Oral lesions of systemic lupus erythematosus: A collaborative Latin American study.

BACKGROUND: Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. METHODS: This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. RESULTS: Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11-77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. CONCLUSION: Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.

Oral squamous cell carcinomas and oral potentially malignant disorders: A Latin American study.

OBJECTIVE: To determine the frequency of oral squamous cell carcinoma (OSCC) associated or not with oral potentially malignant disorders (OPMD), and the epidemiological profile and traditional risk factors in Latin America. METHODS: A retrospective observational study was conducted in 17 Latin American centres. There were included cases of OSCC, analysing age, gender, OSCC and their association with previous OPMD. Clinicopathological variables were retrieved. The condition of sequential-OSCC versus OSCC-de novo (OSCC-dn) was analysed concerning the aforementioned variables. Quantitative variables were analysed using Student's t-test, and qualitative variables with chi-square. RESULTS: In total, 2705 OSCC were included with a mean age of 62.8 years old. 55.8% were men. 53.75% of the patients were smokers and 38% were common drinkers. The lateral tongue border was the most affected site (24.65%). There were regional variations in OPMD, being leukoplakia the most frequent. Of the overall 2705 OSCC cases, 81.4% corresponded to OSCC-dn, while s-OSCC were 18.6%. Regarding lip vermillion SCC, 35.7% corresponded to de novo lip SCC and 64.3% were associated with previous OPMD. CONCLUSIONS: In Latin America, OSCC-dn seems to be more frequent with regional variations of some clinical and histopathological features. Further prospective studies are needed to analyse this phenomenon.

Acquired oral syphilis: A multicenter study of 339 patients from South America.

OBJECTIVE: To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS: Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS: The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION: This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries.

Association between coca (Erythroxylum coca) chewing habit and oral squamous cell carcinoma: a case-control study from Argentina.

OBJECTIVE: Previous isolated reports have hypothesized that chewing coca leaves, a pre-Columbian tradition found in certain regions of South America, may be associated with the development of oral squamous cell carcinoma (OSCC). Coca chewing (CC) is a habit that shares many characteristics with the well-known practice of betel chewing observed in Asia. The aim of this study is to analyze the association between CC and OSCC among patients who attended the Señor del Milagro Hospital in Salta, Argentina. STUDY DESIGN: A case-control study was conducted from 2013 to 2018. For each case of OSCC, three healthy control patients were included. Odds ratios were calculated to compare demographics, concurrent oral conditions, and other classical risk factors for OSCC. RESULTS: A total of 62 cases and 180 controls were included, adjusted for sex and age. OSCC was significantly associated with tobacco use (27.4% vs 9.4%, P = .001), CC (62.9% vs 32.2%, P < .001), and poor oral condition (81.1% vs 67.7%, P = .02). In the multivariate analysis, smoking (OR = 2.77, 95% CI 1.23-6.25, P = .0139), CC (OR = 2.98, 95% CI 1.58-5.63, P = .0007), and poor oral condition (OR = 3.1, 95% CI 1.62-5.85, P = .0006) remained independently associated with OSCC development. CONCLUSIONS: Chewing coca leaves could be considered a risk factor for oral cancer in a subset of Argentinean patients. Further studies are necessary to validate our findings and to elucidate the underlying pathways linking this habit to oral carcinogenesis.

Manifestaciones gingivales de sífilis secundaria: serie de casos / Gingival manifestations of secondary syphilis: case series

Objetivo: La sífilis es una enfermedad de transmisión sexual con una incidencia creciente a nivel mundial. En la sí- filis secundaria, las lesiones orales son frecuentes, siendo a veces la única manifestación. El objetivo de este artículo es presentar una serie de casos clínicos de sífilis con localización predominante o exclusivamente gingival, destacando las ca- racterísticas clínicas más relevantes para su diagnóstico. Casos clínicos: Esta serie de casos clínicos incluyó nueve casos de sífilis secundaria con manifestaciones gingi- vales. El diagnóstico se realizó mediante pruebas serológicas (VDRL, TPPA, FTA-ABS y MHA-TP), y se describieron le- siones tanto gingivales como extragingivales. En la encía se observó sífilis secundaria afectando principalmente la región anterior ­tanto superior como inferior­, presentándose pla- cas rojas o blancas. Algunos casos también presentaban le- siones en otros sitios intraorales, tenían síntomas como dolor o sensación de ardor, o presentaban enfermedad periodontal dependiente de placa. El diagnóstico diferencial de sífilis se- cundaria gingival con condiciones periodontales inespecíficas es fundamental para un diagnóstico adecuado. Por lo tanto, se debe considerar el diagnóstico de sífilis secundaria cuando se enfrentan casos gíngivo-periodontales atípicos en la práctica diaria (AU)

Aim: Syphilis is a sexually transmitted disease with growing incidence worldwide. In secondary syphilis, oral le- sions are common, sometimes being the only manifestation. Gingival features of syphilis are rare and usually present mul- tiple oral lesions. The aim of this article is to present a series of clinical cases of syphilis with predominantly or exclusively gingival localization, highlighting the most relevant clinical characteristics for its diagnosis. Clinical cases: This clinical case series included nine cases of secondary syphilis with gingival manifestations. The diagnosis was made using serological tests (VDRL, TPPA, FTA-ABS, and MHA-TP), and both gingival and extragingi- val lesions were described. Secondary syphilis was observed in the gum, mainly affecting the anterior region ­both up- per and lower­, depicting red or white plaques. Some cases also presented lesions in other intraoral sites, had symptoms such as pain or burning sensation, or showed plaque induced periodontal disease. The differential diagnosis of second- ary syphilis considering non-specific periodontal conditions with gingival involvement is essential for a proper diagnosis. Thus, the diagnosis of secondary syphilis should be consid- ered when dealing with atypical gingivo-periodontal cases in everyday practice (AU)

Cáncer Oral: Conocimiento, Actitudes y Prácticas de los Odontologos de la Provincia de Salta, Argentina, 2018

RESUMEN: Según Global Cancer Observatory de la IARC, el cáncer oral en Argentina tiene una tasa de mortalidad de 1,1 por 100.00 habitantes para 2020. La mayoría de los casos se diagnostican en etapas tardías aun cuando la detección temprana y el control de los factores de riesgo son las herramientas más eficaces para reducir la alta letalidad de esta enfermedad. Se desconoce el nivel de conocimientos, actitudes y prácticas de los odontólogos acerca de la prevención del cáncer oral en Argentina. Evaluar a través de un cuestionario, los conocimientos, actitudes y prácticas sobre el cáncer oral en la provincia de Salta, Argentina. En una muestra a conveniencia de 76 odontólogos que ejercían su profesión y que asistían a un evento de la colegiatura odontológica provincial, se aplicó una encuesta confidencial sobre conocimientos, actitudes y prácticas sobre la prevención del cáncer oral. Se analizó la encuesta a partir de estadística descriptiva e inferen cial. Los odontólogos tienen conocimiento sobre los factores de riesgo del cáncer oral, tales como consumo de tabaco (88,2 %), presencia de lesiones potencialmente malignas (84,2 %), consumo de alcohol, pero también sobre tipos de lesiones premalignas (88,2 %) y principal localización del cáncer oral (84,2 %). Las actitudes dependen de "tener una especialidad en el campo odontológico" y de "haber tomado un curso formal en los últimos 12 meses" (c2 = 13,512, GL= 4, p=0,009). Las prácticas dependen de "haber tomado un curso formal en los últimos 12 meses", de la "creencia de que el profesional está adecuadamente preparado para realizar un examen para cáncer oral", y el "tipo de práctica profesional" (c2 = 14,078, GL=7, p=0,034). Este estudio reveló que es necesario fortalecer los conocimiento, actitudes y prácticas de los odontólogos de la Provincia de Salta en Argentina frente a la prevención del cáncer oral, esto con el propósito de diseñar estrategias de salud pública realmente efectivas, que además no solo deben ser ejecutadas por la autoridad sanitaria, sino que deben ser examinadas por las escuelas de Odontología.

ABSTRACT: According to Global Cancer Observatory of the IARC, oral cancer in Argentina has a mortality rate of 1.1 per 100,000 inhabitants for 2020. Most cases diagnosed in late stages even when early detection and control of risk factors are the most effective tools to reduce the high lethality of this disease. The level of knowledge, attitudes and practices of dentists regarding oral cancer prevention in Argentina is unknown. To evaluate, through a questionnaire, the knowledge, attitudes and practices about oral cancer in the province of Salta, Argentina. In a convenience sample of 76 dentists who practiced their profession and who attended an event of the provincial dental association, a confidential survey applied on knowledge, attitudes and practices on the prevention of oral cancer. The survey analyzed based on descriptive and inferential statistics. Dentists are aware of risk factors for oral cancer, such as tobacco use (88.2 %), presence of potentially malignant lesions (84.2 %), alcohol consumption, but also about types of premalignant lesions. (88.2 %) and main location of oral cancer (84.2 %). Attitudes depend on "having a specialty in the dental field" and "having taken a formal course in the last 12 months" (c2 = 13.512, DF= 4, p=0.009). Practices depend on "having taken a formal course in the last 12 months", on the "belief that the professional is adequately prepared to perform an examination for oral cancer", and the "type of professional practice" (c2 = 14.078, DF=7, p=0.034). This study revealed that it is necessary to strengthen the knowledge, attitudes and practices of dentists in the Province of Salta in Argentina regarding the prevention of oral cancer, this with the purpose of designing really effective public health strategies, which also not only must be executed by the health authority but must be examined by dental schools.

Leishmaniasis mucocutánea con manifestacion oral: reporte de un caso / Mucocutaneous leishmaniasis with oral manifestation: case report

La Leishmaniasis es un grupo de enfermedades transmitidas por vectores y causada por la Leishmania, un parásito intracelular, que se presenta de preferencia en regiones tropicales y subtropicales. Se manifiesta mediante un amplio rango de formas clínicas como la cutánea, mucocutánea, y visceral, dependiendo de la especie y respuesta inmunológica del paciente. Se presenta el caso de un hombre de 35 años que acudió derivado a Unidad de Estomatología del Hospital Señor del Milagro, Salta, Argentina, presentando en la cavidad oral lesión, granulomatosa, ulcerada, dolorosa a la palpación, única, en paladar blando, de tres meses de evolución. Se realizaron estudios serológicos, parasitológicos y PCR. Los ELISAs lisados, PCRs y cultivos de materiales de lesiones fueron positivos, confirmando diagnóstico de leishmaniasis mucocutánea. El paciente fue derivado al Servicio de Dermatología donde recibió tratamiento con Antimoniato de Meglumina, con repuesta clínica favorable. El conocimiento de las manifestaciones orales puede llevar al diagnóstico clínico de leishmaniasis mucocutánea por parte del odontólogo, pudiendo entregar un tratamiento oportuno y a la vez ayudar al paciente, evitando complicaciones de esta enfermedad.

Leishmaniasis is a group of vector-borne diseases caused by Leishmania, an intracellular parasite, which occurs preferentially in tropical and subtropical regions. It manifests itself through a wide range of clinical forms such as cutaneous, mucocutaneous, and visceral, depending on the species and the patient's immune response. We present a case of a 35-year-old man who was referred to the Stomatology Unit of the Señor del Milagro Hospital, Salta, Argentina, presenting in the oral cavity lesion, granulomatous, ulcerated, painful on palpation, unique, soft palate with three months of evolution. Serological, parasitological and PCR studies were performed. Lysed ELISAs, PCRs and cultures of lesion materials were positive, confirming diagnosis of mucocutaneous leishmaniasis. The patient was referred to the Dermatology Service where he received treatment with Meglumine Antimony, with favorable clinical response. The knowledge of the oral manifestations can lead to the clinical diagnosis of mucocutaneous leishmaniasis by the dentist, being able to provide timely treatment and at the same time help the patient, avoiding complications of this disease.

Lesiones orales de sífilis secundaria limitada a la cavidad oral: informe de un caso / Oral lesions of secondary syphilis restricted to the oral cavity: report of a case

Objetivo: Describir un caso clínico de sífilis secundaria localizada en cavidad oral. Caso clínico: Un paciente masculino de 24 años, proveniente de Joaquín V. González, provincia de Salta, fue derivado a Unidad de Estomatología del Hospital Señor del Milagro, con manifestaciones orales de una semana de evolución. Clínicamente, se observaron lesiones blancas opalinas, indoloras, compatibles con pápulas sifilíticas, en diferentes ubicaciones orales. Se realizaron estudios serológicos que confirmaron el diagnóstico de sífilis secundaria. El paciente fue derivado al Servicio de Infectología, donde recibió tratamiento con una dosis de penicilina G benzatínica 2.400.000 UI intramuscular, con repuesta clínica favorable. Conclusión: El conocimiento de las manifestaciones orales puede llevar al diagnóstico clínico de la sífilis secundaria por parte del odontólogo, lo cual, junto con su tratamiento oportuno, puede evitar la transmisión de la enfermedad. El diagnóstico precoz es la mejor manera de ayudar al paciente y de prevenir las complicaciones (AU)

Manifestaciones orales de Paracoccidioidomicosis: informe de un caso / Oral manifestations of Paracoccidioidomycosis: report of a case

Objetivo: un caso clínico de paracoccidioidomicosis restringida a cavidad oral, contribuyendo con el conocimiento de esta patología al odontólogo general. Caso clínico: paciente masculino de 57 años de edad proveniente de la ciudad de Tartagal, Salta, derivado a la Unidad de Estomatología del Hospital Señor del Milagro, por presentar lesiones orales de tres meses de evolución. Clínicamente se observaron lesiones granulomatosas, indoloras, moriformes, en encía vestibulary palatina del sector antero superior derecho con ausencia de lesiones pulmonares. Se realizaron estudios microbiológicos y anatomopatológicos. Posteriormente, el paciente fue derivado al Servicio de infectología, donde recibió tratamiento con itraconasol (200 mg), con repuesta clínica favorable. Conclusión: el conocimiento de las manifestaciones orales puede llevar al diagnóstico clínico de la paracoccidioidomicosis por parte del odontólogo. El diagnóstico precoz es la mejor manera de salvar al paciente de las complicaciones de esta enfermedad.

Objective: a clinical case of paracoccidioidomicosis restricted to oral cavity, contributing to the knowledge of this disease to the general dentist. Case report: male patient of 57 years old from Tartagal, Salta referred to the Stomatology Center of Hospital Señor Del Milagro, presenting oral lesions with an evolution of three months. He had painless granulomatory lesions in the buccal and palatal gingiva of the upper right sector and without lungs injury. It performed microbiological and pathological studies. Subsequently, the patient referred to the Service of Infectious Diseases where he was treated with 200mg Itraconasol with a favorable clinical response. Conclusion: knowledge of oral manifestations can lead to clinical diagnosis of paracoccidioidomicosis by general dentist. Early diagnosis is the best way to save the patient from complications of this disease.