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.

Absence of multinucleated giant cell reaction as an indicator of tumor progression in oral tongue squamous cell carcinoma.

PURPOSE: The aim of this study was to evaluate the presence and distribution of multinucleated giant cell (MGC) reactions in 61 cases of OTSCC and to verify the association of this microscopic finding with clinicopathological parameters (gender, age, tumor size/extent, regional lymph node metastasis, distant metastasis, clinical stage, and histopathological grade of malignancy). METHODS: Clinical data were collected from medical records and the histopathological grade of malignancy of OTSCCs was evaluated using the World Health Organization (WHO) grading system. The presence and distribution of MGC reaction in high power fields (HPFs) were evaluated in hematoxylin-eosin-stained histological sections. In all cases containing MGCs, immunohistochemical analysis for CD68 was performed in order to confirm the histiocytic nature of these cells. RESULTS: Twenty-one (34.4%) cases had MGC reactions, with a higher frequency of the focal distribution pattern (57.1%). All MGCs were immunohistochemically positive for CD68. The absence of MGC reaction was significantly associated with regional lymph node metastasis (PR: 2.75; 95% CI 1.05-7.20; p = 0.027), advanced clinical stage (PR: 3.37; 95% CI 1.28-8.85; p = 0.006), and moderately/poorly differentiated tumors (PR: 3.36; 95% CI 1.51-7.48; p = 0.001). No significant associations were observed between the distribution of MGCs and clinicopathological parameters (p > 0.05). CONCLUSION: Taken together, the results of this study suggest that the absence of MGC reaction may represent an indicator of tumor progression in OTSCCs.