[Epidemiology of oral diseases in a university hospital specialized consultation]. / Étude épidémiologique des pathologies de la muqueuse buccale dans une consultation spécialisée de centre hospitalo-universitaire (CHU).

INTRODUCTION: Oral diseases (OD) are common and affect, according to studies, 2.5 to 61.6% of general population. The main objective of our study was to determine the most common diagnoses of OD in a dedicated consultation in a University Hospital. MATERIAL AND METHOD: We conducted a descriptive observational study over 12 months from weekly OD consultations provided within the oral and maxillofacial surgery department at the Timone university hospital, Marseille, France. We divided our patient population into 4 subgroups: subgroup A, in which each patient was considered as a new one for each consultation; subgroup B, in which each patient was only considered once; subgroup C, including patients seen three times at least and subgroup D, including the children. At each consultation, were identified: age, sex, alcohol and tobacco consumption, corresponding physician specialty, time between onset of symptoms and consultation, reason for consultation and final diagnosis. RESULTS: Subgroups A, B, C and D respectively included 393, 208, 23 and 11 cases. Age and sex were similar in the subgroups A, B and C (mean age: 53.6, 54.3 and 51.4 years, respectively; female predominance: 62.9%, 66.8% and 65.2%, respectively). The most commonly encountered diagnoses were similar in the subgroups A and B: oral lichen planus (19.6% and 19.2%), aphthous stomatitis (11.5 and 7.2%), burning mouth syndrome (11.5 and 14.9%). In subgroup C, were found: oral lichen planus (34.8%), aphthous stomatitis (21.7%), cicatricial pemphigoid (13%) and pemphigus (13%). In the subgroup D, the most common diagnoses were aphthous stomatitis (45.5%) and traumatic injury (18.2%). The mean time before diagnosis was about 2 years. DISCUSSION: The most common diagnoses in a specialized OD consultation are: lichen planus, aphthous stomatitis and burning mouth syndrome. The time before diagnosis could be improved by means of more information for practitioners and patients.

Radiosurgery without whole brain radiotherapy in melanoma brain metastases. Club de Cancérologie Cutanée.

To evaluate the effectiveness of radiosurgery without whole brain radiotherapy in the palliative treatment of melanoma brain metastases, we retrospectively assessed the results in 35 patients: 4 with a solitary brain metastasis, 13 with a single brain metastasis and metastases elsewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 months in patients with a solitary brain metastasis, 7.5 months in patients with a single brain metastasis and metastases elsewhere, and 4 months in patients with multiple brain metastases. Complications were unusual and surgery was required in 2 of 35 patients. These results show for the first time that melanoma patients with a unique brain metastasis with or without metastases elsewhere clearly benefit from tumour control easily obtained by radiosurgery. Although the comparison of radiosurgery with surgery and/or whole brain radiotherapy cannot be adequately addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life.