Association of CD24 and the adenomatous polyposis coli gene polymorphisms with oral lichen planus.

OBJECTIVE: CD24 and the adenomatous polyposis coli (APC) gene polymorphisms are known to predispose to malignant disease. We aimed to investigate their association with risk and susceptibility of oral lichen planus (OLP) in an Israeli Jewish population. STUDY DESIGN: The study included 54 patients, of which 41 were females (75.9%) and 13 males (24.1%); of the 533 controls, 224 were females (42.0%) and 309 males (57.9%). Genotyping was performed. Two APC (I1307 K, E1317 Q) and four CD24 variants--C170 T (rs52812045), TG1527 del (rs3838646), A1626 G (rs1058881), and A1056 G (rs1058818)--were assessed. Frequencies were analyzed using the Chi-square test. Two-sided P < .05 values were considered significant. Odds ratios and 95% confidence intervals were obtained by logistic regression analyses. RESULTS: CD24 A1056 G carriers have a significantly lower risk of OLP compared with individuals with the wild-type variant (P = .001). A significantly lower risk was found for heterozygote (P = .008) and homozygote carriers (P = .002). Homozygote CD24 A1626 G carriers had a significant higher risk for OLP compared with nonhomozygote carriers (P = .040). CD24 C170 T, TG1527 del, and APC polymorphisms did not show significant associations with OLP risk. CONCLUSIONS: CD24 A1626 G is more frequent in OLP patients, contributes to disease risk, and could play a role in OLP susceptibility. A significant association between CD24 A1056 G and a lower OLP incidence was found, suggesting that it may confer protection against OLP risk and progression.

The clinical, histologic, and treatment spectrum in necrotizing sialometaplasia.

OBJECTIVES: The aim of this report was the clinical and histologic characterization of necrotizing sialometaplasia. STUDY DESIGN: We performed a retrospective case series analysis. RESULTS: The study included 4 women 29-71 years old. Possible contributing factors (drugs, alcohol abuse, bulimia, smoking, and pancreatic cancer) were identified. Patients presented with unilateral or bilateral rapidly progressing painful palatal ulcers. Necrotic salivary glands and inflammation were universal microscopic features; ductal metaplasia was present in only 1 case. Thrombosis and heavy fungal and bacterial overgrowth were observed in 1 case. In 3 of the cases the lesions healed within 4-6 weeks under conservative supportive care, whereas in 1 case persistent enlargement up to 25 mm diameter was observed. Surgical debridement combined with a palatal guard resulted in complete healing within 12 weeks. CONCLUSIONS: Significant variations may be observed in both clinical and microscopic manifestations of necrotizing sialometaplasia. Although this disease is considered to be self-limiting in the majority of cases, surgical intervention can be considered in unusually large cases.

Oral intravascular fasciitis: a rare maxillofacial lesion.

Nodular fasciitis is a benign non-neoplastic myofibroblastic proliferation, involving the head in 7% to 20% of cases. Intravascular fasciitis (IVF) is a rare variant, with a unique intravascular growth pattern. Only 4 maxillofacial cases have been previously reported. We describe a 58-year-old woman with a rapidly growing, hard, mobile buccal submucosal swelling. CT scans identified a well-defined, 1.7-cm isodense lesion, located between the mental foramen and masseter muscle, which was excised under general anesthesia. A well-defined cellular nodular mass was composed of bland spindle cells, in a densely vascularized, focally myxoid matrix, involving an arterial lumen, and extending into adjacent tissues. Mitoses were rare. Immunohistochemistry was positive for smooth muscle actin, negative for keratins, S-100, epithelial membrane antigen, caldesmon, p53 and Alk. CD31 and CD34 were positive only in the vascular component, supporting the diagnosis of intravascular fasciitis.