Prevalencia de lesiones en mucosa bucal y su relación con condición sistémica, edad y sexo / Prevalence of lesions in the oral mucosa and its relationship with systemic condition, age and gender

Este estudio tiene la finalidad de analizar la prevalencia de variantes de la normalidad y patología en la mucosa de la cavidad bucal por zona anatómica, de una población controlada en una clínica estomatológica universitaria de pregrado en el Estado de México. Se trata de un estudio transversal, descriptivo y observacional de 542 pacientes, de los cuales el 62.7% (340) pertenecen al sexo femenino y 37.3% (202) al masculino; la edad se distribuyó en un rango de dos a 85 años con una media de 28 años y fue categorizada en cinco grupos etarios: 2 a 12, 13 a 18, 19 a 35, 36 a 69 y > 70 años. En este estudio participaron una especialista en patología bucal, un especialista en odontopediatría y una pasante de la licenciatura de estomatología quien fungió como ayudante de investigación. Fueron identificadas 13 variantes de la normalidad y 52 lesiones en total, mismas que son reportadas por zona anatómica, por rangos de edad y por sexo. El número de condiciones y lesiones diagnosticadas por paciente varió de una a cinco en 87.27% y en el restante 12.73% no se detectó ninguna. Las variantes de la normalidad o condiciones más frecuentes fueron lengua fisurada con 12.17%, apéndice mucoso en frenillo vestibular con 11.25% y gránulos de Fordyce con 10.88%. Las lesiones más prevalentes por zona anatómica fueron: nevo intradérmico con 2.39% en labio externo superior e inferior; queilitis simple con 11.43% en la interfase de piel y mucosa de los labios (borde bermellón); úlcera traumática con 3.87% en mucosa labial; absceso de origen dental con 1.42 en encía; frenillo con inserción baja 1.84% en frenillos; úlcera traumática con 5.53% en mucosa bucal; candidiasis atrófica crónica con 5.53% en paladar; amígdalas hipertróficas con 8.11% en zona amigdalina; lengua pilosa con 1.66% en lengua; úlcera traumática con 3.69% en piso de boca; granuloma piógeno con 0.18% en proceso alveolar; y por último, hipertrofia de glándulas salivales labiales con 0.55% asociadas a presencia de aparatología ortodóntica. Finalmente se llevó a cabo una prueba de χ2 de Pearson para establecer correlación entre variables dependientes e independientes, encontrando significancia estadística de p < 0.000 entre lesiones de lengua y condición sistémica y edad en relación a lesiones de lengua, paladar y labios con p < 0.000 (AU)

The purpose of this study is to analyze the prevalence of variants of normality and pathology in the mucosa of the oral cavity by anatomical area in a controlled population in a university undergraduate stomatological clinic in the state of Mexico. This is a cross-sectional, descriptive and observational study of 542 patients, of which 62.7% (340) belonged to the female gender and 37.3% (202) to the male gender, the age was distributed in a range of two to 85 years with a mean of 28 years and was categorized in five age groups: 2 to 12, 13 to 18, 19 to 35, 36 to 69 and > 70 years. A specialist in oral pathology, a specialist in pediatric dentistry and an intern in stomatology who served as a research assistant participated in this study. Thirteen variants of normality and 52 lesions in total were identified and reported by anatomical area, age range and gender. The number of conditions and lesions diagnosed per patient ranged from one to five in 87.27% and none were detected in 12.73% of the population studied. The most frequent variants of normality or conditions were fissured tongue with 12.17%, mucous appendage in the vestibular frenulum with 11.25% and Fordyce granules with 10.88%. The most prevalent lesions by anatomical area were: intradermal nevus with 2.39% in upper and lower external lip; simple cheilitis with 11.43% in the interphase interface of skin and mucosa of the lips (vermilion border); traumatic ulcer with 3.87% in labial mucosa; abscess of dental origin with 1.42 in gingiva; frenulum with low insertion 1.84% in frenulum; traumatic ulcer with 5. 53% in buccal mucosa; chronic atrophic candidiasis with 5.53% in palate; hypertrophic tonsils with 8.11% in tonsillar area; hairy tongue with 1.66% in tongue; traumatic ulcer with 3.69% in floor of mouth; pyogenic granuloma with 0.18% in alveolar process and finally; hypertrophy of labial salivary glands with 0.55% associated with the presence of orthodontic appliances. Finally, a Pearson's χ2 test was carried out to establish correlation between dependent and independent variables, finding statistical significance of p < 0.000 between tongue lesions and systemic condition and age in relation to tongue, palate and lip lesions with a p < 0.000 (AU)

Gastroesophageal reflux disease: prevalence and Extraesophageal manifestations among undergraduate students in South West Nigeria.

BACKGROUND: The reflux of noxious contents of the stomach may cause oesophageal and extra-oesophageal complications either by direct contact of aspirated gastric refluxate with the upper airway or by a vago-vagal reflex. This study aimed to determine the prevalence of gastroesophageal disease (GERD) and extraesophageal manifestations among undergraduate students in a tertiary institution in Nigeria. METHODS: This is a cross-sectional study involving undergraduate students in a private University in Nigeria. Study proforma had three parts. Part A consisted of self-administered questionnaire designed to obtain students biodata. Part B consisted of standard Carlsson-Dent questionnaire. A score of 4 and above on Carlsson- Dent questionnaire was considered diagnostic of gastroesophageal reflux symptoms (GERD). Thereafter those who had GERD were further questioned and examined for extra-oesophageal symptoms of GERD. RESULTS: The total number of the study participants was 647, out of which 212 (32.8%) had GERD. One hundred and forty-four (67.9%) and 86 (32.1%) females and male had GERD respectively (p = 0.13). The extraesophageal symptoms found in those with GERD were, dysphagia, coated tongue, nocturnal cough, xerostomia, lump in the throat, asthma-like symptoms, recurrent sore throat, frequent throat clearing, halithosis and dental erosion among others. CONCLUSION: GERD is common among this study population, with a prevalence rate of 32.8%. Only age showed significant predictor for GERD. Varying extra-oesophageal manifestations were found in those with GERD.

The tongue features associated with type 2 diabetes mellitus.

Diabetes mellitus (DM) is a public problem closely associated with numerous oral complications, such as coated tongue, xerostomia, salivary dysfunction, etc. Tongue diagnosis plays an important role in clinical prognosis and treatment of diabetes in the traditional Chinese medicine (TCM). This study investigated discriminating tongue features to distinguish between type 2 DM and non-DM individuals through non-invasive TCM tongue diagnosis.The tongue features for 199 patients with type 2 DM, and 372 non-DM individuals, serving as control, are extracted by the automatic tongue diagnosis system (ATDS). A total of 9 tongue features, namely, tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissure, ecchymosis, teeth mark, and red dot. The demography, laboratory, physical examination, and tongue manifestation data between 2 groups were compared.Patients with type 2 DM possessed significantly larger covering area of yellow fur (58.5% vs 22.5%, P < .001), thick fur (50.8% vs 29.2%, P < .001), and bluish tongue (P < .001) than those of the control group. Also, a significantly higher portion (72.7% vs 55.2%, P < .05) of patients with long-term diabetics having yellow fur color than the short-term counterparts was observed.The high prevalence of thick fur, yellow fur color, and bluish tongue in patient with type 2 DM revealed that TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of type 2 DM in light of its simple and non-invasive nature, followed by other more accurate testing process. To the best of our knowledge, this is the first attempt in applying non-invasive TCM tongue diagnosis to the discrimination of type 2 DM patients and non-DM individuals.

Oral lymphoid lesions: a 47-year clinicopathological study in a Brazilian population.

We performed an epidemiological, clinical and histopathological analysis of oral lymphoid lesions (OLLs) during a 47-year period. Data regarding patient age, sex, duration, location, symptomatology, type of growth, implantation, staining, presence of ulceration and bleeding of all cases were compiled from the clinical data. For the histopathological analyses, all slides stained by H/E were reassessed. During the analyzed period, 14,565 patients with oral and maxillofacial lesions were diagnosed, with 45 cases diagnosed as OLLs. The most prevalent location was the tongue. Females were more affected, and the mean age was 40.8 years. OLLs presented a heterogeneous frequency, with the prevalence of reactive lesions (42.3%) followed by developmental lesions (35.6%). Among the reactive lesions, foreign body granulomas were the most common. Regarding diagnosed neoplasms, malignant represented 13.2% of the cases. The average time of evolution of OLLs in general was of 22.2 months. Regarding the histopathological characteristics, the presence of primary lymphoid follicles was observed in 37.8% of the cases, while inflammatory infiltrates were diffuse in 66.7% and epimyoepithelial islands were observed in 13.3%. Our study concludes that OLLs involves a broad spectrum of lesions that share the presence of the lymphoid component, which can range from indolent to more aggressive behavior.

Tongue psoriasis: Clinical aspects and analysis of epidemiological associations in 313 children, with a systematic literature review.

BACKGROUND: Little information is available on the prevalence and clinical aspects of tongue involvement in children with psoriasis. The aim was to evaluate the prevalence, clinical aspects and risk factors concerning tongue involvement in children with psoriasis. PATIENTS AND METHODS: This study was carried out in two stages. We performed a multicentre, cross-sectional study in 23 French dermatology centers. All children seen for psoriasis during the one-year study were systematically included. The clinical features of the tongue and of psoriasis were recorded. Association with clinical aspects of psoriasis and comorbidities was evaluated. We then carried out a literature review to evaluate the prevalence of tongue involvement in children with psoriasis and its positive predictive value for psoriasis. A search was conducted in the PUBMED database using the following keywords: "child" and "psoriasis" and ("tongue" or "glossitis" or "migratory glossitis" or "benign migratory glossitis" or "geographic tongue" or "fissured tongue"). RESULTS: 7.7% of the 313 children with psoriasis had tongue involvement. The clinical aspects were geographic tongue (4.2%), fissured tongue (2.8%) and both (0.64%). There was no association between tongue involvement and the clinical characteristics of the children. Two hundred and ninety-five articles were referenced and 3 were analysed. Psoriasis is very rare in cases of tongue abnormalities. CONCLUSION: The prevalence of tongue involvement was 7.7% in children with psoriasis. No clinical or epidemiological association was shown. Tongue involvement does not modify the management of psoriasis. In the literature review it was not possible to evaluate either the prevalence of tongue involvement in psoriasis or the positive predictive value thereof.

Tongue lesions and anomalies in a sample of Yemeni dental patients: a cross-sectional study

Background: Tongue examination helps considerably in diagnosing the underlying health state of the patient, especially in the cases of chronic diseases. The aim of this study is to determine the prevalence and association of tongue lesions with risk factors among Yemeni dental patients. Materials and methods: An oral medicine specialist examined all 713 patients attending the dental polyclinics at the University of Sciences and Technology (Sana’a, Yemen). The examination sheet was designed to include information related to patient characteristics, medical history, dental history, habits, and tongue lesions. Results: The prevalence of tongue lesions among the examined participants was 76.5 percent. The prevalence rate was 83.4 percent for males and 69.2 percent for females. Fissured tongue was the most common condition. Logistic regression analysis indicated that older age (p<0.001), gender (p=0.007), khat chewing (p<0.001), and smoking (p=0.001) were associated with fissured tongue; gender (p<0.001), khat chewing (p<0.001), and smoking (p<0.001) were associated with hairy tongue; and older age (p<0.001), khat chewing (p=0.001), and smoking (p=.021) were associated with coated tongue. Conclusion: The prevalence of tongue lesions among this sample of Yemeni population was 76.5 percent; fissured tongue and hairy tongue were the most prevalent lesions. Khat chewing, smoking, and older age were the associated risk factors for many of studied lesions and anomalies.

Incidental radiographic findings of thyroglossal duct cysts: Prevalence and management.

OBJECTIVES/HYPOTHESIS: To determine the epidemiology of incidental thyroglossal duct cysts (TGDC) discovered on imaging studies obtained in the head and neck area in children and to discuss subsequent management. METHODS: A retrospective chart review was performed at Texas Children's Hospital of all computed tomography (CT) and magnetic resonance (MR) imaging studies obtained in the head and neck region between July 2011 and July 2014. Images obtained for the purpose of evaluating a neck or lingual mass were excluded from the study, as were patients with previously known TGDCs. Data including age, sex, location of TGDC, size, presence of symptoms, referral to Otolaryngology, and intervention were recorded. RESULTS: A total of 60,663 CT and MR studies of the head, brain, sinus, neck, and C-spine during this time period were reviewed; of these 69 (0.1%) cases contained incidental discovery of probable TGDCs with more males (40) than females (29). Ages ranged from 3 days to 17 years old, with the mean age at 5 years. Locations varied, with majority at base of tongue (83%) followed by hyoid (13%) then infrahyoid straps (4%). Sizes ranged from 2 to 28 mm with average size at 8 mm. 11 of these patients were referred to an Otolaryngologist; 9 were asymptomatic and decision was made to observe, the other two subsequently underwent surgical excision secondary to mass effect and dysphagia with histologic confirmation of diagnosis. CONCLUSION: TGDCs commonly present as an anterior neck mass, however the majority of incidentally discovered TGDCs on imaging are located at the base of tongue. Management of these findings should include referral to an Otolaryngologist for further evaluation with the decision to intervene surgically based on development of clinical symptoms.

Prevalence and distribution of oral mucosal non-malignant lesions in the western Sicilian population.

BACKGROUNG: The aim of the present study was to determine the prevalence of oral mucosal non-malignant lesions in the Sicilian population. In addition, we evaluated the association between each oral lesion and its risk factors. METHODS: This study analyzed a total of 2539 consecutive patients, attending the Department of Surgical, Oncological and Stomatological Disciplines of Palermo University, who were examined for the presence of various oral lesions during the period from January 2012 and February 2015. RESULTS: The sample consisted of 1330 (52%) female and 1209 (48%) male. The age ranged from 13-86 years with a mean age of 47.16 years. Among these subjects 1495 (58%), presented one or more lesions. All subjects were Caucasian. The most common lesion diagnosed was coated/hairy tongue affecting 16.7% of the subjects, followed by: lingual varices (16.3%), secondary herpes lesions (8.1%), aphthous ulcers (7.9%), fordyce granules (7.2%), frictional keratosis (5%), candidosis (4.9%), fibroepithelial hyperplasia (4.6%), squamous papilloma (3.8%), traumatic ulcers (3.7%), leukoplakia (3.2%), fissured tongue (3.2%), hemangiomas (2.7%), morsicatio buccarum (2.5%), melanin pigmentation (2.5%), lichen planus (2.5%), leukoedema (2.1%), petechiae (1.1%), geographic tongue (1%), actinic cheilitis (0.8%), and erythroplakia (0.1%). Overall, the prevalence of oral mucosal non-malignant lesions was linked to age, gender, diseases, and risk habits. CONCLUSIONS: The high prevalence necessitates adequate awareness of these lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions.

Orolingual Angioedema During or After Thrombolysis for Cerebral Ischemia.

BACKGROUND AND PURPOSE: Orolingual angioedema (OLAE) is a life-threatening complication of intravenous thrombolysis. Our objective was to compare outcomes of patients with and without OLAE. METHODS: We prospectively included consecutive patients who received intravenous thrombolysis for cerebral ischemia at Lille University Hospital. We examined tongue and lips every 15 minutes during thrombolysis and ≤30 minutes after. We evaluated the 3-month outcome with the modified Rankin scale (mRS) and compared outcomes of patients with and without OLAE. RESULTS: Of 923 consecutive patients, 20 (2.2%) developed OLAE. None of them needed oro-tracheal intubation. They were more likely to be under angiotensin-converting enzyme inhibitors (adjusted odds ratio [adjOR], 3.9; 95% confidence interval [CI], 1.6-9.7; P=0.005) to have total insular infarcts (OR, 5.0; 95% CI, 1.5-16.5; P=0.004) and tended to develop more symptomatic intracerebral hemorrhages. Results concerning angiotensin-converting enzyme inhibitors were not modified after adjustment for propensity scores (OR, 4.4; 95% CI, 1.6-11.9; P=0.004) or matched analysis based on propensity scores (OR, 3.4; 95% CI, 1.3-8.1; P=0.010). Patients with OLAE did not significantly differ at 3 months for the proportion of patients with mRS score of 0 to 1 (adjOR, 0.9; 95% CI, 0.3-2.1), mRS score of 0 to 2 (adjOR, 0.8; 95% CI, 0.1-1.8), and death (adjOR, 1.1; 95% CI, 0.3-3.8). CONCLUSIONS: OLAE occurs in 1 of 50 patients who receive intravenous thrombolysis, 1 of 10 in case of total insular infarct, and 1 of 6 if they are under angiotensin-converting enzyme inhibitors. Their long-term outcome does not differ from that of other patients.

Operational research on the correlation between skin diseases and HIV infection in Tigray region, Ethiopia.

BACKGROUND: In Ethiopia, skin diseases are among the leading causes of outpatient attendance to primary health service. Correlation of skin diseases and HIV has long been recognized and used to guide medical management in resource-limited settings. Therefore, this study aims to assess the correlation of skin diseases and HIV infection, to estimate epidemiological distribution in the study area, and to provide health workers of skin indicators for HIV early detection. METHODS: The operational research was designed as a case-control study and carried out in three intervention districts of Tigray region; baseline and final data on skin diseases and HIV were compared with those of three control districts matched for population size, density, and environmental characteristics. Health workers of intervention districts were trained on skin diseases/STIs diagnosis and treatment. Data were collected from study and control districts and then analyzed at the Italian Dermatological Centre (IDC) in Mekele. RESULTS: In the research period, a total of 1044 HIV positive patients were detected. Disorders of skin and mucous membranes statistically related with HIV (P < 0.05) were tongue papillary atrophy (80%), oral hairy leukoplakia (69%), herpes zoster (66%), oral candidiasis (50%), pruritic papular eruption (43%), condylomata acuminata (38%), and telogen effluvium (27%). CONCLUSIONS: The high frequency of oral disorders and telogen effluvium is not described in literature and may be indicative for case detection. Operational research offers significant gains on health service delivery and outcomes at relatively low cost and in a short timeframe.

Orolingual angioedema after alteplase therapy of acute ischaemic stroke: incidence and risk of prior angiotensin-converting enzyme inhibitor use.

BACKGROUND AND PURPOSE: Orolingual angioedema (OA) is an uncommon but potentially life-threatening complication of treatment with recombinant tissue plasminogen activator (rt-PA; alteplase) during acute ischaemic stroke. This study aimed to determine the incidence of rt-PA-related OA in an Asian stroke population and the risk of pre-stroke anti-hypertensive drug use for development of this complication. METHODS: A multi-center stroke registry was used to identify the pre-stroke medications of acute ischaemic stroke patients receiving intravenous rt-PA from January 2002 to December 2013. The clinical manifestations of rt-PA-related OA were recorded and the incidence of this complication was determined. The risks of pre-stroke use of different anti-hypertensive agents for the occurrence of rt-PA-related OA were determined from this study and from a meta-analysis. RESULTS: A total of 559 patients received intravenous rt-PA over a 12-year period. Five patients (two males) developed OA after rt-PA administration. The incidence of OA amongst these patients was 0.89% (95% confidence interval 0.29%-2.09%), which was lower than that obtained by meta-analysis (1.9%). Amongst pre-stroke anti-hypertensive medications, angiotensin-converting enzyme (ACE) inhibitors were found in this study to have the highest relative risk for rt-PA-related OA (17.1; 95% confidence interval 3.0-96.9). Meta-analysis also revealed that pre-stroke use of ACE inhibitors was associated with a high relative risk of OA after intravenous rt-PA (12.9; 95% confidence interval 4.5-37.0). CONCLUSIONS: The incidence of rt-PA-related OA in the Asian population is lower than that in the Caucasian population. Pre-stroke use of ACE inhibitors significantly increases the risk of this complication.

[Alcohol dependence syndrome--symptoms in the oral cavity]. / Nastepstwa uzaleznienia od alkoholuobserwowane w jamie ustnej.

Alcohol dependence syndrome is defined as a cluster of physiological, behavioural and cognitive phenomena in which the use of a psychoactive substance takes on a much higher priority for a given individual than other behaviours that once had greater value. In European Union the problem of the addiction affects about 5% of men and 1% of women each year. Long lasting alcohol abuse is detrimental to the whole body, including the oral cavity. The observable changes are usually caused by a convergent impact of a number of factors. The changes differ depending on the chemical features of the consumed substance, the life style adopted - as a consequence of the addiction, simultaneous addiction to nicotine, and finally on the medical treatment applied at different stages of the disease. Pathological changes may occur in all structures in oral cavity (teeth, periodontium, tongue, mucose membrane and salivary glands). Individuals addicted to alcohol revealed high percentage of carious losses and chemical damage enamel and dentine and inflammatory changes of the periapical area of teeth. Presence of these changes is linked unfortunately with low indicator of treatment. There is independence between alcohol addiction and damage of periodontium (clinical attachment level and pocket depth). Results of alcohol abuse may be also double-sided, painless, noninflammatory and non-malignant swelling on salivary glands (sialosis). Alcohol is said to be the risk factor for development of flat-epithelial cancer of the oral cavity. The most frequent localization of cancerous changes is the bottom of the oral cavity and the side of the tongue.

An analysis of biopsy-proven tongue lesions among 8,105 dental outpatients.

AIM: The aim of the present study was to analyze data on the characteristics of tongue lesions in dental patients seeking care at the Oral Pathology Service of Tehran University of Medical Sciences, from 1985-2010. MATERIALS AND METHODS: Demographic data and histopathologic diagnoses were recorded for all lesions that were documented as occurring on the tongue according to the patient records in our department. Statistical analysis included chi-square, t-, and Fisher's exact tests. A 95% confidence interval (CI) was calculated, and p < 0.05 was considered significant. RESULTS: Tongue lesions constituted 6.3% of all received specimens which included 46 different defects. The most common lesions were lichen planus (LP), irritation fibroma (IF), squamous cell carcinoma (SCC) and pemphigus vulgaris (PV). Tongue lesions were significantly more common in women compared to men (CI = 0.65-0.94, p = 0.02). Mean age (47 years) did not differ between male and female subjects (CI = -2.49 - 3.93, p = 0.06). The dorsal surface followed by the lateral aspect was the most common site for tongue lesions. CONCLUSION: It seems that dental practitioners should be perceptive of LP, IF, SCC and PV, when examining the tongue. Histopathologic analysis is essential for achieving final diagnosis in a considerable number of lesions that commonly occur on this organ. Clinical significance: Access to demographic/prevalence data in different populations may be useful in clinical settings and could be complimented by histopathologic diagnosis in most instances. The present findings can be compared with those obtained from other epidemiologic studies in this field resulting in valuable data which may be used in several types of investigations. .

Head and neck tuberculosis in KwaZulu-Natal, South Africa.

OBJECTIVE: To describe the clinical features of head and neck tuberculosis in KwaZulu-Natal, South Africa. STUDY DESIGN: Retrospective, observational study. METHOD: The study included 358 patients who received a histopathologically and/or microbiologically confirmed diagnosis of tuberculosis in the head and neck region between 1 January 2007 and 31 December 2011. RESULTS: A total of 358 new cases of head and neck tuberculosis were identified during the study period, involving 196 males (54.7 per cent) and 162 females (45.3 per cent). These patients had a median age of 31 years (range, 3 months to 83 years). Testing for human immunodeficiency virus was positive in 233 (65.1 per cent) and negative in 125 (34.9 per cent). Right-sided cervical lymphadenitis was the commonest form of presentation of head and neck tuberculosis. CONCLUSION: In this study, right-sided cervical lymphadenopathy was the commonest presentation of head and neck tuberculosis in both human immunodeficiency virus infected and non-infected individuals. Head and neck tuberculosis should not be excluded solely based on a normal chest X-ray, nor on the absence of constitutional symptoms.

A clinical analysis of 58 chinese cases of pigmented fungiform papillae of the tongue.

BACKGROUND: Pigmented fungiform papillae of the tongue (PFPT) is a disorder in which the fungiform papillae of the tongue have abnormal coloration. However, Chinese-specific clinical data for PFPT are lacking. OBJECTIVE: To determine the prevalence and characteristics of PFPT among the Chinese population. METHODS: A survey was carried out using a clinical examination and a questionnaire on 14,346 first-time outpatients in our dermatology department, and 58 cases of PFPT were subsequently diagnosed. RESULTS: The prevalence of PFPT was 0.4% among dermatological outpatients. All patients had pin-sized, brownish fungiform papillae on the tip, lateral or dorsal parts of the tongue. Of the three subtypes, type I was the most common (87.93%). PFPT generally coexisted with Hori's nevus (48.28%), melasma (20.69%), hysteromyoma (24.14%) and breast cystic hyperplasia (20.69%). CONCLUSION: Our study confirms that PFPT is a relatively common disorder among Chinese outpatients, and it was presumed to be closely coupled with Hori's nevus, melasma and other disorders.

Localized tongue amyloidosis: a single institutional case series.

OBJECTIVE: Review Mayo Clinic experience of localized tongue amyloidosis. STUDY DESIGN: Case series with retrospective chart review. SETTING: Academic medical center. SUBJECTS AND METHODS: Cases of localized tongue amyloidosis were identified from the dysproteinemia database at the Mayo Clinic in Rochester, Minnesota. Electronic records were reviewed with focus on presenting symptoms, laboratory results (ie, serum or urine immunoelectrophoresis, bone marrow biopsy, and fat aspirate analysis), treatment modality, and status of disease at follow-up. RESULTS: Six cases of localized tongue amyloidosis presented to the Mayo Clinic between 1969 and 2011. Mean patient age was 69 years (range, 43-90). Patients presented with asymptomatic tongue mass(es). Biopsy of the tongue mass in all patients showed amyloid on Congo red stains. Work-up for systemic amyloidosis, including bone marrow biopsy, fat aspiration, and serum and urine protein immunoelectrophoresis, was negative for all 6 patients, nor was there other organ involvement. Two patients underwent resection of the lesions, and the remaining patients elected for observation. Recurrence requiring repeat excision occurred in 1 of the patients that underwent resection. Repeat evaluation for systemic involvement was performed in 3 patients 1 to 3 years after the initial diagnosis. None of these patients went on to develop systemic involvement. CONCLUSIONS: Localized tongue amyloidosis remains a rare diagnosis and requires exclusion of systemic involvement. Localized lesions may be observed or resected; however, recurrence may occur with resection. Patients with localized tongue amyloidosis do not appear to be at increased risk of developing systemic involvement.

Arsenic exposure and oral cavity lesions in Bangladesh.

OBJECTIVE: To evaluate the relationship between arsenic exposure and oral cavity lesions among an arsenic-exposed population in Bangladesh. METHODS: We carried out an analysis utilizing the baseline data of the Health Effects of Arsenic Exposure Longitudinal Study, which is an ongoing population-based cohort study to investigate health outcomes associated with arsenic exposure via drinking water in Araihazar, Bangladesh. We used multinomial regression models to estimate the risk of oral cavity lesions. RESULTS: Participants with high urinary arsenic levels (286.1 to 5000.0 µg/g) were more likely to develop arsenical lesions of the gums (multinomial odds ratio = 2.90; 95% confidence interval, 1.11 to 7.54), and tongue (multinomial odds ratio = 2.79; 95% confidence interval, 1.51 to 5.15), compared with those with urinary arsenic levels of 7.0 to 134.0 µg/g. CONCLUSIONS: Higher level of arsenic exposure was positively associated with increased arsenical lesions of the gums and tongue.

Tongue lesions.

BACKGROUND: Some authors have shown that tongue lesions represent an important segment of oral mucosal lesions group, with prevalence varying among epidemiologic studies from different countries. OBJECTIVES: The aim of this study was to describe the prevalence of tongue lesions in a Brazilian population. METHODS: A collaborative study was conducted using data from 5 anatomic pathology services in Brazil. After data collection, these tongue lesions were separated in 4 groups: G1/malignant tumors, G2/benign tumors, G3/reactive lesions, and G4/other lesions. RESULTS: Analysis of 6231 specimens for which oral biopsy was performed showed 760 cases (12.2%) diagnosed in the tongue. From this total, 306 cases (40.3%) occurred in females, and 454 (59.7%) occurred in males. Ages ranged from 3 to 93 years, with a global average of 45.3 years. The largest numbers of cases were represented by reactive lesions (44.6%), followed by benign tumors (27.9%), malignant tumors (18.6%), and other lesions (8.9%). CONCLUSIONS: Tongue diseases were more common in male patients, and most of them were reactive lesions or benign neoplasms, but 18.6% were malignant neoplasms. The occurrence of malignant neoplasm increased notably with age.

CT and MRI findings of developmental abnormalities and ectopia varieties of the thyroid gland.

Ectopic thyroid tissue may be observed anywhere from the tongue base to the lower neck. It is rarely seen in the mediastinum and abdominal cavity. Computed tomography and magnetic resonance imaging are very sensitive for detection and localization of ectopic thyroid tissue. This pictorial essay presents the radiological characteristics of developmental abnormalities and ectopia varieties of the thyroid gland.