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[Immunological mechanism of exfoliative tongue fur in children with asthma].

OBJECTIVE: To explore the immunological mechanism of exfoliative tongue fur in children with asthma. METHODS: Thirty-nine children with asthma, twenty-eight children with repetitive respiratory tract infection (non-asthma) and eleven healthy children were divided into five groups, which were asthma with exfoliative fur or with non-exfoliative fur groups, non-asthma with exfoliative fur or with non-exfoliative fur groups and normal control group. The concentrations of keratin 13 and bcl-2 in cells exfoliated from tongue fur were detected by immunohistochemical method. The expression levels of blood cell chemokine receptor-3 (CCR-3) and CD4(+) were examined by flow cytometry, and the levels of serum cortisol and IgE were detected by radioimmunoassay. RESULTS: The levels of blood CD4(+) and CCR-3 of children with asthma and exfoliative fur were higher than those in the asthma with non-exfoliative fur group and the normal control group (P<0.05). The serum level of cortisol in the groups of asthma with exfoliative fur and non-asthma with exfoliative fur were lower than that in the other groups (P<0.05). The serum levels of IgE in asthma with exfoliative fur or with non-exfoliative fur groups were higher than that in the other groups (P<0.05). Concentrations of keratin 13 in the cells exfoliated from tongue fur in the groups of asthma or non-asthma with exfoliative fur were lower than that of the other groups (P<0.05). There was no significant difference of expression level of bcl-2 in the cells exfoliated from tongue fur among these five groups. CONCLUSION: There is a reasonably close relationship between the formation of exfoliative tongue fur and the immune system such as low level of serum cortisol and high levels of blood CD4(+) and CCR-3, which may all promote the formation of exfoliative fur. The disability of keratinization and apoptosis of epithelial cells of tongue may also be one cause for its formation.

Asthma↗

Geographic lip: a variant of geopgraphic tongue.

The following aspects of the classic geographic tongue are discussed: clinical polymorphism with the appearance of annulus migrans, histological appearacne of the spongiform pustule, frequent association with pustular psoriasis and related diseases, and its relationship to psoriasis buccalis. Two cases of geographic lip are described in which annulus migrans was present. In one case, the geographic lip was associated with a plicated lip, a labial form of plicated tongue.

Adolescent↗

[Burning tongue (author's transl)].

Burning tongue mostly does not occur as a disease per se, but as a symptom primarily of internal but also of neurological, dermatological, psychiatric and dental diseases. To facilitate differential diagnostic considerations, a short description is given of the individual clinical pictures as well as of the pertinent findings. The knowledge of these diseases is a prerequisite to the causal and lasting treatment of patients affected by the obstinate and occasionally even painful symptom of the burning tongue.

Adult↗

[Epidemiologic survey of tongue lesions and analysis of the etiologic factors involved].

The prevalence of tongue lesions, and relationships with different systemic diseases, according to the international literature of epidemiologic studies were reviewed. The data were compared with a Hungarian investigation of 5034 individuals, between 1992 and 1995 in Budapest. Tongue lesions were found in 22.76% of the examined individuals. The ratio was similar in women (51%) and men (49%). Fissured tongue was found in 21.49%, geographic tongue in 2.21%, atrophic tongue in 0.12% and central papillar atrophy in 0.70%. These data agree in general with the epidemiological data found in the international literature. Some rare tongue alterations were also investigated. Lingua indentata was found in 1.49% and hypertrophy of papillae foliatae was found in 0.20%. The relationship with different systemic diseases was the following: In diabetes mellitus tongue lesions were found in 29.03%, in hypertension in 28.63%, connected to heart- and vascular diseases in 25.15%, to haematologic diseases in 17.54%. Tongue lesions were found in 23.86% in the case of liver disease, in 22.38% in gastrointestinal diseases and in 20.69% associated to tumors. In the case of Candida's infection tongue alterations were found in 41.6%, in smokers in 23.72%. Tongue lesions caused complaints rarely, only in 2.27%. The recognition of tongue lesions may be helpful in the early diagnosis of systemic diseases.

Cardiovascular Diseases↗

Tongue fissures. A classification and comparative prevalence study among 825 European Caucasian and 605 Xhosa Negro school children.

Six distinct patterns of tongue fissuring have been observed: plication, central longitudinal fissuring, double fissures, transverse fissures arising from a central fissure (type "A"), transverse fissures without a central fissure (type "B") and lateral longitudinal fissures. Some tongues exhibited more than one pattern. There was a significant correlation between double fissures and central longitudinal fissuring (P less than 0.002) but not between other forms of fissuring. No significant relationship was found between the occurrence of atrophic lesions and the prese-ce of fissuring. Significant differences were found between the prevalences in Xhosa and Europeans for central longitudinal fissuring, double fissures and both types of transverse fissures but not for plication. No significant differences were found between males and females and in the age distribution for those with and those without each type of fissuring. It is suggested that most tongue fissuring seen in children should be considered variations in normal anatomy rather than an abnormality.

Adolescent↗

Ectopic erythema migrans in an adolescent with a skin disorder.

Red and white circular lesions of the buccal and labial mucosa were observed in an adolescent. Periodically, these nontender patches would resolve and move to other oral sites. Detection of ectopic erythema migrans aided in the diagnosis of a bothersome skin condition.

Adolescent↗

Treatment approaches to common symptomatic oral lesions in children.

A variety of oral mucosal lesions can be symptomatic in children. This article describes the classic clinical appearance of the most common oral diseases and provides treatment recommendations that are tailored to the pediatric age group. When possible, more than one drug alternative is given for each of the different oral conditions for an improved success rate. It is essential for the clinician to understand that this article should be used as a guide for managing oral and perioral lesions in children and adolescents. Specific dosages and formularies of drugs may require modification in the young child. Consultation with a primary care physician and pharmacist often is needed to ensure the best possible outcome, especially when immunosuppressive drugs are indicated. Most importantly, oral lesions that do not respond to therapeutic protocols should be referred to the appropriate specialist for definitive diagnosis and treatment.

Adolescent↗

[Actinomycosis after renal transplantation: apropos of 1 case and review of the literature].

Actinomycosis is a suppurative infection usually due to a facultative anaerobic bacteria, actinomyces israelii. This rare infection has been reported in immunocompetent individuals, with buccal or pharyngeal mucosal erosions. Paradoxically, few cases have been observed after solid organ transplantation: 2 cases after lung, 1 case after heart-lung transplantation and 1 case after renal transplantation. We report on a renal transplant recipient who developed a tongue and oropharynx suppurative abscess, looking like an epithelioma. Histological examination showed granulomatous inflammation with an angiofibroblastic reaction; few colonies of actinomyces were also observed by the pathologist. This lesion disappeared easily and totally after tetracycline treatment.

Actinomyces↗

[A case of tongue actinomycosis].

The authors present a case of actinomyces of the tongue indicating initial actinomyces with signs of ulceration possibly neoplastic. A swab from a discharge confirmed actinomycosis. A diagnosis by antibiogram led to a cure of the specific location and the general infection.

Actinomycosis↗