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Conditions that mimic skin cancer.

There are several conditions that may clinically and microscopically mimic skin cancer. Some of the more serious and unusual differential problems are infections, neoplasms, non-infectious granulomas, and ulcers. Particular attention is given to giant keratoacanthoma dn the Buschke-Lowenstein wart.

Biopsy↗

Erythema migrans--a psoriasiform lesion of the oral mucosa.

Psoriasiform lesions are unusual occurrences on oral mucosa. Nineteen cases of erythema migrans are presented with a discussion of the literature. Fifty-eight percent of these cases presented with tenderness, pain, or roughness. One case was associated with geographic tongue and two cases with cutaneous psoriasis.

Adult↗

Eruptive familial lingual papillitis: a new entity?

In order to describe the characteristic signs and course of a possibly new clinical entity, we undertook a clinical study of a series consisting of four families (5 children and 10 relatives) with a distinctive eruption of the tongue. The disease always started in a child, usually an infant (mean age 15.2 months), and then spread to one or several other members of the family. It had an abrupt onset and was characterized by difficulties in feeding, increased salivation, and irritability. Inflamed, hypertrophic fungiform papillae were seen on the tip and the dorsolateral part of the tongue, some having a pseudopustular appearance. There were no vesicles, erosions, signs of geographic tongue, or oral thrush; the central part of the tongue, the lips, gingivae, palate, and throat were normal. The acute phase lasted 6 to 7 days and was self-limited. A few days later, one or several relatives experienced an intense burning sensation on the tongue, with an increase and exacerbation caused by food intake, with the identical features of inflamed papillae. The duration of the stomatitis was usually 1 week for the infants, but longer for some adults. The similarity of these cases suggests the existence of a new clinical entity possibly of viral origin. We propose naming this eruption "eruptive familial lingual papillitis."

Adult↗

Prevalence of geographic and plicated tongue in 6090 Iraqi schoolchildren.

The prevalence of geographic and plicated tongue among 6090 Iraqi schoolchildren was determined according to age and sex. Geographic tongue was observed in 4.3% of the population and plicated tongue in 2.6%. Significant sex difference was found only in children with plicated tongue. The prevalence rates varied irregularly with age in both sexes for both tongue anomalies and although significant differences were found between the ages, a steady increase or decrease was not clear, which could be due to the short span of age used in this investigation. The only significant association found was between geographic and plicated tongue in males, which may indicate a genetic linkage between the two conditions.

Age Factors↗

Epidemiologic studies of oral mucosal conditions--methodologic issues.

The methods used in the international English-language literature of epidemiologic investigations of oral mucosal conditions were reviewed. Methods used to study leukoplakia, lichen planus, recurrent herpes labialis, recurrent aphthous ulcers, geographic tongue and candidiasis are highlighted. In addition, studies of the full range of pathologies documented in a population were reviewed. The methodologic issues raised by the epidemiologic literature as well as those to be considered for future studies of oral mucosal conditions are presented. Emphasis is placed on study population selection, diagnostic criteria development, type and training of examiners, risk factor assessment and issues related to data collection, analysis and reporting.

Candidiasis, Oral↗

Prevalence of tongue lesions in 1013 Jordanian dental outpatients.

Over a period of 10 months, 1013 consecutive dental outpatients attending the Screening Clinic in Faculty of Dentistry, Jordan University of Science and Technology, in the city of Irbid were investigated for the presence of tongue lesions. All subjects were seeking treatment for caries and periodontal diseases and none was complaining of oral mucosal disorder. The results showed that 240 subjects (23.7%) had one or more tongue lesions. Geographic tongue and fissured tongue were detected in 6.8% and 11.4% of the examined population respectively, and an association of the two conditions was observed in 2.9% of the subjects. Hairy tongue was diagnosed in 3.4% of the subjects with significantly higher prevalence in males (P < 0.0005). A strong correlation was found between hairy tongue and smoking.

Adult↗

Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87.

Oral mucosal lesion findings from a national multistage probability oral health survey of United States schoolchildren in kindergarten through grade 12 are reported. In the 1986-87 school year 39,206 children aged 5-17 yr were examined by 14 dentists trained in standardized clinical diagnostic criteria for dental caries, periodontal conditions and oral mucosal lesions. In addition all children were asked whether or not they ever had "cold sores," "fever blisters," or "canker sores", and adolescents (grades 6-12) were questioned about their history of tobacco use. About 4% of the children had one or more oral mucosal lesions present at the time of the examination, while 33 and 37% reported a history of recurrent herpes labialis and recurrent aphthous ulcers, respectively. The most prevalent lesions clinically observed were recurrent aphthous ulcers (1.23%), recurrent herpes labialis (0.78), smokeless tobacco lesions (0.71), and geographic tongue (0.60). Differences in prevalence were analyzed by age, sex, race, metropolitan area, and geographic region. Almost 10% of 12-17-yr-olds reported current use of some type of tobacco product. In adolescents the current use of tobacco products had a marked effect on the prevalence of oral lesions.

Adolescent↗

Geographic tongue: an SEM study.

In this study, scanning electron microscopy (SEM) was used to describe in detail the surface structure of geographic tongue. Tissue samples from the anterior part of the tongue were removed from 15 patients with geographic tongue and from 15 control subjects. Normally, the surface mucosa of the tongue was covered by filiform papillae, which consisted of the body and hairs. The mucosal surface of the body was smooth with some desquamating cells, but hairs were covered by an extensive plaque of microorganism. With SEM, the surface of geographic tongue contained 3 different types of mucosa: atrophic area, white margin, and area of normal appearance. On the atrophic area, the mucosa formed low elevations, and hairs were lacking. At high magnification, the superficial cells of the low elevations were polygonal, and they had parallel or branching microplicae. The white margin contained many desquamating cells, which had broken microplicae or no surface structures. Here the inflammatory infiltrate of the epithelium and that of the subepithelial connective tissue was moderate. On the normal-appearing area, desquamation of the mucosa on the papillar bodies was more pronounced than normally. On every specimen was a fissure, on the walls of which the superficial cells had broken microplicae and knob-like structures. The adherence of candidal hyphae within the superficial cells was seen in the area of the fissure. On the geographic tongue some fungiform papillae with taste pores were seen.

Adult↗

Clinical, histologic and scanning electron microscopic study of the development of chronic candidiasis of the rat tongue.

In order to examine the development of the chronic candidal lesion of the dorsal rat tongue, 210 rats were given a single oral inoculum of Candida albicans on Day 0 and were sequentially killed over a 20-wk period. Dorsal tongue changes were evaluated using clinical photographs, histologic sections and scanning electron microscopy (SEM). Clinically evident lesions became apparent at 2 wk post-inoculation, and inflammatory changes of the underlying connective tissue were observed by 3 wk post-inoculation. SEM showed a gradient of destruction of the dorsal tongue papillae at the periphery of the candidal lesions. Hyphae were seen infrequently on the lesional surface by SEM, a finding which correlated with the light microscopy.

Animals↗

Geographic stomatitis: report of 6 cases.

The macro- and microscopic appearance and results of microbiologic and immunohistochemical investigations in six patients with geographic stomatitis are described. On the background of similarities in both the clinical, histologic and immunohistochemical findings it is felt that psoriasis and stomatitis geographica are related lesions.

Adult↗

Oral psoriasis: report of six new cases.

This article presents six cases of oral psoriasis originally diagnosed by means of the histological changes found on biopsies of the oral lesions. Three of the patients presented with oral and skin psoriasis. Of the remaining three, two presented with oral manifestations alone, although their follow-up was short, whilst the third showed delayed dermatological changes. Two of the cases were also complicated by psoriatic arthritis, one of them to the temporomandibular joint.

Adult↗

Oral manifestations in glycogen storage disease type 1b.

Glycogen storage disease type 1b is a rare metabolic disorder which affects the transport system of glucose-6-phosphatase metabolism. As a result, hepatomegaly, failure to thrive, renal dysfunction and recurrent infections occur in affected patients. In this paper, the oral complications in three children with glycogen storage disease type 1b are discussed. Oral ulcers were a common finding, probably due to severe neutropenia and impaired neutrophil migration which characterises the onset of this rare disorder.

Child, Preschool↗