Tongue Mucosa Research Articles

Non-syndromic oropharyngeal hamartoma: A case report

This case report details the presentation, investigation, management, and histopathological examination of a rare occurrence – non-syndromic oropharyngeal hamartomas in a 2-year-old child. The child presented with a substantial orofacial mass on the dorsum of the tongue, causing significant functional impairments. Notably, the mass measured 8×4 cm and protruded outside the oral cavity. Additional findings included a nodular mass at the tongue tip, a lobulated mass on the right buccal mucosa (3×4 cm), cleft palate, microphthalmos of the right eye, and an accessory pinna on the right cheek. Diagnostic investigations, including ultrasound, revealed irregular soft tissue lesions with hypoechoic areas and vascular channels, indicative of hemangioma. Blood parameters were within normal limits. Due to the size and symptomatic nature of the mass, surgical intervention was planned and executed under general anesthesia with nasal intubation. The procedure involved complete dissection and excision of the masses from the tongue and buccal mucosa. The surgical site was meticulously closed in layers using 4-O vicryl. Postoperatively, the child resumed oral feeds on the third day, and the recovery period was uneventful. Histopathological examination of the excised specimen depicted a hamartomatous lesion of the tongue characterized by stratified squamous epithelial lining, admixture of blood vessels, adipose tissue, fibrocollagenous tissue, cartilaginous tissue, nerve bundles, adnexal structures, and minor salivary glands. The report concludes by highlighting the rarity of lingual hamartomas, emphasizing the exceptional size and vascularity of the presented case. It stresses the necessity of considering hamartomas in the differential diagnosis of tongue lesions in pediatric patients. The definitive management approach discussed is complete surgical excision, with the importance of confirming the diagnosis through histopathological examination of the excised specimen. This case contributes with valuable insights into the clinical presentation and management of non-syndromic oropharyngeal hamartomas in pediatric patients.

Decoding the Enigma: Harnessing HPV Testing for the Precision Care in Carcinoma Unknown Primary with Secondary Metastasis to the Neck in North Indian Population Undergoing TORS for Primary Identification.

To assess the exact role of high-risk HPV testing in patients of carcinoma unknown primary with secondary metastasis to the neck who underwent TORS and neck dissection for identification of the primary site. A prospective study was carried out at a tertiary care centre over one year. Patients with unilateral neck swelling, which was cytologically proven squamous cell carcinoma neck metastasis, were included in the study. After clinicopathological evaluation, they underwent TORS-assisted ipsilateral radical tonsillectomy, tongue base mucosal wedge biopsy for primary site identification, and ipsilateral neck dissection. They underwent HPV RNA ISH from the tonsil, the base of the tongue and blood. They also underwent HPV DNA testing from the blood. P16 was done in the base of tongue, tonsil, and lymph node specimens. In the study cohort of 18 patients who underwent ipsilateral radical tonsillectomy, mucosal tongue base wedge biopsy and neck dissection, p16 positivity was isolated in 5.56%, 0% and 2.78% of patients, respectively. (n = 1/18, 0/18, 5/18). Interestingly, HPV E7 mRNA expression was absent in the tonsil /base of tongue specimens, but metastatic lymph nodes displayed expression in 11.11%. HPV DNA was undetected in all analysed tissues and patients' blood. In the Indian subcontinent, it is not essential to do detailed high-risk HPV analysis in cases of carcinoma unknown primary with secondary metastasis to the neck.

Pyogenic Granuloma of the Gingiva

Pyogenic granuloma is a benign vascular lesion that usually occurs in response to various stimuli caused by chronic irritation, trauma and hormonal factors. These lesions generally occur on the gingiva but can also occur on the lips, tongue and buccal mucosa. A 22 year old female patient came with complaints of a lump on the gingiva between teeth 35 and 36 and felt uncomfortable. I have had complaints since 7 months ago after a filling was made on the left back molar tooth, then 1 day later a lump appeared. Complaints are not accompanied by pain. The treatment plan in this case is to carry out information education communication, scaling, gingivectomy and a histopathological examination to confirm the diagnosis and carry out control and evaluation. Pyogenic granuloma is a benign, non-neoplastic lesion. The clinical picture of this lesion is generally a mass with a soft consistency, painless, and dark red to reddish purple in colour which usually appears as a solitary lesion with a diameter of 5-10 mm and is very fragile, so it bleeds easily due to minor trauma. Management of this lesion can be done with a surgical procedure to completely remove the lesion and then carry out an anatomical histopathological examination to confirm the diagnosis of this lesion. This lesion has no signs of malignancy

The immunomodulatory impact of naturally derived neem leaf glycoprotein on the initiation progression model of 4NQO induced murine oral carcinogenesis: a preclinical study.

Murine tumor growth restriction by neem leaf glycoprotein (NLGP) was established in various transplanted models of murine sarcoma, melanoma and carcinoma. However, the role of NLGP in the sequential carcinogenic steps has not been explored. Thus, tongue carcinogenesis in Swiss mice was induced by 4-nitroquinoline-1-oxide (4NQO), which has close resemblance to human carcinogenesis process. Interventional role of NLGP in initiation-promotion protocol established during 4NQO mediated tongue carcinogenesis in relation to systemic immune alteration and epithelial-mesenchymal transition (EMT) is investigated. 4NQO was painted on tongue of Swiss mice every third day at a dose of 25µl of 5mg/ml stock solution. After five consecutive treatment with 4NQO (starting Day7), one group of mice was treated with NLGP (s.c., 25µg/mice/week), keeping a group as PBS control. Mice were sacrificed in different time-intervals to harvest tongues and studied using histology, immunohistochemistry, flow-cytometry and RT-PCR on different immune cells and EMT markers (e-cadherin, vimentin) to elucidate their phenotypic and secretory status. Local administration of 4NQO for consecutive 300 days promotes significant alteration in tongue mucosa including erosion in papillae and migration of malignant epithelial cells to the underlying connective tissue stroma with the formation of cell nests (exophytic-hyperkeratosis with mild dysplasia). Therapeutic NLGP treatment delayed pre-neoplastic changes promoting normalization of mucosa by maintaining normal structure. Flow-cytometric evidences suggest that NLGP treatment upregulated CD8+, IFNγ+, granzyme B+, CD11c+ cells in comparison to 4NQO treated mice with a decrease in Ki67+ and CD4+FoxP3+ cells in NLGP treated cohort. RT-PCR demonstrated a marked reduction of MMP9, IL-6, IL-2, CD31 and an upregulation in CCR5 in tongues from 4NQO+NLGP treated mice in comparison to 4NQO treated group. Moreover, 4NQO mediated changes were associated with reduction of e-cadherin and simultaneous up-regulation of vimentin expression in epithelium that was partially reversed by NLGP. Efficacy of NLGP was tested first time in sequential carcinogenesis model and proved effective in delaying the initial progression. NLGP normalizes type 1 immunity including activation of the CD8+T effector functions, reduction of regulatory T cell functions, along with changes in EMT to make the host systemically alert to combat the carcinogenic threat.

Pyogenic granuloma of gingiva –A case report

Reactive hyperplasia of connective tissue caused by local irritants is known as pyogenic granuloma. It is a tumor-like development of the oral cavity that is thought to be neoplastic in nature. It is typically found around the skin or anterior teeth. Numerous stressors, such as intense injury, low-grade local discomfort, hormone fluctuations, or certain drugs, are commonly the cause of it. Histologically, the surface epithelium may show foci of ulcerations, hyperkeratosis, or even intact. It sits on top of a thick mass of connective tissue with a high concentration of fully grown collagen. The most often impacted area is the gingiva, which is followed by the lips, tongue, and buccal mucosa. In general, pyogenic granuloma does not develop when the base and its contributing variables are removed.

Mechanism underlying the anti-diabetic potential of bee venom as compared to bone marrow mesenchymal stem cells in the diabetic rat tongue.

Diabetes mellitus (DM) is a critical chronic metabolic disease. Several treatment modalities are currently under investigation. Both bee venom (BV) and bone marrow mesenchymal stem cells (BMSCs) can possibly offer an approach for treating type I diabetes. The aim of the present study was to investigate the mechanism underlying the anti-diabetic effect of BV as compared to BMSCs on the tongue mucosa of diabetic rats. A total of 52 male albino rats were used in the current study. The rats were randomly assigned into 4 groups: group 1 (control); group 2 (streptozocin (STZ)); group 3 (BV-treated); and group 4 (BMSC-treated). Diabetes mellitus was induced via an intraperitoneal (IP) injection of STZ in the rats from groups 2, 3 and 4. Following the diagnosis of DM, the rats in group 3 were injected with a daily dose of 0.5 mg/kg of BV, while the rats in group 4 were treated with a single injection of BMSCs. All rats were euthanized after 4 weeks, and their tongues were dissected and divided into halves. The right halves of the tongues were utilized for the histological examination, followed by morphometric analysis. In contrast, the left halves were used to detect the local gene expression of transforming growth factor beta 1 (TGF-β1) and vascular endothelial growth factor (VEGF). Group 2 revealed marked disruption in the morphology of the fungiform and filiform papillae, and atrophic epithelial changes in both dorsal and ventral surface epithelium as compared to other groups. Group 4 showed a significantly larger number of taste buds, and a higher gene expression of TGF-β1 and VEGF as compared to groups 2 and 3. Additionally, BV and BMSCs effectively increased the thickness of dorsal and ventral surface epithelium as compared to group 2. Treatment with BMSCs was associated with significant improvement in the morphology and number of lingual epithelial cells and taste buds in the tongues of diabetic rats as compared to BV-treated rats, which was due to the local upregulation of TGF-β1 and VEGF gene expression.

Proliferative verrucous leukoplakia: a general dental practitioner-focused clinical review

Proliferative verrucous leukoplakia (PVL) is a distinct type of oral leukoplakia which has the potential to enlarge or develop into new areas of leukoplakia coupled with areas of a warty surface texture. PVL is usually diagnosed from the fifth decade onwards and is more common in female patients. The most frequent sites involved tend to be gingivae, followed by buccal mucosa and lateral border of tongue. It is one of the oral potentially malignant conditions with a high risk of malignant transformation. It is important for general dental practitioners (GDPs) to identify such lesions to facilitate referral for further investigation and diagnosis. Management is challenging with long-term monitoring and surgical excision when appropriate; however, PVL tends to recur following surgical excision. This article provides an up-to-date review tailored for GDPs on the present knowledge of PVL and illustrates the management challenges with clinical cases.

Structural and functional abnormalities of the tongue: An epidemiological study from a tertiary care center in India.

The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. Many notable structural and functional alterations can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 to February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed on the tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend their tongue out. Medical history, drug history, and social history were recorded. The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were mostly in the anterior two-thirds (4.2%) of the tongue. Functional abnormalities of the tongue were noted in 8.7% of the study participants. The results of the present study showed that structural and functional abnormalities of the tongue were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkups. This shall help in the prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

АНАЛИЗ СТОМАТОЛОГИЧЕСКОЙ ЗАБОЛЕВАЕМОСТИ СРЕДИ ДЕТЕЙ ДОШКОЛЬНОГО ВОЗРАСТА ИЗ НЕПОЛНЫХ И РАСШИРЕННЫХ СЕМЕЙ

Introduction. This article is devoted to the study of the prevalence of dental diseases in preschool children living in incomplete and extended families. In the course of the study, children from both types of families were examined for dental caries and its complications, for non-caries dental diseases. While studying periodontal diseases, were distinguished inflammatory diseases, such as catarrhal and hypertrophic gingivitis, as well as localized periodontitis, when studying diseases of the oral mucosa, we highlighted diseases of the lips, tongue and oral mucosa. When studying dentoalveolarabnomalies, we identified both abnormalities of bite, dental arches and rows, and individual teeth. 
 The subject of research is dental diseases in preschool children.
 The goal of the study is to analyze dental morbidity in children from extended and incomplete families.
 Methodology. The study was conducted on the basis of the UniDent network of dental clinics, as well as in the Fairy Tale preschool commercial institution in Kazan and municipal preschool institutions of Tatarstan Republic. A total of 222 children from 217 incomplete families and 213 children from 199 extended families of both sexes participated in the voluntary study. Examination of children included examining the child and talking with parents or guardians, filling out medical records, determining the type of family, filling out an individual card in which identified dental diseases were recorded.
 The results of the study indicate a high prevalence of dental diseases among preschool children in TR. The progression of dental diseases is observed with the age of the child. Children from incomplete families are more susceptible to the occurrence and development of dental diseases, compared with children from extended families.
 Conclusions. The findings on the disparate prevalence of dental diseases in children from incomplete and extended families suggest the presence of family type influences, which may be useful in planning prevention methods and predicting dental outcomes in children from different family types.

Case report on Irritational Fibroma

ABSTRACT Traumatic or irritation fibroma is the healed end product of the inflammatory hyperplastic lesion, which can occur at any age from almost any softtissue site, tongue, gingiva, and buccal mucosa being the most common. It is usually characterized by a slow, painless growth accumulated over a period of months or years.

Management of Hemangioma Buccal Mucosa by Sclerotherapy - A Case Report

Haemangiomas are the most common benign soft tissue tumours of the oral cavity. It often presents at birth or soon after and appears as a soft and vascular swelling in the lip, tongue, or buccal mucosa. It can be managed medically or surgically. This article reports a case of hemangioma of the buccal mucosa in a 13- year-old boy effectively managed by sclerotherapy

Lichenoid and psoriasiform drug induced rush during imatinib therapy: a clinical case

Tyrosine kinase inhibitor imatinib is a standard agent for treatment of gastrointestinal stromal tumors (GIST). Treatment courses are quite long and are usually well tolerated. However, skin rash can occur on treatment, with a prevalence of 7 to 88.9%. We describe a clinical case of a patient with GIST, who has been on treatment with imatinib at daily dose of 400 mg for one year. Several weeks from the treatment initiation, she had facial edema, and 4 months thereafter psoriasiform rash appeared which was initially considered to be psoriatic. After 8 months, the patient had lichenoid rash on the inguinal skin and oral, tongue and vulvar mucosae. Clinically, the lichenoid rash was similar with lichen ruber planus. To confirm the diagnosis, we performed biopsy of psoriasiform and lichenoid foci. Histological examination verified the drug-induced rash. Topical treatment of psoriasiform rash with glucocorticosteroids resulted in regression of some plaques, although a proportion of them persisted. Inguinal and vulvar lichenoid rashes completely regressed and numbers of oral and tongue foci decreased after a 6-week daily application of the 0.1% tacrolimus cream. Treatment with imatinib 400 mg daily was not interrupted. The clinical observation illustrates the possibility of skin and mucosal lichenoid and psoriasiform rash simultaneously during treatment with imatinib and demonstrates the first successful experience in the treatment of lichenoid rashes with 0.1% tacrolimus cream.

Dyskeratosis congenita: beyond the triad and beyond the cause

Introduction: Dyskeratosis congenita (DC) is a rare genodermatosis caused by mutations in various genes encoding the proteins responsible for maintaining the telomere length. It is defined by the presence of three clinical features: nail dystrophy, abnormal skin pigmentation, and oral leukoplakia. We herein report a typical case of DC with all three classical features along with pancytopenia, osteopenia, and epiphora but with no identifiable pathogenic mutations of DC-associated genes. Case presentation: Cutaneous examination revealed areas of hypopigmented and hyperpigmented macules forming a reticular pattern all over the body but mainly over the neck and upper chest, with relative sparing of the face. Skin atrophy with hypopigmentation was observed on the knuckles. The nails showed dystrophy in the form of pterygium, anonychia, and brittleness. The palms showed mild wrinkling with hypopigmented macules. Examination of the oral cavity revealed a white non-removable coating over the tongue and bilateral buccal mucosae (oral leukoplakia); the teeth were normal. Syringing of both eyes was performed by an ophthalmologist, and the patient was diagnosed with punctual stenosis (occlusion of the opening of the lacrimal canaliculus). Discussion: DC is a genodermatosis caused by germline mutations in genes encoding telomerase-associated components, shelterin proteins, and other regulators of telomere length and replication. Depending upon the gene involved, the mode of inheritance can be X-linked autosomal dominant or autosomal recessive. DC is characterized by the clinical triad of abnormal skin pigmentation, dystrophic nails, and oral leukoplakia. Patients with DC are also known to develop other rare clinical features at later stages, including epiphora, early graying of the hair, premature tooth loss, enteropathy with malabsorption, immune deficiency, esophageal stricture, cardiomyopathy, liver cirrhosis, osteoporosis and avascular necrosis of the bone. Patients with DC are predisposed to the development of malignancies, especially hematological malignancies and head/neck cancer. Management of DC involves a multidisciplinary approach and includes genetic counseling of family members at risk, regular surveillance of the patient for bone marrow failure and malignancies, and treatment of the associated features and any complications. Conclusion: Dyskeratosis congenita (DC) is a rare genodermatosis caused by mutations in various genes encoding telomerase complex. We present a typical case of DC with all three classical features but with no pathogenic mutations of existing DC-associated genes thus raising the possibility of new unidentified genes in the pathogenesis of DC.

P-10 A rare case of Triple A Syndrome with familial involvement

Abstract Introduction Alacrimia, achalasia cardia, and adrenocorticotrophic hormone (ACTH)-resistant adrenal insufficiency make up the triple-A syndrome. It is an uncommon disease with an autosomal recessive inheritance pattern. The AAAS gene, which codes for the ALADIN protein and is located on chromosome 12q13, is the cause of Allgrove syndrome. The initial and typical symptoms are achalasia cardia and adrenal insufficiency. The majority of neurological disorders have autonomic signs, and they typically show in later life. The other typical neurological conditions are polyneuropathy, amyotrophy, and optic atrophy. Clinical Case A 25-year-old female patient presented to our clinic with complaints of weakness, dizziness, and hyperpigmentation of the skin. Her medical history revealed a recent intensive care unit (ICU) stay due to hypotension, during which her condition was managed with steroid therapy. However, she did not continue the steroid treatment after discharge. Notably, the patient had a family history of achalasia with operative intervention in all three siblings. The patient and her family members were also under the care of a gastroenterology specialist. Additionally, the patient reported experiencing dry eyes, for which she was using artificial tears. Physical examination revealed hyperpigmentation of tongue, gums and buccal mucosa. Upon examination, her baseline investigations revealed a hemoglobin of 11.4 g/dL, sodium 137 mmol/L and potassium 4.0 mmol/L. The patient's adrenocorticotropic hormone (ACTH) level was measured at 1250 pg/ml, with a basal cortisol level of 0.5 ug/dL, leading to the diagnosis of adrenal insufficiency. Hydrocortisone treatment was initiated at a dosage of 2×10mg, resulting in a decline of the ACTH level to 31. Given the combination of symptoms including achalasia, alacrima, and adrenal insufficiency, genetic testing was conducted. Both alleles revealed a homozygous c.1432C>T (p.Arg478*) mutation, confirming the diagnosis of Triple A Syndrome. Following the genetic diagnosis, a familial investigation was initiated. This investigation revealed the presence of the homozygous positive mutation in two siblings and two cousins. The constellation of symptoms and the genetic findings confirmed the occurrence of Triple A Syndrome within this family. Conclusion This case highlights the significance of recognizing Triple A Syndrome as an underlying cause of adrenal insufficiency in the presence of achalasia, alacrima, and a suggestive clinical history. In order to confirm the diagnosis and identify any affected family members, genetic testing is crucial. To avoid potential complications brought on by adrenal insufficiency and other systemic Triple A Syndrome manifestations, early identification and treatment are crucial.

Establishing a causal link between the human papilloma virus and oral fibromas

Fibroma, a benign tumour of fibrous connective tissue, can be seen as a reactive connective tissue hyperplasia in response to trauma and irritation. They typically have a firm consistency, are nodular and asymptomatic, have a colour that is similar to the mucosa, a sessile base, a smooth surface, and are situated in the buccal mucosa along the line of occlusion, tongue, and lip mucosa. We retrospectively investigated total 79 cases and intriguingly, 41 cases were not associated with any history or clinical evidence of chronic trauma of dental origin suggesting different pathogenesis mechanism. Out of 79 cases of oral fibroma, 18 showed evidence of koilocytes in the overlying epithelium with 14 cases not associated with history of any trauma. This might suggest the cause and effect relationship between HPV and oral fibromas, however, the possibility of secondary infection in already existing fibroma can be considered. This intriguing finding prompt us to propose a novel hypothesis explaining the role of human papilloma virus in the pathogenesis of fibroma.

Assay Analysis of Tannase from Lactobacillus plantarum.

Tannin, which is an astringent taste in the mouth, is a polyphenol compound contained in some plants. Tannin causes denaturation of proteins of the tongue or oral mucosa. Tannase, a hydrolase that cleaves carboxylic ester bonds specifically, is used in many industrial fields. Some tannase (tannin acyl hydrolase, EC3.1.1.20) is used widely to prevent or reduce creaming of some foods and beverages. Because some tannins are formed of insoluble salts combined with protein, they reduce creaming such as the white hazing of iced tea. Moreover, they can clarify beverages such as fruit juices during wine and beer production. Tannase is produced by microorganisms under conditions with tannic acid present, mainly from plants. Tannase characteristics differ according to its microorganism of origin. Therefore, it is important to study the microbes used as lactic acid bacteria (LAB), evaluate new methods of tannase assay, and apply them in food or other industries. In this chapter, assay of tannase in LAB is demonstrated using methyl gallate as substrate, with color development by rhodanine and potassium hydroxide solution, using a spectrophotometer. Actual data of high tannase-producing LAB, Lactobacillus plantarum, and enzyme characteristics in optimum conditions are presented in this chapter.

Atypical Presentation of Lobular Capillary Haemangioma of the Maxillary Alveolus: A Case Report

Pyogenic Granuloma (PG) is a benign vascular lesion that rapidly grows, is painless, and presents as a friable, smooth, or lobulated exophytic lesion, manifesting as small, red, erythematous papules with a pedunculated or sessile base. The most common site is the gingiva, followed by the tongue and buccal mucosa. Hereby, the authors present a case of a five-year-old girl who reported for an oral and maxillofacial consultation with a swelling in her left upper gum region, associated with multiple episodes of intermittent bleeding. On presentation, a bluish-red, sessile lesion was observed on the gingiva of the left upper 1st molar. Magnetic Resonance Imaging (MRI) and Angiography provided a provisional diagnosis of a vascular tumour, following which embolisation and excision of the lesion were performed by Interventional Radiologists (IR) and Maxillofacial Surgeons. The patient’s recovery was uneventful, and histopathology{Haematoxylin and Eosin (H&E)} was reported as Lobular Capillary Haemangioma (LCH).

Clinicopathological Features of a Lower Lip Verruciform Xanthoma: A Rare Case Report

Verruciform Xanthoma (VX) is an uncommon, benign, asymptomatic lesion of the oral cavity. The incidence rate of VX is 0.025%, with the most common location reported to be the gingival margin, followed by the tongue, hard palate, buccal and labial mucosa. It may also present on the skin and genitals. VX can manifest as a solitary or multiple lesion with well-defined margins. It appears as a papule or plaque with verrucous or papillary growth, exhibiting variable colours ranging from reddish-pink and yellow to grey. While the lesion typically appears verruciform, it may also have a polypoid, papillomatous, or sessile nature. In the present case report, the authors present a 45-year-old male patient with a history of tobacco use, who exhibited a reddish-pink papillomatous growth on his labial mucosa for a duration of three months. The growth was surgically excised, and histopathological evaluation confirmed the characteristic features of VX. The lesion healed without complications, and no recurrence was observed. Clinically, VX may be mistaken for various malignant or premalignant lesions such as papilloma, verrucous carcinoma, or proliferative verrucous leukoplakia. Therefore, it is crucial to differentiate VX from these conditions to avoid inappropriate intervention. Histopathological evaluation is necessary for the definitive diagnosis of the lesion, which reveals the pathognomonic presence of foamy histiocytes within the elongated dermal papillae. The present case report highlighted the diverse clinical features of VX and discusses its histological findings along with the differential diagnosis.

Oral Soft Tissue Metastasis from Breast Cancer as the Only Primary Source: Systematic Review.

Background Breast cancer is one of the most lethal neoplasms causing death. Oral cavity is the rare site of distant metastasis from breast cancer. Very little research has been conducted to date to analyze breast cancer as the sole primary source of metastasis to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from breast cancer as the only primary source to date. Methods An electronic search of the published literature was performed without publication year limitation in PubMed/Medline, Scopus, Google Scholar, Web of Science, Science Direct, Embase, and Research Gate databases, using mesh keywords like ("Breast cancer", OR "Breast carcinoma") AND ("Metastasis" OR "Metastases"), And ("Oral soft tissues" OR "Tongue" OR "Palate" OR "Tonsil" OR "Buccal mucosa" OR "Floor of mouth" OR "Vestibule" OR "Salivary glands"). We also searched all related journals manually. The reference list of all articles was also checked. Results Our research revealed 88 relevant papers (September 1967-September 2023) with 96 patients in total. The most predominant oral soft tissues involved were salivary glands followed by the gingiva, tonsils, tongue, and buccal mucosa. A total of 23% of patients died with an average survival time of 1 to 15 months. Conclusions Oral soft tissue metastasis from breast cancer is a rare event and has a bad prognosis. More cases need to be published to raise awareness of these lesions.

Evaluation of rat model oral candidiasis mucosal response immune

Background: The choice of antifungal drugs is limited and has not yet made significant progress. The animal model of oral candidiasis is a crucial factor in exploring antifungals. In our previous study's oral candidiasis rat model, we found an increase in the sedimentation rate and a decrease in infection microbiologically and histologically on day 8 compared to day five after inoculation. On the other hand, blood plasma levels of IL-17, as the main cytokine in fungal infections, keep at a low level. The study aims to prove the increase in the immune response in the oral mucosa of an oral candidiasis rat model on the 8th day after inoculation of C. albicans. Methods: The sample consisted of 2 groups; healthy Wistar rats as a control and Wistar Rat rats treated as an oral candidiasis rat model. Eight days after inoculating C. albicans,The immune response was evaluated by counting the number of visual field inflammatory cells on the dorsum of the rat dorsum tongue.Results: The number of inflammatory cells, including macrophages in the dorsal tongue mucosa of oral candidiasis rats, was higher than that of healthy rats. Conclusion: There was an increase in the number of inflammatory cells in the dorsum of the tongue mucosa of the oral candidiasis rat model on day 8, which is a sign of an increased immune response in the experimental animal model.