Tongue Mucosa Research Articles

The epidemiological and histopathological factors for delayed local recurrence in oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is a prevalent malignancy in oral cancer. Approximately 26% of OSCC cases recur after initial curative treatment, with over 80% of these recurrences occurring within the first 2years. Delayed local recurrence (DLR) occurring beyond the 2-year period in cases of OSCC is infrequent. The aim of this study is to investigate the histopathological characteristics associated with DLR. This study included 197 patients diagnosed with OSCC who underwent primary surgery from 2006 to 2022. Epidemiological features, such as age and gender, and histopathological features, including primary tumor sites, TNM staging, histopathological grading, depth of invasion, the presence of lymphovascular or perineural invasion, and the utilization of radiation therapy (RT) and neck dissection (ND) were analyzed. The mean interval until local recurrence was 22 ± 27months. There were 10 cases of DLR (20.83%) among 51 patients with local recurrence. The epidemiological and histopathological analysis of these cases is as follows: 10 patients (3 males and 7 females) aged 51-80years (median, 56.5years). Primary tumor sites were tongue (n = 3), maxillary gingiva (n = 1), mandibular gingiva (n = 3), retromolar trigone (n = 1), and buccal mucosa (n = 2). Tumor size was advanced (T3/T4) in 5 cases, while a smaller size (T1/T2) was observed in 5 cases. No lymph node metastasis was 80.0%. Histopathological grading was well differentiated in 9 cases and moderately differentiated in 1 case, with no cases of poorly differentiated tumors. Depth of invasion > 5mm was 70.0% of the cases (n = 7). Lymphovascular invasion and perineural invasion were not present. Three patients received RT, and 8 patients underwent ND. There were 2 patients who consumed alcohol, and 2 patients who smoked tobacco. The results showed that histological differentiation had a significant relationship with the interval (p = 0.031). DLR, occurring more than 2years after the initial tumor resection surgery, is infrequent. Histological differentiation is associated with tumor recurrence intervals. Patients with a higher histological grading require more precise follow-up observation during the initial 2years after surgery.

Moxidectin elevates Candida albicans ergosterol levels to synergize with polyenes against oral candidiasis.

Candida albicans, the most common opportunistic pathogenic fungus, is also the main pathogenic organism for oral candidiasis. This condition is particularly prevalent among the elderly, children, and individuals undergoing radiotherapy or suffering from HIV. The lack of new antifungal drugs, and drug resistance coupled with the side effects of current antifungal agents have increased the challenges of clinical antifungal therapies. Polyenes, including amphotericin B and nystatin, are clinical fungicidal drugs, however, their side effects and low solubility have limited their clinical applications. Here, we identified that moxidectin, a novel approved antiparasitic agent, could synergize with both amphotericin B and nystatin to inhibit the growth and biofilm formation of Candida albicans including 60 clinical isolates. The transcriptome and RT-PCR analysis indicated that moxidectin activated the biosynthesis pathway of ergosterol, the direct target of polyenes, further being verified by the loss of the synergistic activities with polyenes against ergosterol pathway mutants, including Δ/Δerg3, Δ/Δerg11 and Δ/Δerg3 Δ/Δerg11. Moxidectin was then confirmed to elevate the ergosterol biosynthesis levels of C. albicans and enhance the binding between cells and polyenes. In a mouse oral candidiasis model, moxidectin combined with low dosages of polyenes to significantly reduce the infection area, colonization of C. albicans and the inflammatory degree of tongue mucosa. Our study originally demonstrated that moxidectin could activate the ergosterol biosynthesis then elevate the ergosterol contents to enhance the antifungal effects of polyenes against C. albicans and its infections. Moxidectin can serve as the candidate potentiator of polyenes for further clinical practice. KEY POINTS: • Moxidectin synergized with polyenes against Candida albicans. • Moxidectin activated the ergosterol biosynthesis of Candida albicans. • Moxidectin combined with polyenes to effectively combat oral candidiasis in mice.

Effect of Lingual Nerve Block and Localised Somatosensory Abnormalities in Patients With Burning Mouth Syndrome-A Randomised Crossover Double-Blind Trial.

To investigate the effect of a lingual nerve block on spontaneous pain in patients with burning mouth syndrome (BMS) and to estimate associated somatosensory abnormalities by quantitative sensory testing (QST). A standardised QST battery including cold detection threshold (CDT), warmth detection threshold (WDT), thermal sensory limen (TSL), paradoxical heat sensation (PHS), cold pain threshold (CPT), heat pain threshold (HPT), mechanical pain threshold (MPT), wind-up ratio (WUR) and pressure pain threshold (PPT) was performed at the oral mucosa of the most painful site and intraoral control site in 20 BMS patients, and at the tongue and cheek mucosa in 22 age- and gender-matched healthy controls. The effect of a lingual nerve block on spontaneous burning pain reported by the BMS patients on a 0-10 cm visual analogue scale (VAS) was investigated in a randomised double-blind crossover design using (1 mL) lidocaine (lido) or saline (sal) with an interval of 1 week. The BMS patients were grouped into 'central' and 'peripheral' mechanisms based on the effect of the lingual nerve injections. For each BMS patient, Z-scores and Loss/Gain scores were computed. Differences among groups and sites were analysed using a two-way ANOVA. Differences within group were assessed by paired t-test. The 20 BMS patients were characterised on the basis of VAS changes (ΔLido-ΔSal) as a peripheral BMS subgroup (n = 9) with pain relief more than 1 cm on the VAS and a central BMS subgroup (n = 11) with pain relief less than 1 cm. BMS patients (n = 20) had lower sensitivity to thermal stimuli (i.e., CDT, WDT, TSL, CPT, HPT and PPT) and higher sensitivity to mechanical stimuli (i.e., PPT) compared with controls (p ≤ 0.007). Based on Loss/Gain coding, L1G0 (loss of thermal somatosensory function with no somatosensory gain, 55.0%) was the most frequent coding in the BMS group, which was higher than 11.4% in the control group (p < 0.001). Surprisingly, there was no significant difference between the peripheral and central BMS subgroups with regard to the Z-scores of any of the nine QST parameters (p > 0.097). The results of the lingual nerve blocks demonstrated two distinct phenotypes with either peripheral or central mechanisms but no direct impact on somatosensory function. Overall, somatosensory function in BMS patients seems abnormal in the painful areas compared to matched controls with a conspicuous loss of thermosensory function.

Successful emergency management of hemorrhagic shock due to carotid artery aneurysm: the role of awake intubation in difficult airway control

We describe the clinical scenario, analyze the decision-making process in airway management, and application of the Difficult Airway Society (DAS) guidelines for awake tracheal intubation (ATI) in a patient involving life-threatening bleeding from an internal carotid artery aneurysm caused by a fistula following radiotherapy for tongue cancer at Hong Ngoc Phuc Truong Minh General Hospital, on March, 2024. A 53-year-old male, diagnosed with tongue cancer, underwent surgery. Days before admission, he experienced pain and bleeding from the right lateral neck due to an internal carotid artery aneurysm. An attempt at tracheal intubation for endovascular intervention at another hospital failed. Upon arrival at our emergency department, he exhibited massive neck hemorrhage, remained conscious, pale, with ongoing bleeding from a right neck fistula, and limited cervical motion due to irritation. A treatment strategy for permanent occlusion of the aneurysm was devised. Awake tracheal intubation using a fiberoptic scope via the nasal route was performed. The patient received light sedation with midazolam, and the airway was topicalized with 10% lidocaine spray over the mouth, tongue, and oropharyngeal mucosa. Continuous monitoring of heart rate, ECG, and oxygen saturation showed no decrease in oxygen levels, and the patient maintained spontaneous breathing throughout. Intensive treatment with crystalloid fluids and blood transfusion, along with right internal carotid embolization with a spring coil, effectively prevented massive hemorrhage. The patient was successfully extubated after three days in the ICU and discharged 15 days post-surgery without any neurological deficits. Keywords: Awake Tracheal Intubation; Difficult Airway Management; Fiberoptic Scope; Emergency Airway Management Citation: Ba NTT. Successful emergency management of hemorrhagic shock due to carotid artery aneurysm: the role of awake intubation in difficult airway control. Anaesth. pain intensive care 2024;28(5):955−959. DOI: 10.35975/apic.v28i5.2572 Received: January 03, 2024; Reviewed: May 05, 2024; Accepted: June 11, 2024

Clinical outcomes of NBF gel application in managing mucositis associated with xerostomia

BackgroundXerostomia, or dry mouth, can be a temporary or persistent symptom resulting from various factors, such as medication use, therapeutic radiation, chemotherapy, autoimmune conditions (e.g., Sjögren’s syndrome), and hormonal imbalances. Xerostomia often leads to associated mucositis, which significantly impacts patients’ quality of life. The nano-bio-fusion (NBF) gingival gel, a gel-type functional toothpaste containing vitamins C, E, propolis, and herbal extracts in a nano-emulsion state, has shown potential in accelerating the healing of oral mucosal lesions.MethodsA total of 127 patients (102 females, 25 males) with persistent xerostomia were treated from 2018 to 2023. Of these, 32 patients were treated exclusively with NBF Gel, while 95 patients received NBF Gel in combination with other medications, such as pilocarpine. The underlying causes of xerostomia included irradiation and chemotherapy (12 patients), medication (40 patients), hormonal imbalance (28 patients), and Sjögren’s syndrome (47 patients). NBF Gel was applied 2–3 times daily to the tongue and oral mucosa. Treatment effectiveness was evaluated through physical examinations and a patient-reported scale ranging from 1 (no improvement) to 10 (complete improvement), focusing on the healing of mucosal lesions rather than saliva production.ResultsBoth treatment groups showed significant improvements in the healing of xerostomia-associated mucositis, particularly in severe cases with visible lesions. Patients treated with NBF Gel reported improved symptoms related to mucosal health, while those who received combination therapy also experienced reduced side effects of pilocarpine due to dose reduction. The most substantial improvements were observed in patients with drug-induced and hormonally-caused xerostomia-related mucositis. No adverse side effects from NBF Gel were reported during the study.ConclusionNBF gingival gel proved to be beneficial in accelerating the healing of mucositis associated with xerostomia, regardless of the underlying cause, including medication use, radiotherapy, chemotherapy, hormonal imbalances, and Sjögren’s syndrome. It presents a promising adjunctive treatment to improve mucosal health and quality of life for patients suffering from xerostomia-associated mucositis.

Mucoadhesive and drug release of cholic acid based thiomeric micelles and encapsulated silver and gold nanoparticles for anticancer studies

Among the various drug delivery system, mucoadhesive formulation is a promising approach to deliver drugs and vaccine through close contact with the absorption site and mucous membrane. Bile acids have received considerable interest in drug delivery (DD) applications owing to their advantages of biocompatibility, ability to act as both drug solubilizing and permeation-modifying agents. In this aspects, cholic acid (CA) based thiomeric micelles with improved mucoadhesive properties have been synthesized by functionalization of thiol groups and conjugation of PEG. The synthesized CA based thiomeric micelles (TCA-PEG) were characterized by 1HNMR, ATR-IR, GPC, Zeta potential and contact angle techniques. The critical micelle concentration (CMC) of TCA-PEG was measured by a fluorescence spectrometer using pyrene as a probe. The mucoadhesive properties of TCA-PEG polymeric micelles (PMs) were examined on the goat anterior tongue mucosa with an effectively higher adhesion of 40 % up to 3 h study period. Also, curcumin loaded TCA-PEG PMs showed only 13 % of the drug released up to the period of 3 h. The TCA-PEG PMs act as reducing and stabilizing agents for the preparation of gold and silver nanoparticle (Ag and Au NPs) and were characterized by UV–visible, DLS, Zeta potential, XPS, and HR-TEM techniques. The cytotoxicity and cellular apoptosis of TCA-PEG PMs encapsulated Ag and Au NPs were examined by MTT assay and AO/PI dual staining using MCF-7 breast cancer cells wherein AgNPs showed an effective cytotoxicity than AuNPs. The developed TCA-PEG PMs act as reservoir for soubilization of hydrophobic and hydrophilic drugs and ideal template for encapsulation of silver and gold nanoparticles for mucoadhesive DD system.

Oral donor site evaluation in the early and late postoperative periods for augmentation and replacement urethroplasty

Introduction. The use of oral mucosa in augmentation and replacement urethroplasty is the gold standard for several reasons. Most commonly, the mucous membrane of the cheek, the underside of the tongue or lip is employed. Assessing postoperative complications in the donor area is crucial as it impacts patients' quality of life.Objective. To evaluate early and late postoperative changes in the donor area after oral graft extraction for urethroplastyMaterials &amp; methods. A retrospective analysis of the results of surgical treatment using oral mucosa from 2017 to 2022 was carried out. The study included 65 patients. The intensity of pain syndrome in the graft sampling area was assessed by patients on a visual analog scale (VAS). The donor area was sutured only in the case of tongue and lip mucosa sampling.Results. The mucous membrane of the oral cavity was harvested from different sites in 65 patients. Specifically, it was taken from the inside of the cheek in 49 patients (75.38%), from both inner sides of the cheeks in 13 (20.0%), the lower lip in two (3.07%) and the lower surface of the tongue in one (1.54%) patient, respectively. On the first day after surgery, the median pain level according to VAS was 4 points (range: 2 – 7), at the time of discharge — 3 points (1 – 6). After 120 days, a follow-up examination showed a regression of pain symptoms: the median was 0 points (0–1). In the late postoperative period, incomplete opening of the mouth was recorded in two patients (3.07%), cosmetic defect in the donor area in two (3.07%), discomfort during meals in six (9.23%), impaired sensitivity in the donor area in two (3.07%), exacerbation of chronic stomatitis and hypersalivation in two (3.07%) patients, respectively.Conclusion. The incidence of complications in the donor area is low, but for some patients this can result in a reduced quality of life. Using proper technique when extracting oral mucosa grafts reduces pain and the likelihood of early- and late-stage postoperative complications in this area.

Oral manifestations of COVID-19 in children: a narrative literature review

COVID-19 triggers an acute inflammatory response in organs, tissues, tongue mucosa, and salivary glands. Some symptoms such as lesions on the tongue and oral mucosa, oral pseudomembranous candidiasis, pharyngitis, taste alteration, gingivitis, canker sores, and even multisystem inflammatory syndrome have been reported in children with COVID-19. Early diagnosis of oral manifestations improves patients' prognosis and quality of life. A narrative literature review was conducted based on studies published in PubMed and LiLacs from January 2020 to April 2024, related to oral manifestations in COVID-19 in children. Of the 68 articles found, 7 were selected after analysis. The main manifestations presented were: abscesses, mucositis, ulcerative lesions, gingivitis, pseudomembranous candidiasis, mucosal lesions, lip and tongue fissures, hemorrhagic crust, inflammation of salivary glands, lip swelling, and reactive infectious mucocutaneous eruption. The selected articles showed that these oral manifestations of COVID-19 can affect children in various age groups, serving as indicators of the disease and signs of worsening infection.

Melatonin as a preventive treatment of tongue mucosa alterations in an animal model of orofacial radiation

Melatonin as a preventive treatment of tongue mucosa alterations in an animal model of orofacial radiation

Surgical Puzzle: Concurrent Comprehensive Neck Dissection Strategies Unravelling the Mystery of Carcinoma Unknown Primary when Performed with TORS Radical Tonsillectomy and Mucosal Tongue Base Wedge Biopsy in Northern Indian Cohort

Surgical Puzzle: Concurrent Comprehensive Neck Dissection Strategies Unravelling the Mystery of Carcinoma Unknown Primary when Performed with TORS Radical Tonsillectomy and Mucosal Tongue Base Wedge Biopsy in Northern Indian Cohort

A Study to evaluate Oral Candidal Colonization and Species Variation in Diabetes Patients

Introduction Diabetes mellitus is a clinical syndrome characterized by hyperglycemia due to absolute or relative deficiency of insulin. In the oral cavity, yeasts commonly colonize the tongue, palate, and buccal mucosa. Aside from oral mucosa, recent research have revealed the existence of C. albicans in other oral sites such as root canal, including persistent infection, carious lesions, and periodontal pockets5. The main aim of the study is to evaluate and compare Candidal colonization and species variation in healthy individuals and Diabetic patients. Material &amp; Methods Study includes 60 samples which are divided into Group –I consist of 30 Diabetic patients &amp; Group II consists of 30 healthy individuals. Blood samples were collected to estimate the glucose levels using Glucose Tolerance Test &amp; HbA1C. Saliva Sample was collected to estimate the candida using VITEK_2 Procedure. The absorbance values were measured on a digital calorimeter for Glucose Tolerance Test &amp; HbA1C levels using the standard protocol. Results Statistical Analysis was done using SPS software. Anova test &amp; Paired t –test were done to estimate the comparison of Candidal positivity to HbA1C and VITEK_2 Procedure showed a mean of 97.33 and SD of 11.02 and with that of HbA1C, showed a mean of 4.93 and SD of 1.00. Comparison of study &amp; control groups with VITEK2 status showed (46%) Candida albicans, followed by (16.67%) Candida famata and (10%) Candida tropicalis. Conclusion The patients with diabetes mellitus are at a higher risk of developing oral Candidiasis. These members of the normal flora probably acquire invasiveness and become pathogenic leading to change in disease progression and develop resistance to the existing drug regime. Key Words: Diabetes mellitus, Glucose, Hyperglycemia, Oral candidasis, Lesions etc.

Rare presentation of drug-induced oral erythema multiforme and its management: a case report

Aim. This case report discusses a rare variant of drug-induced erythema multiforme, focusing on its clinical features, diagnosis, and management. Background. Drug-induced erythema multiforme (DI-EM) is a hypersensitivity reaction occurring due to exposure to certain medications. DI-EM typically presents as erythematous and painful lesions on the oral mucosa, including the lips, tongue, and buccal mucosa. Case description. A 42-year-old male was referred to the Oral Medicine clinic with a chief complaint of painful lip ulceration and eruptions on the body after consuming medications. A detailed history was taken, and after a thorough examination, a perilesional biopsy for histopathological and immunopathological tests was performed. Following the exclusion of all other conditions with a similar presentation, a diagnosis of drug-induced erythema multiforme (DI-EM) was established. Conclusion. DI-EM can pose a diagnostic challenge due to its presentation. However, a diagnosis can be established by excluding other conditions associated with chronic inflammation or the formation of vesicles or bullae. Clinical Significance. DI-EM is a rare variant of EM with a very low prevalence in the general population, making it a challenging condition to diagnose due to its similarity in presentation with other mucocutaneous disorders. A thorough medical history, along with histopathology and immunology tests, coupled with ruling out other diseases and noting a positive history of recent drug consumption, aids in recognizing this condition, given the absence of any confirmatory diagnostic test. Early diagnosis and cessation of causative drugs, along with supportive medications, contribute to the complete resolution of the condition.

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs.

Psychiatric patients suffer from oral diseases and side effects of antipsychotic medication. In particular, the typical antipsychotic drugs may cause severe hyposalivation with subsequent oral symptoms. We therefore aimed to compare oral health behavior and oral side effects of in-hospital patients taking typical vs. atypical antipsychotic drugs with the hypothesis that the former drugs cause more oral pain than the newer drugs. This cross-sectional questionnaire and interview study investigated subjective oral symptoms and their health behavior in 170 hospitalized psychiatric patients, comparing those taking typical vs. atypical antipsychotic drugs. Cross-tabulations and chi-square tests were used for analyses. Persistent oral pain lasting throughout the day was reported by 46% in the typical, and 5% in the atypical antipsychotic group patients, respectively. In both groups, the pain was mainly in the tongue and buccal mucosa and was described as a burning sensation. A significantly higher prevalence of xerostomia was reported in the typical antipsychotic medication group (66%) compared with the atypical antipsychotic medication group (53%, p<0.01). Self-assessed dental health was assessed as poor by two-thirds of the patients of whom 69% reported toothbrushing once daily. Approximately half of them reported having had a visit to a dentist within the previous year. Of the women 28%, and of the men 17%, respectively, had received professional consultations for oral symptoms. The current results on psychiatrically hospitalized patients emphasize the need for awareness of oral discomfort and its subsequent effects on the quality of life in this challenging patient group. Focus should also be placed on a wide range of support encouraging the patients to maintain good daily oral hygiene and seek professional dental help when needed.

Photobiomodulation minimizes taste changes during hematopoietic cell transplantation: A randomized clinical trial.

Prevention and treatment protocols for taste changes observed during hematopoietic cell transplantation (HCT) are not well-established. The purpose of this study was to assess the efficacy of photobiomodulation (PBM) in relieving taste changes and preventing lingual papillae atrophy. HCT patients received PBM (n = 42) on the tongue dorsum using an InGaAIP laser (660 nm, 100 mW, 1.1 W/cm2, 8.8 J/cm2). During the HCT conditioning (T0), severe neutropenia (T1), and after neutrophil engraftment (T2), taste acuity for sweet, bitter, sour, and salty solutions, and clinical appearance of lingual papillae were compared with those of a placebo group (n = 43). PBM significantly reduced hypogeusia, ageusia, and parageusia at T1 and T2, and also successfully prevented papillae atrophy during all the analyzed HCT periods. In conclusion, PBM enhanced taste acuity during HCT. The decrease in papillae atrophy indicated a potential regenerative effect of this therapy on tongue mucosa.

A retrospective study on the clinical characteristics and treatment outcomes of patients with burning mouth syndrome.

Burning mouth syndrome (BMS) refers to a condition characterized by pain sensations such as burning or tingling, or sensory disturbances in the tongue or oral mucosa without any specific local or systemic cause for more than 3 months. This study retrospectively investigated the clinical characteristics of 248 BMS patients (217 women, 31 men, mean age 64.7±11.2 years). Treatment outcomes were assessed using the Numeric Rating Scale (NRS). Parafunctional habit control education, saliva substitute, and counselling for psychological stability were implemented at the first visit, resulting in a significant reduction in NRS scores at the second visit. Medication such as clonazepam or zinc supplements were administered from the second to fourth visit, leading to a significant reduction in NRS scores compared to the initial visit. The various treatment options can be applied to alleviate the symptoms of BMS. Forty-eight patients (19.35%) exhibited serum zinc concentration of 70μg/dL or lower. A well-designed clinical study with a large number of patients is needed to compare the therapeutic effects between underlying conditions, medications, and nutritional supplementation including zinc.

Induction of Peroxiredoxin 1 by Hypoxia Promotes Cellular Autophagy and Cell Proliferation in Oral Leukoplakia via HIF-1α/BNIP3 Pathway.

Hypoxia is a key trigger in the transformation of oral leukoplakia into oral cancer. However, it is still too early to determine the role of hypoxia in the development of oral leukoplakia. Prx1, an antioxidant protein, upregulated by hypoxia, regulates cellular autophagy in leukoplakia. This study aimed to understand the mechanisms by which hypoxia induces Prx1 expression during autophagy in oral leukoplakia. We used an experimental model of tongue epithelial hyperplasia induced by 4-nitroquinoline-1-oxide (4NQO) and dysplastic oral keratinocytes. Prx1 knockdown DOK cells, Leuk-1 cells and control cells were harvested, and cell proliferation was assayed using the Cell Counting Kit-8. Several hypoxia and autophagy-related proteins were examined using quantitative real-time polymerase chain reaction, immunohistochemistry, immunofluorescence, and western blotting in cells and mouse tongue tissues. In addition, the ultrastructure of the cells was observed by transmission electron microscopy. Hypoxia induces cell proliferation, autophagic vesicles and the expression of Prx1, BNIP3, LC3II/I and Beclin-1 in DOK and Leuk-1 cells. However, these effects were all attenuated by Prx1 knockdown. Histologically, 4NQO induced epithelial hyperplasia in the tongue mucosa. The expression of proliferation marker PCNA, autophagy-related proteins LC3B and Beclin-1, as well as HIF-1α/BNIP3 was significantly lower in the tongue tissues of Prx1flox/flox:Cre+ mice compared with Prx1flox/flox mice. In Prx1flox/flox:Cre+ mice, an increased expression of HIF-1α/BNIP3, LC3B and Beclin-1 was detected in epithelial hyperplasia tongue tissues compared to normal tissues. The current study suggests that Prx1 may promotes cell proliferation and autophagy in oral leukoplakia cells via the HIF-1α/BNIP3 pathway.

Secondary oral squamous cell carcinoma following haematopoietic stem cell transplantation.

We report the cases of 10 patients with oral squamous cell carcinoma (SCC) post-haematopoietic stem cell transplant (HSCT). Median latency from HSCT to oral SCC diagnosis was 10 years (range: 4-17 years), with 90% (9/10) reporting a history of chronic graft-versus-host disease (cGVHD) and 40% (4/10) exhibiting active severe manifestations of oral GvHD. Clinical findings at diagnosis included induration, ulceration, tenderness, bleeding, hyperkeratosis, speckling and lymphadenopathy. The tongue and buccal mucosa were the most common sites affected. The disease stage at presentation ranged from T1N0M0 to T4N2M0. Management included surgical resection in 90% (9/10) of patients with or without chemotherapy and/or radiotherapy. The median follow-up for the cohort was 1 year, with a 50% (5/10) mortality rate. SCC-specific mortality was 30% (3/10). Our data highlight the importance of regular, active oral and cutaneous surveillance of patients post-HSCT in specialized dermatology clinics, irrespective of GvHD severity and length of iatrogenic immunosuppression.

Conditional knockout mouse model reveals a critical role of peroxiredoxin 1 in oral leukoplakia carcinogenesis

Peroxiredoxin 1 (Prx1) is an antioxidant protein that may promote the carcinogenesis in oral leukoplakia (OLK). To investigate the effect of Prx1 on the oral mucosal epithelium of OLK, we generated a Prx1 conditional knockout (cKO) mouse model. The mRNA and gRNA were generated using the clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) technique. An infusion cloning method was used to construct a homologous recombination vector. To obtain the F0 generation mice, fertilized eggs of C57BL/6J mice were microinjected with Cas9 mRNA, gRNA, and a donor vector. Polymerase chain reaction (PCR) amplification and sequencing were used to identify F1 generation mice. Using the cyclization recombination-enzyme-locus of the X-overP1 (Cre-loxP) system, we created a Prx1 cKO mouse model, and the effectiveness of the knockout was confirmed through immunohistochemistry. We examined the influence of Prx1 knockout on the occurrence of OLK in mice by constructing a model of tongue mucosa carcinogenesis induced by 4-nitroquinoline-1-oxide (4NQO). Prx1 modification was present in the F1 generation, as evidenced by PCR amplification and sequencing. Prx1flox/flox: Cre + mice exhibited normal growth and fertility. Immunohistochemical analysis revealed that tongue epithelial cells in Prx1flox/flox: Cre + mice displayed a distinct deletion of Prx1. An examination of the heart, liver, spleen, lung, and kidney tissues revealed no visible histological changes. Histological analysis showed a reduction in the occurrence of the malignant transformation of OLK in the tongue tissues of Prx1flox/flox: Cre + mice. Ki67 immunostaining showed that Prx1 knockout significantly inhibited cell proliferation in the tongue epithelial. Our research developed a conditional knockout mouse model for Prx1. The obtained results provide insights into the function of Prx1 in the development of oral cancer and emphasize its potential as a therapeutic target for precancerous oral lesions.

Characteristics of Oral Hemangioma and Vascular Malformation Cases: A Study at Hasan Sadikin General Hospital, 2019-2023

This observational retrospective study conducted at Hasan Sadikin General Hospital (RSHS) in Bandung from January 2019 to February 2023 aimed to characterise oral hemangiomas and vascular malformations. Out of 52 medical records analysed, infantile hemangioma was the most common type (17%), typically presenting between ages 13 to 24 years. Predominantly located around the lip, tongue, and buccal mucosa, it seldom caused bleeding or pain, with women being more affected. Treatment often involved sclerotic agent injections. Venous malformations accounted for 58% of vascular malformations, showing similar age of presentation and distribution as hemangiomas, and were also treated with sclerotic agents. Accurate diagnosis and tailored treatment are crucial due to the diverse nature of these anomalies. Early detection using imaging techniques like ultrasound and CT angiography is imperative, given the potential impact on patients, including pain, swelling, and cosmetic concerns, particularly in the head and neck area. However, treatment approaches vary based on factors such as type and size, necessitating further research to refine diagnostic and therapeutic strategies and optimise patient outcomes.

Mucous extravasation phenomenon: A clinicopathologic evaluation of 68 cases.

A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland also called a sialocele and ptyalocele. Two types are recognized as mucus extravasation cyst and the other is retention type. To evaluate the clinicopathologic features of oral mucocele cases. The archival blocks which were signed out as mucocele were taken for the study. The following parameters such as age, gender, history of trauma, site, histological features, and clinical presentations were taken into consideration. 68 cases of mucous extravasation cysts were analysed, among which 58% were males and 42% were females. Age of the patients ranged from 4 to 70 years with an average of 20 years. The most common locations were the lower lip (87%), tongue (5%) and buccal mucosa (8%). Almost 53% of cases are seen on the left side of the oral cavity. Most of the cases presented a history of trauma. Histopathologically 23% of cases presented with muciphages in the lumen and connective tissue. The commonly encountered benign salivary lesion of the oral cavity is the mucus extravasation phenomenon of the mucocele. Various histopathological features were discussed in this study to avoid misdiagnosis of this common lesion in dental practice.