplatin-based chemotherapy and aetoposidum for 6 months and against the background of this treatment we observed the disease progression associated with the involvement of the retroperitoneal lymph nodes, the left adrenal gland and the penis. Circumcision was performed in the case associated with the involvement of the penis. The treatment was continued. The lytic left iliac bone lesion, the retroperitoneal lymph nodes, the iliac lymph node groups, as well as the left inguinal lymph nodes, the left adrenal gland and the lungs were characterized by a high F-18 FDG uptake after 3 months of the treatment, according to the results of Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography combined with computed tomography (PET/CT).
 Conclusion. Kaposi sarcoma in patients with HIV infection had an aggressively course with disseminated skin lesions and internal organ involvement, including bones as showed in this clinical case. In this case, the axial skeleton was more commonly involved. PET/CT is a diagnostic imaging method in the differential diagnosis and determination of the prevalence of the cancer process.

Histopathological Spectrum of Oral Mucosal Lesions in a Tertiary Care Hospital.

Neoplastic as well as non-neoplastic lesions commonly involve oral mucosa. It had been observed that benign lesions were more common than malignant ones. The present study was done to evaluate the pattern of distribution of various oral mucosal lesions in a tertiary care hospital. This retrospective cross-sectional study reviewed the archival records in the Department of Pathology, Gandaki Medical College, Nepal from January 2017 to December 2020. The records of patients with histopathologic diagnosis of oral mucosal lesions were obtained. The histopathological diagnosis, age, gender, and the site of involvement were collected using a prepared form. Descriptive statistics was applied using SPSS 20 software. Oral mucosal lesions included 3.7% (180 out of total 4895) of cases diagnosed histopathologically. The cases were common among females (101cases/56.1%). Most of the oral mucosal lesions were diagnosed in more than 45 years old patients (75cases/41.7%). The non-neoplastic oral lesions (106cases/58.9%) were the most common lesions followed by neoplastic oral lesions (52cases/28.9%). Among non-neoplastic oral lesions, reactive hyperplastic oral lesions were the most common (50cases/27.8%). Reactive hyperplastic oral lesions frequently affected gingiva (18cases/36%). Neoplastic lesions (Benign neoplasm: 12cases/44.4%; Malignant lesions; 10cases/40%) frequently affected the tongue. Oral lesions were mostly non-neoplastic and reactive hyperplasia being the most commonest presentation Keywords: Neoplastic; non-neoplastic; oral mucosal lesions; reactive.

Prevalence of Xerostomia and Associated Systemic Risk Factors in Riyadh, Saudi Arabia: A Cross-sectional Study

Purpose: Xerostomia is a feeling of dry mouth and may result in poor oral hygiene, dental caries, mucosal lesions and burning mouth syndrome. Medication, systemic diseases and stress are common etiological factors of xerostomia. The present study investigated the prevalence of xerostomia and explored the possible risk factors associa­ted with this condition among Saudi population.
 Methods: The present cross-sectional study was conducted on 418 participants visiting at Maxillofacial clinic, at secondary care hospital, Riyadh. Demographic data and complete medical history were obtained from participants. All participants were requested to fill the Xerostomia-Inventory (XI) questionnaire. Comparisons between mean scores of XI-inventory and categorical variables like gender, comorbid conditions were made with students t-test or Wilcoxon test. Chi-square or Fischer’s Exact test were used for comparison between categorical variables like gender and responses to XI-items (No/Yes). P value of <0.05 was considered significant. All analysis was done on JMP-version-12.
 Results: Total 418-participants with mean age (41.1 ± 12.8 years) were included in the study in which 302-participants (72.2%) were female and 116-participants (27.8%) were male. Xerostomia’s prevalence was 24.7% and it was higher in males (34%) as compared to females (21%). A statistically-significant association was found between xerostomia and participant’s age (P < 0.0001). The participants with systemic illness showed a significantly higher mean Xerostomia Inventory (XI) score as compared to the healthy patients. In our study population common comorbid conditions were hypertension and diabetes.
 Conclusion: The prevalence of xerostomia increases with increasing age and it has strong positive co-relation with chronic systemic diseases.

Geographic Stomatitis with Multiple Areas Involvement of Oral Cavity: A Case Report and Review of Literatures.

Background:Geographic stomatitis is an uncommon migratory benign lesion of oral mucosa with unknown etiology. It can affect all the areas of the oral mucosa, but the dorsum and lateral borders of the tongue are the most commonly involved areas called geographic tongue. The clinical appearance of this condition is the oval or circular erythematous areas with irregular elevated keratotic borders. These characteristic features of geographic stomatitis are diagnostic for all clinicians when appearing on the dorsum of the tongue, despite other affected areas of oral mucosa that can confuse clinicians. This condition may be associated with some diseases such as psoriasis, Reiter’s syndrome, and atopic conditions, so the clinicians should rule out these diseases and diagnose the geographic stomatitis.Case Report:A 17-year-old male attended to our department for a routine dentistry checkup. During the intraoral examination, we found multiple erythematous areas surrounded by a thin white border on different surfaces of his oral cavity. His extraoral examinations were completely normal.Conclusion:Due to the rarity of this lesion on the other sites of oral mucosa rather than dorsum and lateral borders of the tongue such as labial mucosa, buccal mucosa, the floor of the mouth, ventral surface of the tongue, and palate, it is necessary to report, study and evaluate each case of this condition that clinicopathologic findings have confirmed this diagnosis, to treat and advice these patients on the best approach.

Adjunctive Utility of Toluidine Blue in Detecting Dysplastic Cells in Oral Mucosal Lesions in Comparison with Histopathology

Introduction: Oral cancer is one of the most common cancers globally and in Sri Lanka, which follows premalignant lesions. It is curable if it is detected early. Several adjunctive methods to diagnose premalignant lesions early are available. Among these, Toluidine blue staining method before a biopsy is currently receiving much attention.
 Method: This is a prospective study done by studying 103 patients presented to the Oral and Maxillofacial Surgery Unit, District General Hospital, Gampaha, Sri Lanka. The oral lesions of all the patients are categorized as benign, premalignant, and malignant by clinical examination. Toluidine Blue mouth wash is introduced to all the patients, followed by biopsy from the stained sites and the clinically decided sites in non-stained lesions. Histopathological diagnosis was obtained for all cases. The accuracy of diagnosis of premalignant, malignant, and benign cases by clinical assessment and by using Toluidine blue was assessed and compared statistically in relation to sensitivity, specificity, positive predictive and negative predictive values, and likelihood ratios (LR).
 Results: Toluidine blue has no added advantage over clinical examination in our setup even though it might be helpful in screening. However, it has an added value to confirm clinically benign cases as benign.
 Conclusion: Toluidine Blue can be used as an adjunct in screening and to confirm clinically benign cases so that those can be followed up in clinics without doing unnecessary biopsies.

Oral health status and associated factors among Sudanese older adults: A cross-sectional study.

The aim was to assess the oral health status, prosthetic needs and the associated factors among older adults living in Khartoum State, Sudan. Understanding the extent of the oral health problems and the associated factors in the older population is important for the determination of treatment needs and future planning of dental services. A cross-sectional study among individuals ≥60years attending Health Care Centers. Two calibrated examiners examined participants according to the WHO oral health examination form for adults. DMFT, periodontal conditions, oral mucosal lesions, tooth wear, prosthetic status and prosthetic needs were reported. Risk indicators investigated include age, gender, socioeconomic status, general health, oral hygiene practices, tobacco use and utilisation for dental services. Two hundred forty-nine older adults participated in the study, and 64.3% were males. The mean age was 68.4 years (SD ±6.7). The mean DMFT was 15.9 (SD ±9.1), with 85.3%, 94.8% and 19.3% of the participants having decayed, missing or filled teeth respectively. Periodontal pockets were present in 41.9%, mucosal lesions in 14.9% and tooth wear in 46.2% of the participants. Although only 5.2% were completely edentulous, 93.2% need prosthetic replacement. Risk indicators for poor oral health were being female, oral hygiene practices, frequency and reason of dental visits. Old adults showed a high experience of missing and decayed teeth, periodontal inflammation and prosthetic treatment needs. Future oral health policies need to consider the different needs between men and women, exposure to risk factors and barriers to access dental care.

Prevalence of Denture-Related Stomatitis in Edentulous Patients at a Tertiary Dental Teaching Hospital.

Oral mucosal lesions can be uncomfortable and can result in a poorer oral health related quality of life. This can be seen especially in edentulous patients who are mostly elderly and have comorbid diseases such as Diabetes Mellitus, which can impair their ability to withstand oral infections. In South Africa, one of the most unequal countries in the world, almost 50% of the population is edentulous and this prevalence increases as age increases. The aim of this cross-sectional study was to determine the prevalence of denture-related stomatitis in subjects who presented to a tertiary institution in Cape Town, South Africa for new complete dentures and to determine the risk indicators associated with it. Three hundred and ninety-six folders of participants who received complete dentures during the period 2014–2019 were included in this study. Categorical data was displayed as frequencies and percentages and a multiple adjusted logistic regression was used to determine associations between Candida and certain risk indicators. The prevalence of denture-related stomatitis was 25.76% (n = 102). Almost 75% (n = 225) females and 72.63% (n = 69) males had no denture-related stomatitis. The most common site for candidiasis in this population was the palate and tonsillar area (40.2%, n = 41) and the least common site was the upper ridge (2.94%, n = 3). Candidiasis, in edentulous patients are highly prevalent in this population and more needs to be done to prevent it.

Prevalence of oral mucosal lesions in an adult population from eight communities in Santo Domingo, Dominican Republic.

The purpose of the study was to evaluate the prevalence of Oral Mucosal Lesions (OMLs) in an adult population from Santo Domingo, Dominican Republic. 751 subjects from eight communities from Santo Domingo accepted the invitation to participate in an oral screening from October 2016 to January 2017. 248 subjects were evaluated and clinically examined, age range 18-86 years. A validated instrument was designed to record demographic factors, age group, gender, anatomical location, presence or absence of OMLs, risk factors such as tobacco consumption and its frequency, and different forms of tobacco and alcohol use. A systematic oral clinical examination was conducted by a specialist. The presence or absence, and anatomic location of OMLs were recorded. The sample consisted of 44.4% males and 55.6 % females. 228 subjects had 1 or more lesions (91.9%), the median was 3 lesions per patient. In relation to risk factors, tobacco use in general was reported by 26.2 % of the subjects, with cigarette smoking reported by 75.4%, followed by other forms as "hookah" 9.2 %, marihuana 9.2%, cigars ("puros")4.6% and pipe smoking 1.5%. Among the oral lesions detected by screening, the nonpathological group was prevalent, and included physiologic melanin pigmentation as the most frequent (25.0%) followed by palatal/mandibular tori (20.2%), Fordyce granules (7.9%), and Exostosis (5.6%). Potentially malignant disorders (Oral Leukoplakia, Oral Lichen Planus and Actinic Cheilitis) corresponded to 2.2%, 0.3 %, and 0.3%, respectively. No malignancy was observed clinically. This study Authorutes to determining the prevalence of OMLs in Dominican Republic and to identifying risk factors. This is the first study reporting the prevalence of oral mucosal lesions among the Dominican adult population. This information is vital for establishing a public health program targeting the high-risk group to improve the oral health status in this population.

Stevens-Johnson syndrome linked to tramadol use and ultraviolet radiation

Abstract Rationale: Stevens-Johnson syndrome (SJS) is a cutaneous reaction characterized by necrosis and epidermal detachment, commonly triggered by medications. Tramadol rarely causes SJS, and ultraviolet radiation (UVR) has limited recognition as being linked to SJS presentations. Patient concerns: A previously healthy 18-year-old female presented to the emergency department with what she believed to be a severe sunburn. Five days prior, she was exposed to extensive sun exposure while swimming all day at a lake. The following day, she developed a rash on her shoulders, which became widespread, extending to the palms of her hands and soles of her feet, and eventually involved her oral and ocular mucosa. At the time of hospital admission, the rash had progressed to form vesicles/bullae with skin sloughing and a positive Nikolsky sign, bleeding ulcers throughout the oral mucosa, and bilateral conjunctival hyperemia with purulent discharge. Diagnosis: The patient reported no medication use apart from a single dose of tramadol 7 to 10 days prior to rash onset. Given the clinical presentation and histopathological findings that were consistent with SJS, a diagnosis of SJS was made. The nature of this patient's rash onset, character, and progression suggests that UVR precipitated the event in conjunction with tramadol as the causative agent. Interventions: The patient received fluid resuscitation and was transferred via air ambulance to a trauma and burn center to receive treatment. Outcomes: Complete resolution of the patient's cutaneous and oral mucosal lesions occurred 4 weeks after discharge; however, hypopigmentation was evident in areas where cutaneous re-epithelialization had occurred. The patient was advised to strictly avoid the use of tramadol and limit her exposure to UVR. Lesson: Physicians should be aware that tramadol may cause SJS and that UVR may precipitate SJS in patients taking tramadol. Rapid diagnosis of SJS and transfer to a trauma or burn center improves patient outcomes.

Dermatologic Manifestations of Systemic Diseases in Childhood

Dermatologic Manifestations of Systemic Diseases in Childhood

Prevalence and Risk Factors of Oral Mucosal Lesions: A Retrospective Study of Patients Attending Oral Diagnosis Department of Siohs Karachi, Pakistan

Background: The present study was conducted to evaluate the frequency of different types of Oral Mucosal Lesions (OMLs) and to identify the associated risk factors. Methodology: A retrospective study was conducted at the Department of oral diagnosis in collaboration with the department of oral pathology SIOHS, Karachi Pakistan between January 2017 to December 2020. All cases of lesions and ulcers of the oral cavity were included in the study. Missing data were excluded. Diagnosed cases of oral mucosal lesions were documented. The data was then stratified according to the age groups, gender, symptoms, comorbidities, marital status, etc. Results: A mean age of 38.3 ± 11.86 years was observed. The subjects manifested multiple lesions with OSF standing as the most prevalent one at 29%, followed by aphthous ulcers at 20.2%, candidiasis at 14%, and nicotinic stomatitis at 10.4%. The majority of the patients with aphthous ulcers were significantly associated with young age while frictional keratosis was significantly associated with elderly age (p=0.002), respectively. 15 (93.8%) patients who were married were diagnosed with squamous cell carcinoma (p<0.004) and stiffening of the mouth was significantly associated with squamous cell carcinoma (p<0.0001). Conclusion: In conclusion, the increased occurrence of oral mucosal lesions with age is most likely attributable to an age-related decline in health status and is highly correlated to substance abuse; its amount, duration, type, and regularity. Keywords: oral mucosal lesion, carcinoma, gingiva, buccal, maxillofacial, tumor

Efficacy of Platelet Gel in Children with Stomatitis during Chemotherapy

Abstract Introduction. Stomatitis (oral mucositis) is a very serious adverse effect of anticancer therapy, and it may exacerbate treatment outcomes as well as prognoses. Stomatitis is associated with pain during chewing and swallowing, causing discomfort and interfering with eating. It can also lead to weight loss and a delay in child growth and development. None of the numerous therapies used for stomatitis management can be considered universal or sufficiently effective. Allogeneic platelet gel, a formulation that adheres closely to mucosal lesions and is rich in growth factors, may be an effective treatment for accelerating the erosion-healing process. Methods. A prospective, open-label study on the efficacy of platelet gel used for the treatment of stomatitis in children during chemotherapy. Platelet gel was applied to oral mucosal lesions four times a day. Results. 28 patients with Grade II and Grade III stomatitis were enrolled in the study. The first day after applying platelet gel, 93% of patients reported relief from pain. Within 4 to 5 days, one degree of mucosal lesion regression was reported in 89% of patients, indicating a 3 to 5 day reduction in therapy compared to our previous experience. In only two patients did we observe mild adverse events in the form of a burning sensation. Conclusion. Platelet gel contributed to both pain reduction and acceleration of the oral mucosa healing process. It is a safe and effective therapy for children with stomatitis induced by chemotherapy.

Manifestaciones orales asociadas a SARS-COV-2: Revisión de la literatura

Objective: Identify the main oral manifestations associated with COVID19 and describe their location in the oral cavity. Methods: The literature search was conducted in PubMed, Medline, LILACS, LIVIVO, Web of Science, and SciELO. The following words were searched for: oral mucosa, oral mucosa lesion, oral manifestations, COVID-19, and SARS-CoV-2.  Duplicate articles were eliminated, and the pieces were shortlisted. Finally, inclusion and exclusion criteria were applied. Results: This study included 47 articles. The main oral manifestations in patients with COVID-19 are taste disorders, xerostomia, ulcers, vesicles, and others located in different areas of the oral mucosa. Conclusions More studies are needed to determine the potential oral etiopathogenesis of SARS-CoV-2. Moreover, dentists play a significant role in the multidisciplinary and telemedicine team.

Ex vivo fluorescent confocal microscopy images of oral mucosa: Tissue atlas and evaluation of the learning curve.

Ex vivo fluorescence confocal microscopy (FCM) is a developing tool providing rapid digital imaging of fresh tissue utilizing high-resolution optical sectioning that highly corresponds with conventional hmatoxylin and eosin (H&E)-stained slides. A very little data on oral mucosa lesions exist currently. The present work aimed to create an image atlas of benign and malignant oral tissues and compare them to the corresponding histopathology. Furthermore, we aimed to evaluate the learning curve for confocal image interpretation. From 50 samples obtained from the oral mucosa, including oral squamous cell carcinoma (OSCC), dysplasia, and healthy oral tissue, ex vivo FCM images and corresponding H&E slides were created and collected into a tissue atlas. Additionally, two experts were asked to analyze the images to assess the learning curve. Ex vivo FCM images revealed high comparability with histopathological images. Tissues including OSCC, dysplasia, and normal oral mucosa were implemented in the image atlas to provide the diagnostic fundament for pathologists and surgeons; the learning curve was short. Future studies on this topic will be advantageous for the development of artificial intelligence-based diagnostic approaches. The current work provides a novel set of data that are structured as an atlas of common pathologies of the mucosa to enhance the existing knowledge and material on confocal images.

Low serum levels of vitamin C in patients with oral lichen planus: a case-control study

ObjectiveTo clarify the relationship between oral lichen planus (OLP) and systemic oxidative stress, we examined serum antioxidant and urinary oxidative stress marker levels in patients with OLP. MethodsFifteen female patients with clinical and histopathological diagnoses of OLP were enrolled in this study. The mean patient age was 67.6 years (range, 56–81 years). Ten age- and sex-matched volunteers without oral mucosal lesions were selected as a control group. Serum levels of the antioxidants vitamin A, vitamin C, vitamin E, folate, zinc, uric acid, and superoxide dismutase activity were evaluated. Urinary levels of the oxidative stress marker 8-hydroxy2’-deoxyguanosine (8-OHdG) were measured by enzyme immunoassays. All values were compared between the two groups. ResultsThe mean value of serum vitamin C was lower in the OLP group (5.73 ± 2.34μg/mL) than in the control group (9.22 ± 3.65 μg/mL; P = 0.0125). Serum levels of vitamin A, vitamin E, folate, zinc, uric acid, and superoxide dismutase activity did not significantly differ between the two groups. The mean values of creatinine adjusted urinary 8-OHdG were 10.1 ± 7.34 ng/mg creatinine in the OLP group and 13.7 ± 12.7 ng/mg creatinine in the control group; these values did not significantly differ between the two groups (P = 0.5189). ConclusionOur results suggested that serum levels of vitamin C are low in patients with OLP. However, oxidative stress (determined by measurement of urinary 8-OHdG level) was not significantly higher in patients with OLP. Thus, the relationship between OLP and systemic oxidative stress was not fully elucidated in this study.

Oral clinical courses of patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection: A clinical follow up (a prospective prevalent cohort) study

IntroductionContemporary literature has revealed that SARS-CoV-2 causes acute sialadenitis and related symptoms, such as discomfort, pain, swelling, and secretory dysfunction in salivary glands. The secretory dysfunction is due to SARS-CoV-2 infection-induced xerostomia and other associated clinical courses such as sore tongue, mucosal ulcer, and gingivitis in the oral cavity. Furthermore, it has been reported that COVID-19 causes the development of other oral manifestations.PurposeThis cohort study was initiated to identify the possible oral clinical manifestations of patients with SARS-CoV-2 infection admitted at Eka General Hospital COVID-19 treatment center in Addis Ababa, Ethiopia.Materials and MethodsA prospective clinical follow-up (a prevalent cohort) study was conducted to identify the possible oral manifestations of SARS-CoV-2 infection among patients admitted at the Eka General Hospital COVID-19 treatment center. Patients were followed for an average period of 3.5 weeks.ResultsThe findings of this cohort prevalent study were adjusted around the main objectives of the research. A total of 55 patients (36 males and 19 females) fulfilling the inclusion criteria were included in the cohort. The age of the cohorts ranged from 8 to 90 years. The overall prevalence of oral clinical courses in patients with SARS-CoV-2 was 0.18 (n=10). Oral mucosal lesions, xerostomia, thickening of saliva yielded prevalence data of 0.5 (n=6), 0.42 (n=5), and 0.08 (n=1), respectively. The oral mucosal lesions prevalence finding was further refined into aphthous lesions 0.5 (n=3), candidiasis 0.17 (n=1), geographic tongue 0.17 (n=1), and localized gingivitis 0.17 (n=1).ConclusionThe findings of the study suggest the importance of initiating oral health care for patients with COVID-19. Therefore, multidisciplinary healthcare approaches to management should be promoted to assure optimal health outcomes. Accordingly, oral health care should be a substantial part of the multidisciplinary approach.