Smokeless tobacco habits and oral mucosal lesions in dental patients.

As part of a smokeless tobacco (ST) intervention study, we collected data on tobacco use habits and oral health for 245 male ST users aged 15 to 77. The study sample was identified during routine dental office visits and represents a relatively diverse population of patients. Oral health data collection included grading the clinical appearance of oral mucosal lesions using Greer and Poulson's classification system, as well as identifying and recording the primary anatomic location of ST placement. Results show that 78.6 percent of ST users had observable oral lesions, 23.6 percent of which were in the most clinically advanced category (degree III). Of the lesions noted, 85 percent were in the same location the patient identified as his primary area of smokeless tobacco placement. In a comparison sample of 223 non-ST-users with the same age distribution, only 6.3 percent had observable lesions. A multiple logistic regression model for ST users showed that lesion presence and severity were most significantly related to current frequency of ST use.

African Burkitt's lymphoma: case report and light and electron microscopic findings.

An African Burkitt's lymphoma occurred in a 9-year-old American boy who had jaw tumors, proptosis, and abdominal masses. Histologically, the tumor consisted of a monotonous overgrowth of undifferentiated lymphocytes with a "starry sky" appearance. The differential diagnosis of African versus American form and Burkitt's lymphoma versus non-Burkitt's lymphoma is discussed.

Multiple familial ossifying fibromas: relationship to other osseous lesions of the jaws.

Multiple familial ossifying fibroma is a very rare jaw lesion. A 31-year-old white woman who had this heritable condition is reported. A differential diagnosis has been discussed to delineate an entity that has not appeared in the previous literature.

Spindle cell squamous carcinoma of the tongue in the first decade of life.

A case of spindle cell squamous cell carcinoma of the tongue in a 4-year-old boy is presented. The diagnosis is supported by immunohistochemical demonstration of cytokeratins within the tumor cells. The authors believe this report represents the first case of "nonkeratinizing" spindle cell squamous carcinoma of the tongue in the first decade of life.

Purpuric oral and cutaneous lesions in a case of drug-induced thrombocytopenia.

This case, from all appearances, seems to constitute a case of secondary thrombocytopenia caused by drugs. Whether the etiology is one of over-dosage achieved when the two drugs, propranolol and disulfiram, were used in combination, or the interaction of the two drugs, or a response to disulfiram is difficult to state definitely. The use of propranolol alone does not seem to be the triggering factor because the patient resumed use of the drug without ill effect. Either an overdosage, exceeding a triggering threshold, was achieved in the combined usage of these two potentially purpuric drugs, or a reaction to disulfiram occurred subsequent to prior sensitizing exposure to this drug. The case does point out that the practitioner, whether dental or medical, should take a careful drug history--particularly in cases of purpura but also in other conditions, such as xerostomia, lichenoid reactions, and burning mouth or tongue. A copy of a current Physician's Desk Reference should be available in every dental or medical office.