Oral medicine case book 65: Necrotising stomatitis.

Necrotising stomatitis is a fulminating anaerobic polybacterial infection affecting predominantly the oral mucosa of debilitated malnourished children or immunosuppressed HIV-seropositive subjects. It starts as necrotising gingivitis which progresses to necrotising periodontitis and subsequently to necrotising stomatitis. In order to prevent the progression of necrotising stomatitis to noma (cancrum oris), affected patients should be vigorously treated and may require admission to hospital. Healthcare personnel should therefore be familiar with the signs and symptoms of necrotising gingivitis/necrotising periodontitis, of their potential sequelae and of the need for immediate therapeutic intervention.

A 20-year retrospective study of oral and maxillofacial histopathology in a South African paediatric population sample.

INTRODUCTION: The characterisation of oral and maxillofacial (OMF) histopathology found in children has not yet been reported from South Africa. AIMS AND OBJECTIVES: This study aims to evaluate the spectrum of OMF histopathological diagnoses encountered in a sample of South African children. METHODS: A retrospective study was designed to analyse the clinico-pathologic data, as obtained from OMF histopathology reports, at the University of the Witwatersrand's Division of Oral Pathology over a 20-year period. RESULTS AND CONCLUSIONS: A total of 1,258 OMF biopsies from children < or = 16 years of age with histologically confirmed disease were recorded, accounting for 6,5% of the total number of OMF biopsies received during this period. Pathology involving the jaw bones formed the largest category of all OMF pathologies and was predominated by odontogenic cysts and tumours. The remaining pathology, in decreasing order of frequency; involved the oral/perioral soft tissues, salivary glands and oral mucosa. Malignant neoplasms comprised 4,1% of the total number of cases with Burkitt's lymphoma emerging as the most common malignancy. Although the smallest number of biopsy specimens was obtained from children younger than 5-years of age, the likelihood of a malignant diagnosis in this age group was substantially higher than in older children.