Eosinophilic Granuloma of the Mandible: Is a Conservative Treatment Sufficient for Local Disease Control?

Eosinophilic granuloma is the most benign and common form of the Langerhans cell histiocytosis, a rare proliferative disease that can affect single or multiple organs. In the quite common head and neck manifestation these lesions can be confused in the beginning, with other bone diseases such as odontogenic cysts, periodontal disease, or malignancies. Treatment varies depending on the size, number, localization of the lesions, and patient's general conditions. The authors describe here a patient of a single lesion of eosinophilic granuloma localized in the posterior mandible region treated with a very conservative surgical approach in a patient with poor socio-economic conditions. The authors performed teeth extractions, an excisional biopsy and open curettage and after a follow-up of 24 months without partial mandible resection and reconstruction time the lesion had healed. The clinical situation confirmed that, in carefully selective patients, a conservative approach could be a useful therapeutic opportunity.

Use of Patient and Observer Scar Assessment Scale for evaluation of facial scars treated with self-drying silicone gel.

In this prospective study, we used the Patient and Observer Scar Assessment Scale (POSAS) to evaluate the outcome of the healing process of posttraumatic and surgical facial scars that were treated with self-drying silicone gel, by both the patient and the observer. In our division, the application of base cream and massage represents the standard management of facial scars after suture removal. In the current study, 15 patients (7 men and 8 women) with facial scars were treated with self-drying silicone gel that was applied without massage, and 15 patients (8 men and 7 women) were treated with base cream and massage. Both groups underwent a clinical evaluation of facial scars by POSAS at the time of suture removal (T0) and after 2 months of treatment (T1). The patient rated scar pain, itch, color, stiffness, thickness, and surface (Patient Scale), and the observer rated scar vascularity, pigmentation, thickness, relief, pliability, and surface area (Observer Scale [OS]). The Patient Scale reported the greatest improvement in the items color, stiffness, and thickness. Itch was the only item that worsened in the group self-drying silicone gel. The OS primarily reported an improvement in the items vascularization, pigmentation, and pliability. The only item in the OS that underwent no change from T0 to T1 was surface area. The POSAS revealed satisfactory healing of posttraumatic and surgical facial scars that were treated with self-drying silicone gel.