Investigation of oral atopic diseases: Correlation between geographic tongue and fungiform papillary glossitis.

INTRODUCTION: The correlation between oral lesions and atopy is not new, but few studies have investigated the prevalence of mucosal changes in diseases within the atopic spectrum, leading to conflicting data. Some studies found a possible relationship between geographic tongue, transient lingual papillitis and atopic diseases. AIM: To investigate the frequency of geographic tongue and fungiform papillary glossitis in patients with atopic diseases, and its correlation with serum IgE levels and skin test results. MATERIAL AND METHODS: The sample was comprised of participants with atopic diseases paired with participants who received negative puncture skin tests. All were submitted to stomatological and medical evaluations, prick test and oral cytopathological. RESULTS: The female sex was more numerous in both groups. Mean age was 21 years. A total of 60 diagnoses of atopic diseases were obtained, with allergic rhinitis being the most prevalent. Fungiform papillary glossitis was the most frequent oral lesion in both groups, while geographic tongue was present in 2 cases (2%) in the test group and 2 (2%) in the control group. Atopic patients with fungiform papillary glossitis presented high serum IgE levels. In atopic patients with geographic tongue, the prick test positively identified extracts of Dermatophagoides pteronyssinus (100%) and Dermatophagoides farinae (100%). CONCLUSION: Due to the low frequency of geographic tongue lesions found in the study, it is no possible to conclude if that could be an oral manifestation of atopy. However fungiform papillary glossitis is a common alteration in atopic and non-atopic patients and has a relationship with high IgE serum levels. However, the consolidation of this result requires a larger sample size.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with iron deficiency.

BACKGROUND/PURPOSE: Our previous study found that 180 of 1064 atrophic glossitis (AG) patients have iron deficiency. This study assessed whether all AG patients with iron deficiency (so-called ID/AG patients) had iron deficiency anemia (IDA) and evaluated whether the ID/AG patients had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. METHODS: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 180 ID/AG patients and 532 healthy control subjects were measured and compared. RESULTS: We found that 180 ID/AG patients had significantly lower mean corpuscular volume (MCV) and lower mean blood Hb and serum iron levels as well as significantly higher mean serum homocysteine level than healthy control subjects (all P-values < 0.001). Moreover, 180 ID/AG patients had significantly higher frequencies of blood Hb (46.1%), serum iron (100.0%), vitamin B12 (8.3%), and folic acid (4.4%) deficiencies, hyperhomocysteinemia (16.1%), and serum GPCA positivity (31.1%) than 532 healthy control subjects (all P-values < 0.001). In addition, of 83 anemic ID/AG patients, 9 (10.8%) had pernicious anemia, 40 (48.2%) had normocytic anemia, 30 (36.2%) had IDA, and 4 (4.8%) had thalassemia trait-induced anemia. CONCLUSION: We conclude that ID/AG patients had significantly higher frequencies of blood Hb, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than 532 healthy control subjects. Normocytic anemia is the most common type of anemia in ID/AG patients, followed by IDA, pernicious anemia, and thalassemia trait-induced anemia.

Anemia, hematinic deficiencies, hyperhomocysteinemia, and gastric parietal cell antibody positivity in atrophic glossitis patients with vitamin B12 deficiency.

BACKGROUND/PURPOSE: Our previous study found that 56 of 1064 atrophic glossitis (AG) patients have vitamin B12 deficiency. This study assessed whether the AG patients with vitamin B12 deficiency (B12D/AG patients) had significantly higher frequencies of anemia, hematinic deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity than healthy control subjects. METHODS: The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, and GPCA levels in 56 B12D/AG patients and 532 healthy control subjects were measured and compared. RESULTS: We found that 56 B12D/AG patients had significantly lower mean blood Hb and serum iron levels as well as significantly higher mean corpuscular volume (MCV) and mean serum homocysteine level than healthy control subjects (all P-values < 0.05). Moreover, 56 B12D/AG patients had significantly higher frequencies of macrocytosis (53.6%), blood Hb (64.3%), iron (26.8%), and folic acid (3.6%) deficiencies, hyperhomocysteinemia (89.3%), and serum GPCA positivity (55.4%) than 532 healthy control subjects (all P-values < 0.005). In addition, of 36 anemic B12D/AG patients, 22 (61.1%) had pernicious anemia (PA), 6 (16.7%) had macrocytic anemia other than PA, 4 (11.1%) had normocytic anemia, 3 (8.3%) had iron deficiency anemia (IDA), and one (2.8%) had microcytic anemia other than IDA and thalassemia trait-induced anemia. CONCLUSION: We conclude that B12D/AG patients have significantly higher frequencies of macrocytosis, blood Hb, iron, and folic acid deficiencies, hyperhomocysteinemia, and serum GPCA positivity than healthy control subjects. PA is the most common type of anemia in our B12D/AG patients.

CONTRIBUTIONS TO RECOGNITION OF SOME PARTICULARITIES OF THE LINGUAL MUCOSA CONDITIONS.

UNLABELLED: Part of the oral cavity structure, the tongue plays an important role, both by its functions, and pathology, which sometimes can seriously damage the state of the entire body. As an important component of the dento-maxillary apparatus, the tongue has particular appreciative and perceptive abilities, also playing a role in articulation. The conditions of the mucosa and profound tissues of the tongue are generically named glossitis. Glossitis encompasses a wide range of conditions, from the common saburral deposits up to various forms of glossitis or the impressive tumoral lesions. MATERIAL AND METHOD: A clinical-statistical study has been conducted on a group of 24 patients, females and males, 55 - 70 years old, in order to monitor the detection of the lingual mucosa lesions. RESULTS: The damage of the lingual mucosa of the examined patients was subject to statistical analysis, revealing 24 patients with lingual mucosa lesions. The analysis of the type of lesion highlighted the diversity of the presented forms of lesions. CONCLUSIONS: For a proper medical conduct, the dentist should know the degree of involvement of the aggravating factors in the onset of oral mucosa lesion, its particularities, and apply them in a customized manner; proper examination can be very important in detecting and treating these conditions.

Prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, Northeast Iran.

OBJECTIVE: The aim of this study was to determine the prevalence of oral mucosal lesions in institutionalized elderly people in Mashhad, northeast of Iran. BACKGROUND: This study was conducted to assess the prevalence of oral lesions in the institutionalized elderly. METHODS: In this survey, we studied all of the nursing homes in Mashhad; a total of five encompassing 237 residents. The subjects were examined and lesions recorded in a designed checklist. T-test, chi-square and Fisher's exact tests were used for the analysis. RESULTS: The mean age of the patients was 79.59 ± 8.88. Ninety-eight per cent of cases had at least one oral mucosal lesion. The most common lesions were fissured tongue (66.5%), atrophic glossitis (48.8%), sublingual varicosity (42%) and xerostomia (38%). There was no significant difference in the prevalence of denture-related lesions (DRLs) between men and women (p > 0.05). Xerostomia was more prevalent in 70-79-year-old than in 60-69-year-old subjects. No case of oral malignant lesion was detected. DISCUSSION: These findings revealed a higher prevalence of oral mucosal lesions in Mashhad city compared with other studies conducted in other major cities in Iran and abroad. The results emphasise the necessity of national programmes towards oral health promotion.

Oral signs in the diagnosis of celiac disease: review of the literature.

This study explores the possibility that the celiac disease (CD) may be correlated with the insurgence of some oral signs, as based on a systematic review of the literature. Should this correlation be proven, any dentistry's screening would then be important to diagnose early celiac sprue pathogenesis. A literature survey was accomplished by using the Medline database (Entrez PubMed). The survey, which covered the period from the year 1972 to 2009, provided 382 published articles. Of these, 29 articles were selected according to inclusionary/exclusionary criteria, and consequently qualified for the final review analysis. Manual searching through the reference lists of the selected articles allowed the obtainment of others 17 articles. Findings gathered through this literature's review corroborate the significance of a causal relationship between some oral signs and CD. There are enough evidence making the correlation between CD and oral defects scientifically sustainable. This recognition should lead dentists to play more significant roles in screening for CD, as otherwise, if not properly diagnosed and not treated with a gluten-free diet, may eventually cause some malignancies.

The prevalence of oral mucosal lesions in adults from the Turin area.

AIM: To assess the prevalence of oral mucosal lesions (OML) and evaluate its association with tobacco and alcohol consumption and the wearing of removable dentures in an adult population from the Turin area, Italy. MATERIALS AND METHODS: A retrospective study, based on an invitational self-selected screening, was performed on 4098 subjects. It included clinical examination plus biopsies when necessary. Patient history included age, sex, denture wearing and risk habits. Internationally accepted criteria were adopted to classify the OMLs. RESULTS: Males were observed to have more OMLs (557/2040; 27.3%vs 471/2058; 22.89%). Overall OML prevalence was linked to risk habits and age. Tobacco was linked to leukoplakia, melanin pigmentation, smoker's palate, frictional lesions and papilloma. It was negatively related to recurrent aphthous stomatitis and oral lichen planus. Alcohol was linked to leukoplakia, frictional lesions and median rhomboid glossitis. The tobacco-alcohol association was linked to frictional lesions, leukoplakia, melanin pigmentation and smoker's palate. Denture wearers had an overall higher prevalence of OMLs, in particular candidiasis, traumatic and frictional lesions. CONCLUSIONS: The prevalence of OMLs in Turin seems to be comparable to those in other European studies and emphasize that risk habits and denture wearing have some relationship with the presence of OMLs.

[Burning mouth syndrome]. / Zungenbrennen.

Burning mouth syndrome (BMS) is characterized by oral dysesthesia, xerostomia and dysgeusia without visible alterations of oral mucosa. While secondary BMS results from an underlying general condition such as diabetes or iron deficiency, no causal disorder can be identified in primary BMS. The estimated prevalence is 1 - 2%, postmenopausal women are substantially more frequently affected than men. Current etiologic concepts assume a focal peripheral and central neuropathy. Only few controlled drug trials have yet been conducted. Thioctic acid appears the medical treatment of choice due to its comparatively good evidence for efficacy and low incidence of adverse reaction. Gabapentin and pregabalin are modern GABA-analogue anticonvulsants, which are also efficient in the treatment of peripheral neuropathies. Also conceptually appropriate for BMS treatment, current evidence for efficacy in BMS is insufficient. In two trials, local oral treatment with clonazepam has been beneficial in BMS. The efficacy of antidepressants is equivocal.

Frequency of and risk factors associated with lingual lesions in dogs: 1,196 cases (1995-2004).

OBJECTIVE: To categorize histologic lesions affecting the tongue, determine the frequency with which they develop, and identify risk factors associated with their development in dogs. DESIGN: Retrospective case series. ANIMALS: 1,196 dogs. PROCEDURES: Diagnostic reports of lingual biopsy specimens from dogs evaluated from January 1995 to October 2004 were reviewed. RESULTS: Neoplasia comprised 54% of lingual lesions. Malignant tumors accounted for 64% of lingual neoplasms and included melanoma, squamous cell carcinoma, hemangiosarcoma, and fibrosarcoma. Large-breed dogs, especially Chow Chows and Chinese Shar-Peis, were at increased risk for melanoma. Females of all breeds and Poodles, Labrador Retrievers, and Samoyeds were more likely to have squamous cell carcinomas. Hemangiosarcomas and fibrosarcomas were commonly diagnosed in Border Collies and Golden Retrievers, respectively. Benign neoplasms included squamous papilloma, plasma cell tumor, and granular cell tumor. Small-breed dogs, especially Cocker Spaniels, were at increased risk for plasma cell tumors. Glossitis accounted for 33% of diagnoses; in most cases, the inciting cause was not apparent. Whereas large-breed dogs were more likely to have lingual neoplasia, small-breed dogs were more likely to have glossitis. Calcinosis circumscripta accounted for 4% of lingual lesions and predominately affected young large-breed dogs. The remaining submissions consisted mostly of various degenerative or wound-associated lesions. CONCLUSIONS AND CLINICAL RELEVANCE: The frequency of lingual lesions was not evenly distributed across breeds, sexes, or size classes of dogs. Veterinarians should be aware of the commonly reported lingual lesions in dogs so that prompt diagnosis and appropriate management can be initiated.

[Importance of oral signs in the diagnosis of atypical forms of celiac disease]. / Importanza dei segni orali nella diagnosi di forme atipiche di malattia celiaca.

The dramatic improvement in knowledge concerning celiac disease (CD) has disclosed the pattern of the associated clinical manifestations and the often atypical or silent presentation of this disease, which makes clinical diagnosis difficult. Also oral manifestations, mostly recurrent apthous stomatitis (RAS) and dental enamel hypoplasia, are atypical signs of CD. Our opinion about the possibility of performing mass-screening to reveal atypical or silent CD is in agreement whit who is asserting that a sistematical case-finding is, at present, the most suitable epidemiological approach. So, we think that patients affected by RAS, or dental enamel hypoplasia, should be considered, even in the absence of any gastrointestinal symptom, at-risk subjects, and should therefore undergo diagnostic procedure for CD.

[Diabetes mellitus and tumors of the oral cavity--epidemiologic correlations]. / Diabetes mellitus és a szájüregi daganatok epidemiológiai összefüggései.

INTRODUCTION AND AIMS: Numerous publications have already demonstrated that diabetes mellitus (DM) is a risk factor for the development of periodontal diseases and various inflammatory lesions in the oral mucosa. A possible correlation between DM and oral premalignancies and tumors was examined in this study, as no literature data are available concerning this problem. METHODS: Stomato-oncological screening was carried out on 200 DM patients in the medical departments: The lesions found were classified in three groups: inflammatory lesions, benign tumors and precancerous lesions. Benign tumors were found in 14.5%, and precancerous lesions in 8% of diabetics. Earlier Hungarian screening studies indicated lower frequency of these lesions in the general population. A retrospective DM screening of 610 inpatients with histologically confirmed oral malignancies was also performed. The control group comprised 574 complaint- and tumor-free adults. Fasting blood glucose levels were determined in both groups, and the tumor location was registered in the cancer patients. RESULTS: In the group of the oral cancer patients, DM was present in 14.6% and an elevated blood glucose level in 9.7%. These values are significantly higher than those for the tumor-free control group (p < 0.01). The gingival and labial tumor location was significantly more frequent among diabetic cancer patients than in the non-diabetic group (p < 0.01). CONCLUSION: The combination of DM and smoking means a higher risk for oral precancerous lesions and malignancies. DM may be a risk factor for oral premalignancies and tumors.

Transient lingual papillitis.

We describe a relatively common yet poorly documented condition of the anterior dorsal tongue characterized by one or more moderately painful, transient, red to yellow papules. This study surveyed a number of people on their experiences with these lesions. Although some of the respondants had not had lesions of this sort, most were at least aware of their occurrence in other persons. A summary of respondents' experiences including symptoms and demographics is included. We suggest the term "transient lingual papillitis" to describe this process.

Prevalence study of tongue lesions in a Hungarian population.

The aim of the study was to assess the prevalence of tongue lesions in a district population, in Budapest, called regularly for X-ray lung examinations. Oral examinations of 7820 individuals were performed, 42% were over 60 yr of age, 42.9% were men and 57.1% women. Tongue alterations were found in 18.52% of the examined individuals, more frequently in women than in men. Lingua fissurata has been diagnosed in 8.8%, geographic tongue in 3.0% of the examined subjects. Atrophic lesions of the tongue were found in 6.37%, among them 5.42% central papillary atrophy (median rhomboid glossitis): 0.35% of the total sample. Manifest clinical symptoms of oral Candidiasis were found in 2.15% of the total sample, and in 4.28% of patients with tongue lesions. The occurrence of oral leukoplakia and lichen in patients with tongue lesions was respectively 0.47 and 0.07%. The prevalence of tongue alterations was consistent with the literary data, the oral screening attached to the X-ray lung examinations proved to be useful in detecting changes of the oral mucosa.

Some local and systemic factors related to tongue inflammation.

As part of a larger study aimed at surveying the clinical, histological and immunohistochemical features of filiform atrophy and geographic and fissured tongue, this work presents the clinical findings of three patient groups and controls. 200 individuals were examined; 18 (9%) had atrophic tongue, 15 (7.5%) geographic tongue and 53 (26.5%) fissured tongue; further, 12 (6%) had hyperkeratotic lesions of the tongue and 102 (51%) subjects had no tongue lesions. According to the anamnestic information, patients with atrophic or geographic tongue seemed to have a stronger tendency toward allergy than subjects in other groups, while patients with atrophic tongue had more abnormalities of the heart and circulatory system. These tongue forms did not show any association with smoking or drinking habits, but hyperkeratotic lesions (leukoplakia, lichen planus, hairy tongue) of the tongue were clearly associated with moderate and heavy smoking. Atrophic, geographic and fissured tongue seem to be specific changes of the lingual mucosa; patients with these changes did not have more changes elsewhere on the oral mucosa than the controls. Patients with atrophic tongue had lowered rates of saliva secretion. Histologically, heavy inflammation was noted in fissured tongue. In geographic tongue, inflammation was moderate and in atrophic tongue often only mild. Each tongue form seems to have its own typical histological morphology.