Oral leukoplakia and erythroplakia in young patients: a southern Brazilian multicenter study.

The objective of the present study was to investigate the frequency of oral leukoplakia and oral erythroplakia among young patients from three Brazilian reference centers in Oral and Maxillofacial Pathology. A retrospective study was carried out from 2011 to 2021 on 861 patients diagnosed with oral leukoplakia and oral erythroplakia. Demographic and clinicopathological data were evaluated. Fisher's exact test was used to evaluate the association among sex, age, anatomical location, and histopathological diagnosis. A total of 83 (9.64%) cases involved young patients (aged <40 years). Among these, biopsy records were included in 31 (37.34%) cases, all of which received a clinical diagnosis of oral leukoplakia. Seventeen (54.84%) patients were female, mostly in their fourth decade of life (n = 22/70.97%), and their mean age at diagnosis was 32.61(± 5.21) years. Among informed cases, seven (22.58%) patients were smokers. The lateral border of the tongue (n = 9/29.03%) was the most affected site. In 13 (41.94%) cases, oral leukoplakias showed a homogeneous appearance. The mean size of the lesions was 1.47 cm (0.2-3.0 cm) and the mean time of disease progression was 64.37 (± 65.90) months. The histopathological analysis showed that 11 cases (35.48%) exhibited some degree of epithelial dysplasia. Acanthosis and/or hyperkeratosis were observed in 20 cases (64.52%). No significant associations were observed between sex and anatomical location, age and anatomical location, nor between sex and histological diagnosis (p > 0.05). Oral leukoplakia and oral erythroplakia are uncommon diseases in young patients. In this population, oral leukoplakia shows a slight predilection for women aged between 30 and 39 years.

Leukoplakia and erythroplakia in youngers versus older individuals: a clinicopathological retrospective study.

BACKGROUND: The incidence of oral cancer has exhibited a rise within the young population. Considering that oral potentially malignant disorders (OPMDs) can precede the development of oral cancer, it is imperative to conduct studies in this particular younger population. This study aimed to evaluate the frequency and conduct a comparative analysis of the clinical-demographic characteristics of OPMDs in two distinct age groups. MATERIAL AND METHODS: A retrospective analysis was conducted with patients diagnosed with leukoplakia, erythroplakia, and leukoerythroplakia between 1965 and 2020. The individuals were categorized into two groups: those aged up to 40 years (Group Younger) and those aged 41 years and above (Group Older). RESULTS: A total of 640 lesions were subjected to analysis. Among these, patients aged up to 40 years constituted 10.63% of the sample, however, this proportion decreased significantly to 6.9% between 2010 and 2020. A predominant male representation was observed in both groups, with white lesions being the most common in both as well. However, the frequency of red or mixed lesions was significantly higher (p=0.034) in the older group, along with a higher prevalence of dysplastic lesions (26.9% versus 11.8%, p=0.01). Moreover, the older group exhibited a relatively higher percentage of smokers/ex-smokers (78.6%), compared to the younger group (61.5%, p=0.085) and alcohol consumers/ex-consumers (54.9% versus 22.7%, p=0.028). Elderly individuals exhibited an unfavorable progression (p=0.028). However, a logistic regression analysis identified as significant variables associated with malignant transformation, the presence of epithelial dysplasia, and red lesions diagnosed as erythroplakia. CONCLUSIONS: A declining frequency of OPMDs in young adults was observed over the years, whereas in older adults, these disorders exhibited an unfavorable progression.

Desordens orais potencialmente malignas: o que o cirurgião-dentista precisa saber? / Oral potentially malignant disorders: what do dentists need to know?

Introdução:as desordens orais potencialmente malignas (DOPMs) são condições que podem preceder o aparecimento do câncer em cavidade bucal. Objetivo: descrever os principais aspectos clínicos, histológicos e tratamento da leucoplasia, eritroplasia, queilite actínica e líquen plano oral. Metodologia: trata-se de uma revisão da literatura atual, em que foram consultados artigos nas bases do MEDLINE/PUBMED e Biblioteca Virtual em Saúde, publicados nos últimos 10 anos. Os descritores foram localizados usando o vocabulário controlado do MeSH, sendo eles: Leukoplakia; Erythroplakia, Actinic cheilitis, Oral lichen planus, Diagnosis, Therapeutics. Resultados: asapresentações clínicas das DOPMs são diversas. A leucoplasia é a mais comum e deve ser distinguida da leucoplasia verrucosa proliferativa que tem uma apresentação clínica generalizada e uma tendência à recorrência após a excisão; a eritroplasia, embora rara, tem maior chance de malignização. A queilite actínica acomete com frequência o lábio inferior, tem forte relação com exposição solar e pode progredir para o carcinoma escamocelular labial; o líquen plano oral tem uma variedade de apresentações clínicas, sendo a forma reticular a mais comum. O tipo erosivo, atrófico ou bolhoso é acompanhado de sintomatologia dolorosa variável. A biópsia é essencial para confirmar a suspeita clínica das DOPMs e o encaminhamento oportuno para um especialista é indicado. Conclusão: as DOPMs podem ser encontradas durante o exame bucal, possibilitando assim, o diagnóstico precoce, e o correto encaminhamento a um especialista e a intervenção adequada, podendo reduzir a taxa de progressão dessas condições para câncer.

Introduction: Oral Potentially Malignant Disorders (OPMDs) are conditions that may precede the onset of cancer in the oral cavity. Objective: To describe the main clinical features, histological aspects and treatment of leukoplakia, erythroplakia, actinic cheilitis and oral lichen planus. Methodology: this is a review of the current literature, in which articles in the databases of MEDLINE/PUBMED and the Virtual Health Library, published in the last 10 years, were consulted. The descriptors were located using the MeSH controlled vocabulary, namely: Leukoplakia; Erythroplakia, Actinic cheilitis, Oral lichen planus, Diagnosis, Therapeutics. Results:the clinical presentations of OPMDs are diverse. Leukoplakia is the most common and must be distinguished from proliferative verrucous leukoplakia which has a generalized clinical presentation and a tendency to reoccur after excision; erythroplakia, although rare, has a greater chance of becoming malignant. Actinic cheilitis frequently affects the lower lip, is strongly related to sun exposure and can progress to labial squamous cell carcinoma; oral lichen planus has a variety of clinical presentations, with the reticular form being the most common. The erosive, atrophic or bullous type is accompanied by different levels of pain. Biopsy is essential to confirm the clinical suspicion of OPMDs and timely referral to a specialist is indicated. Conclusion: OPMDs can be found during oral examination, thus enabling early diagnosis, correct referral to a specialist and appropriate intervention, which may reduce the rate of progression of these conditions to cancer.

Abordaje quirúrgico primario en un paciente con eritroplasia de Queyrat / Primary surgical approach to a patient with erythroplasia of Queyrat

Presentación del caso. Paciente masculino de 52 años que se presentó a la consulta de urología con historia de dos años de notar una lesión en el glande y el prepucio, de color rojo brillante, pruriginosa y dolorosa con aumento progresivo del tamaño que no mejoró con tratamientos antibióticos y anti fúngicos. Intervención terapéutica. Se realizó una glandectomía parcial con injerto de piel de muslo. Evolución clínica. Luego de un mes, el injerto presentó un 95 % de acoplamiento. No se observó recurrencia local de cáncer. El estudio histopatológico reportó un carcinoma escamoso invasor en la lesión del prepucio y en la piel del glande, con todos los márgenes quirúrgicos, limites laterales y profundos, negativos a malignidad. Luego de ocho meses posquirúrgicos, se observó el recubrimiento del glande con un adecuado resultado estético, con apariencia similar a la cubierta natural

Case presentation. A A 52-year-old male patient presented to the urology office with a two-year history of noticing a bright red, pruritic, and painful lesion on the glans and foreskin with a progressive increase in size that did not improve with antibiotic and antifungal treatments. Treatment. Partial glandectomy with thigh skin graft was performed. Outcome. After After one month, the graft presented a 95 % of coupling. No local recurrence of cancer was observed. The histopathological study reported invasive squamous cell carcinoma in the lesion of the foreskin and glans skin, with all surgical margins, lateral and deep limits, negative for malignancy. After eight months post-surgery, the covering of the glans was observed with an appropriate esthetic result, with a similar appearance to the natural covering

Desordens orais potencialmente malignas: uma análise bibliométrica dos trabalhos apresentados na sociedade brasileira de pesquisa odontológica (sbpqo) / Oral potentially malignant disorders: a bibliometric analysisof the works presented at brazilian society of dental research (sbpqo)

Objetivo: as Desordens Orais Potencialmente Malignas (DOPMs) consistem em lesões e condições epiteliais que apresentam risco aumentado de malignidade. Nessa pesquisa, buscou-se identificar o perfil da produção cien-tífica brasileira sobre as DOPMs, a partir de uma análise bibliométrica dos trabalhos apresentados nas Reuniões da Sociedade Brasileira de Pesquisa Odontológica (SBPqO). Materiais e Métodos: foi realizado um estudo bibliométrico, em que foram analisados os anais das reuniões anuais da SBPqO realizadas entre 2015 a 2019. Incluiu-se resumos sobre DOPMs apresentados em qualquer categoria e as seguintes informações foram extraídas: ano, desenho do estudo, tipo de DOPM, unidade federativa, localização e instituição de ensino superior de origem. Os dados foram analisados por meio de estatística descritiva. Resultados:foram identificados 91 resumos. A maior parte foi publicada em 2015 (24,2%) e por autores do estado de São Paulo (22%). A leucoplasia foi a desordem mais frequente (36,2%), seguida pela queilite actínica (35,2%). A maioria dos estudos foi de autoria de pesquisadores das regiões Sudeste (29%) e Sul (28%). Em relação à instituição de ensino, grande parte (68,1%) foi proveniente de universidades públicas. O tipo de estudo mais frequente foi pesquisa labo-ratorial básica (57,1%). Discussão: os achados do estudo indicam que o número de pesquisas sobre as DOPMs apresentadas nas Reuniões da SBPqO ainda é reduzido, concentrados na região sudeste e nas universidades públicas. Conclusão: realizar novas pesquisas a respeito desse tema é muito importante, pois permite a descoberta de informações relevantes para a saúde dos indivíduos frente a essa neoplasia.

Objective: Oral Potentially Malignant Disorders (OPMDs) are lesions and epithelial conditions that present an increased risk of malignancy. In this research, the aim was to identify the profile of Brazilian scientific produc-tion on DOPMs, based on a bibliometric analysis of the works presented at the Meetings of the Brazilian Dental Research Society (SBPqO). Materials and Methods: a bibliometric study was carried out, in which the annals of the annual SBPqO meetings held between 2015 and 2019 were analyzed. Abstracts about DOPMs presented in any category were included and the following information was extracted: year, study design, type of DOPM, federative unit, location and educational institution of origin. The data were analyzed using descriptive sta-tistics. Results: 91 abstracts were identified. Most were published in 2015 (24.2%) and by authors from the state of São Paulo (22%). Leukoplakia was the most frequent disorder (36.2%), followed by actinic cheilitis (35.2%). Most of the studies were authored by researchers from the Southeast (29%) and South (28%) regions. Regarding the educational institution, a large part (68.1%) came from public universities. The most frequent type of study was basic laboratory research (57.1%). Discussion: the study findings indicate that the number of researches on DOPMs presented at the SBPqO Meetings is still small, concentrated in the Southeast region and in public universities. Conclusion: conducting new research on this topic is very important, as it allows the discovery of information relevant to the health of individuals in the face of this neoplasm.

Imunoexpressão da Yes-Associated Protein (YAP) em hiperceratoses e displasias epiteliais orais / Immunoexpression of Yes-Associated Protein (YAP) in hyperkeratosis and oral epithelial dysplasia

A busca por um biomarcador que auxilie na predição de risco de transformação maligna das desordens orais potencialmente malignas (DOPMs) representa um grande desafio, já que pode auxiliar no manejo precoce e adequado dos pacientes. Este estudo avaliou a imunoexpressão da Yes-Associated Protein (YAP) em lesões intraorais leucoplásicas, eritroplásicas ou leucoeritroplásicas, com diagnóstico histopatológico de hiperceratose ou displasia epitelial oral (DEO), correlacionando essa imunoexpressão com o grau de severidade morfológica dessas lesões. A amostra foi composta por 20 casos de hiperceratoses e 53 casos de DEOs, além de 10 casos de mucosa oral normal (grupo controle). Para a avaliação do grau de displasia, foram utilizadas as gradações da OMS (EL-NAGGAR et al., 2017) e o Sistema Binário (KUJAN et al., 2006), sendo o perfil imunoistoquímico da proteína YAP avaliado por meio de escores, que variaram entre 0 e 3, com base em sua localização intracelular (citoplasmática ou nuclear) e por sua distribuição no tecido epitelial. Para a análise entre os parâmetros estudados foram realizados os testes estatísticos Qui-quadrado de Pearson, Exato de Fisher, além de testes não paramétricos, (nível de significância de 95%). Displasias leves foram enquadradas (100%) no baixo risco de transformação maligna, enquanto as moderadas dividiram-se entre baixo (47%) e alto risco (53%), sendo as displasias severas, em sua maior parte (71%), classificadas como de alto risco (p < 0,001). O grupo controle exibiu imunomarcação de escore 0 (80%), as hiperceratoses e displasias leves (em 80% das vezes) exibiram escore 1, já nas displasias moderadas (63%) e severas (79%), foram predominantes os escores 2 e 3; com padrão de imunomarcação nuclear associado ao alto risco de transformação maligna sugerido pelo Sistema binário (p = 0,002). A imunoexpressão da YAP foi semelhante entre hiperceratoses e displasias leves, o que deve suscitar maior atenção dos profissionais frente aos casos de hiperceratose, além disto a expressão da YAP aparenta dicotomizar as DOPMs entre as lesões com baixo risco de transformação maligna e as lesões com alto risco, o que pode sugerir no futuro, sua utilização como potencial marcador preditivo de progressão destas lesões (AU).

The search for a biomarker that helps to predict the risk of malignant transformation of oral potentially malignant disorders (OPMDs) represents a great challenge, as it can help in the early and adequate management of patients. This study evaluated the immunoexpression of Yes-Associated Protein (YAP) in intraoral leukoplastic, erythroplastic or leukoerythroplastic lesions, with histopathological diagnosis of hyperkeratosis or oral epithelial dysplasia (OED), correlating this immunoexpression with the degree of morphological severity of these lesions. The sample consisted of 20 cases of hyperkeratosis and 53 cases of OED, in addition to 10 cases of normal oral mucosa (control group). To assess the degree of dysplasia, the WHO grading (EL-NAGGAR et al., 2017) and the Binary System (KUJAN et al., 2006) were used, and the immunohistochemical profile of the YAP protein was evaluated through scores, which ranged from 0 to 3, based on their intracellular location (cytoplasmic or nuclear) and their distribution in the epithelial tissue. For the analysis of the studied parameters, Pearson's Chi-square and Fisher's Exact statistical tests were performed, in addition to non-parametric tests (significance level of 95%). Mild dysplasias were classified (100%) in the low risk of malignant transformation, while the moderate ones were divided between low (47%) and high risk (53%), with severe dysplasias, for the most part (71%), classified as high risk (p < 0.001). The control group exhibited score 0 of immunostaining (80%), hyperkeratosis and mild dysplasias (80% of booth) exhibit score 1, whereas in moderate (63%) and severe dysplasia (79%), the predominant scores was 2 and 3; with a pattern of nuclear immunostaining associated with the high risk of malignant transformation suggested by the Binary System (p = 0.002). The immunoexpression of YAP was similar between hyperkeratosis and mild dysplasias, which should attract greater attention from professionals in cases of hyperkeratosis. Furthermore, the expression of YAP appears to dichotomize OPMDs between lesions with low risk of malignant transformation and lesions with high risk, which may suggest, in the future, its use as a potential predictive marker of the progression for these lesions (AU).

Oral leukoplakia, leukoerythroplakia, erythroplakia and actinic cheilitis: Analysis of 953 patients focusing on oral epithelial dysplasia.

BACKGROUND: To analyse the clinical and histological characteristics from a series of oral leukoplakias, leukoerythroplakias, erythroplakias and actinic cheilitis diagnosed in a 14-year period. METHODS: The files were reviewed and all cases diagnosed as leukoplakia, leukoerythroplakia, erythroplakia and actinic cheilitis were selected. Clinical information was obtained from the biopsy submission forms, and histological review was performed in all cases. RESULTS: Final sample included 953 lesions, mostly affecting females (534, 56%), and 87.5% of the patients were 41 to 80 years old. The most commonly affected regions were the lower lip (20.1%), tongue (18.1%) and buccal mucosa (16.9%). Leukoplakias, actinic cheilitis, leukoerythroplakias and erythroplakias represented, respectively, 74.6%, 15.2%, 9.3% and 0.8% of the sample. Most cases presented no dysplasia (42.1%) or mild dysplasia (33.5%). Lesions in the tongue, floor of mouth and lower lip, as well as lesions that presented hyperparakeratosis, showed higher frequencies of moderate dysplasia and severe dysplasia/carcinoma in situ. The most common histological criteria were the increase in number and size of nucleoli, loss of polarity of the basal cells and variations in cellular size and shape. Classification by the binary system showed that 7% were high-risk lesions. CONCLUSION: All histological criteria for classification of oral epithelial dysplasia recommended by the World Health Organization showed increased frequency as grading increased. Additional criteria seem to be useful in grading oral epithelial dysplasia, such as the presence of normal and abnormal superficial mitotic figures and endophytic epithelial proliferation.

Oral leukoplakia and erythroplakia in young patients: a systematic review.

OBJECTIVE: The aim of this study was to estimate the frequency of oral leukoplakia and oral erythroplakia in young patients. STUDY DESIGN: The systematic review was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and performed in the following electronic databases: PubMed, Scopus, and Embase. The studies included were cross-sectional, cohort, and diagnostic, which provided with clinical and microscopic data of patients younger than 40 years. The Critical Appraisal Checklist for Prevalence Studies from the Joanna Briggs Institute and the Quality Assessment Tool for Diagnostic Accuracy Studies were used to assess the risk of bias. RESULTS: Five studies met eligibility criteria and were included. The total number of patients from the studies was 1246, of which 115 were young patients (9.2%) with oral leukoplakia as the only oral potentially malignant disorder reported. Oral epithelial dysplasia was identified in 40 cases (34.7%), of which 8 (6.9%) presented malignant transformation. CONCLUSIONS: The frequency of oral leukoplakia is low in young patients. Observational studies are necessary for understanding oral leukoplakia and other oral potentially malignant disorders in younger patients.

Correlation Between Clinical and Histopathologic Diagnosis of Oral Potentially Malignant Disorder and Oral Squamous Cell Carcinoma

ABSTRACT Objective: To determine the frequency of oral potentially malignant disorders and Oral Squamous Cell Carcinoma (OSCC) and evaluate the consistency between their clinical and pathological features. Material and Methods: This retrospective study was conducted on records with a diagnosis of oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, lichen planus, and OSCC in the Pathology Department of Kerman dental school from September 1997 to September 2017. Data were analyzed in SPSS 21 at the significance level of ≤5%. Results: There were 378 cases of oral potentially malignant disorders and 70 cases of OSCC with a mean age of 46.82 ± 15.24 years. Buccal mucosa was the most frequent site, and lichen planus the most common lesion. Females were significantly older than males in leukoplakia and carcinoma in situ lesions. Clinical diagnosis and histopathology were consistent in 69.03% of cases. Conclusion: Clinical and histopathological diagnoses were consistent in 69.03% of records. The highest degree of clinical compliance with histopathology was observed in OSCC. Dentists should pay attention to oral potentially malignant disorders for early diagnosis to prevent their transformation to malignancy.

Revisión bibliográfica descriptiva: lesiones orales precancerosas en relación con contacto sexual / A descriptive review of the literature: precancerous oral lesions related to sexual contact

Los términos lesión precancerosa, cancerizable o premaligna son sinónimos e involucran aquellas entidades con posibilidades estadísticamente demostrables de transformarse en cáncer. El porcentaje de transformación es variable de acuerdo con el tipo de lesión. La lesión precancerosa fue definida por la OMS (Organización Mundial de la Salud) como aquel tejido de morfología alterada con mayor predisposición a la cancerización (superior al 5%) que el tejido equivalente de apariencia normal, independientemente de sus características clínicas o histológicas. La cátedra de Anatomía Patológica considera como lesiones precancerosas o cancerizables a las siguientes entidades: la leucoplasia, los líquenes atípicos, las queilitis crónicas, eritroplasia y las ulceras traumáticas crónicas. Con frecuencia, factores relacionados con los estilos de vida son más importantes en la predisposición al cáncer, si bien en algunos casos los factores genéticos o ambientales pueden jugar algún papel en grado variable. No se conocen todos los factores de riesgo, y no siempre las asociaciones son de causaefecto. Las infecciones bacterianas, micóticas y virales se vinculan al surgimiento y desarrollo de los cánceres bucales por diferentes mecanismos, no del todo esclarecidos. En los últimos años han aumentado de manera significativa las manifestaciones orales y faríngeas secundarias a la práctica de sexo oral. El cambio de los hábitos sexuales en países occidentales ha dado lugar a la aparición de patologías otorrinolaringológicas, antes excepcionales, por lo que es importante su conocimiento por parte de los profesionales de la salud relacionados con la atención primaria para realizar un diagnóstico precoz, seguimiento precoz, seguimiento y oportuno tratamiento específico (AU)

The terms precancerous, cancerable or premalignant lesion are synonyms and involve those entities with statistically demonstrable possibilities of transforming into cancer. The transformation percentage is variable, according to the type of injury. The precancerous lesion was defined by the WHO as that tissue of altered morphology with a greater predisposition to cancerization (greater than 5%) than the equivalent tissue of normal appearance, regardless of its clinical or histological characteristics. The Chair of Pathological Anatomy considers the following entities as precancerous or cancerous lesions: leukoplakia, atypical lichens, chronic cheilitis, erythroplasia, and chronic traumatic ulcers. Lifestyle-related factors are often more important in cancer predisposition, although in some cases genetic or environmental factors may play a role to varying degrees. Not all risk factors are known, and the associations are not always cause and effect Bacterial, fungal, and viral infections are linked to the emergence and development of oral cancers by different mechanisms, not fully understood. In recent years, oral and pharyngeal manifestations secondary to oral sex have increased significantly. The change in sexual habits in western countries has given rise to the appearance of exceptional otorhinolaryngological pathologies previously, which is why it is important for them to be known by health professionals related to primary care in order to make an early diagnosis, early follow-up, follow-up and timely specific treatment (AU)

Oral potentially malignant disorders: clinical-pathological study of 684 cases diagnosed in a Brazilian population.

BACKGROUND: The frequency and distribution of oral potentially malignant disorders (OPMD) may vary among different populations. The aim of the present study was to evaluate the clinical-pathological characteristics of OPMD diagnosed in a Brazilian oral pathology laboratory over a period of 11 years. MATERIAL AND METHODS: All cases diagnosed as leukoplakia, speckled leukoplakia, erythroplakia, and actinic cheilitis from 2005 to 2015 were analyzed. Clinical information was obtained from laboratory forms and histological information was obtained from histological slides stained with hematoxylin and eosin. RESULTS: the final sample was comprised of 684 cases, of which 292 were males and 392 were females. The mean age was 58 years. The anatomical site most often involved was the lateral border of the tongue (23%), followed by the lower lip (20%), and by the buccal mucosa/vestibule (18%). Leukoplakia accounted for 82% of the sample (564 cases). The mean size of the leukoplakia and speckled leukoplakia lesions was 13 mm (ranging from 1 to 100 mm) and 15 mm (ranging from 5 to 30 mm), respectively (p=0.460). Males reported smoking and drinking alcohol more frequently than females (p=0.001 and p<0.0001, respectively). In half of the cases, dysplasia was not histologically detected, while slight dysplasia was detected in 28% of the cases. The lesions from patients aged from 41 to 80 years presented moderate and severe dysplasia more often than lesions from patients in other age groups. CONCLUSIONS: OPMD were more common in females in their sixties. Females were more frequently affected in all anatomical sites, except for the lips. Leukoplakia lesions were the most common OPMD, followed by actinic cheilitis. The lateral border of the tongue was the most affected anatomical site. OPMD located in the floor of the mouth/sublingual mucosa and lesions from older patients presented severe epithelial dysplasia with greater frequency.

Evaluación clínico-epidemiológica de trastornos bucales potencialmente malignos en adultos de Montalvo en Ambato, Ecuador / Clinical-epidemiological evaluation of potentially malignant oral disorders in adults of Montalvo in Ambato, Ecuador

RESUMEN Introducción: Las neoplasias de cabeza y cuello representan el 17,6 por ciento a nivel mundial. El cáncer de la cavidad bucal es uno de los más comunes que aparece en dicha región; el 95 por ciento corresponde a carcinoma epidermoide con un pobre pronóstico de supervivencia, debido a que algunos se desarrollan a partir de trastornos potencialmente malignos peligrosamente asintomáticos, por lo que su detección precoz es imprescindible. Objetivo: Caracterizar los trastornos bucales potencialmente malignos mediante aspectos epidemiológicos, clínicos y topográficos en adultos atendidos en el subcentro de salud de Montalvo. Métodos: Se realizó un estudio descriptivo y transversal en 99 pacientes atendidos en el subcentro de salud de Montalvo en Ambato, Ecuador, desde noviembre de 2012 a enero de 2013. Los datos fueron recogidos en la historia clínica estomatológica, que incluyó: datos generales, interrogatorio y examen físico de la cavidad bucal. Los trastornos bucales potencialmente malignos que se consideraron fueron la leucoplasia, eritroleucoplasia, eritroplasia y paladar del fumador invertido. Se aplicó la estadística descriptiva y el estadígrafo chi cuadrado de Sperman. Se trabajó con confidencialidad en el manejo de los datos obtenidos y con la autorización correspondiente al consentimiento. Resultados: Los pacientes con más de 60 años representaron el grupo de edad más afectado para el 60,6 por ciento, con un predominio del sexo femenino (54,5 por ciento). El color de la piel no tuvo una diferencia significativa. El trastorno más frecuente fue la leucoplasia (30 por ciento), seguida de la eritroleucoplasia (15 por ciento) y la eritroplasia (11 por ciento). El 75,8 por ciento de los pacientes no presentó síntomas, sin embargo, el 73 por ciento de los casos con lesiones presentó trauma físico. La localización más frecuente de la leucoplasia fue la mucosa del carrillo y la base de la lengua. Conclusiones: La leucoplasia, la eritroleucoplasia y la eritroplasia fueron los trastornos bucales potencialmente malignos más frecuentes, localizados con mayor frecuencia en la base de la lengua y la mucosa del carrillo, con un predominio en los pacientes mayores de 60 años y en las mujeres(AU)

ABSTRACT Introduction: Head and neck neoplasms represent 17.6 percent worldwide. Cancer of the oral cavity is one of the most common that appear in this region, being 95 percent epidermoid carcinoma with a poor prognosis of survival because they develop from premalignant lesions dangerously asymptomatic, the reason why the precocious detection is imperative. Objective: Characterize potentially malignant oral disorders through epidemiological, clinical and topographical aspects in adults served at the Montalvo health subcenter. Methods: A descriptive and cross-sectional study was conducted on 99 patients treated at the Montalvo health subcentre in Ambato, Ecuador, from November 2012 to January 2013. The data were collected in the stomatological medical history, which included: general data, interrogation and physical examination of the oral cavity. The potentially malignant oral disorders considered were leukoplakia, erythroleukoplakia, erythroplasia and the palate of the inverted smoker. The descriptive statistic and the Sperman chi square statisticwast were applied. It was worked with confidentiality in the handling of the data obtained and with the authorization corresponding to the consent. Results: Patients over 60 years of age accounted for the most affected age group for 60.6 percent, with a female predominance (54.5 percent). The skin color did not make a significant difference. The most common disorder was leukoplakia (30 percent), followed by erythroleukoplakia (15 percent) erythroplasia (11 percent). 75.8 percent of patients had no symptoms, however 73 percent of injured cases had physical trauma. The most common location of leukoplakia was the mucosa of the cheek and the base of the tongue. Conclusion: Leukoplakia, erythroleukoplakia and erythroplasia were the most common potentially malignant oral disorders, most commonly located at the base of the tongue and mucosa of the carrillo, with predominance in patients over 60 years of age and in patients over 60 years of age and in Women(AU)

Prevalence of oral potentially malignant disorders: A systematic review and meta-analysis.

Oral potentially malignant disorders (OPMD) are chronic conditions, which have a higher risk of transformation to oral squamous cell carcinoma. The aim of this systematic review and meta-analysis was to answer the question: "What is the prevalence of oral potentially malignant disorders among adults?" Studies reporting the prevalence of these conditions (leukoplakia, erythroplakia, oral submucous fibrosis [OSMF], and actinic cheilitis) were selected, only studies in which a clinical assessment and histopathological confirmation were performed were included. Of the 5513 studies, 22 met the inclusion criteria for qualitative and quantitative analyses. The risk of bias (RoB) of the selected studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Seven studies were classified as high risk, 12 as moderate risk, and 3 as low RoB. The meta-analysis showed that the prevalence of OPMD was 4.47% (95% CI = 2.43-7.08). The most prevalent OPMDs were OSMF (4.96%; 95% CI = 2.28-8.62) and leukoplakia (4.11%; 95% CI = 1.98-6.97). OPMDs were identified more commonly in males (59.99%; 95% CI = 41.27-77.30). Asian and South American/Caribbean populations had the highest prevalence rates of 10.54% (95% CI = 4.60-18.55) and 3.93% (95% CI = 2.43-5.77), respectively. The overall prevalence of OPMD worldwide was 4.47%, and males were more frequently affected by these disorders. The prevalence of OPMD differs between populations; therefore, further population-based studies may contribute to the better understanding of these differences.

Erythroplasia of Queyrat treated with topical 5-fluorouracil

Abstract We report a 33-year-old male patient diagnosed with erythroplasia of Queyrat. The patient had an erythematous and eroded lesion affecting more than 50% of the glans associated with bleeding and local pain. Despite previous indication of penectomy, he was successfully treated with topical 5-fluorouracil.

Potentially malignant oral lesions: clinicopathological correlations.

OBJECTIVE: To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. METHODS: The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). RESULTS: Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). CONCLUSION: In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

Prevalence and factors associated with oral potentially malignant disorders in Brazil's rural workers.

OBJECTIVES: To determine the prevalence of oral potentially malignant disorders (OPMDs) in a population of rural workers in the northeast of Brazil and to investigate the association with sociodemographic, occupational, and health factors. METHODS: A total of 1385 workers answered a validated questionnaire and were examined by calibrated dentists. A descriptive analysis, chi-square homogeneity test, and binary logistic regression were performed. RESULTS: The prevalence of OPMDs was 29.6%. Actinic cheilitis was the most predominant (28.4%), followed by leukoplakia (2.3%) and erythroplakia (0.3%). Gender, type of skin, and time exposed to the sun explained the presence of OPMD (P < 0.0001). The study found increased prevalence, especially for males over the age of 60 years and being exposed to the sun for more than 45 years. CONCLUSION: Rural workers showed high vulnerability to the presence of OPMDs, as estimated prevalence exhibited was high.

Potentially malignant oral lesions: clinicopathological correlations / Lesões orais potencialmente malignas: correlações clínico-patológicas

ABSTRACT Objective To determine the incidence of potentially malignant oral lesions, and evaluate and correlate their clinical and pathological aspects. Methods The sample consisted of cases clinically diagnosed as oral leukoplakia, oral erythroplakia, erythroleukoplakia, actinic cheilitis, and oral lichen planus treated at a diagnostic center, between May 2012 and July 2013. Statistical tests were conducted adopting a significance level of 5% (p≤0.05). Results Out of 340 patients, 106 (31.2%) had potentially malignant oral lesions; and 61 of these (17.9%) were submitted to biopsy. Actinic cheilitis was the most frequent lesion (37.5%) and the lower lip was the most affected site (49.6%). Among 106 patients in the sample, 48 (45.3%) reported nicotine consumption, 35 (33%) reported alcohol intake and 34 (32.1%) sun exposure while working. When clinical and histopathological diagnoses were compared, oral erythroplakia and atypical ulcer were the lesions that exhibited greater compatibility (100% each). Conclusion In most cases, clinical and histopathological diagnoses were compatible. An association between the occurrence of erythroplakia, leukoplakia and erythroleukoplakia with smoking was observed. Similarly, an association between actinic cheilitis and sun exposure was noted. Erythroleukoplakia presented the highest malignancy grade in this study. Finally, dental surgeons should draw special attention to diagnosis of potentially malignant oral lesions, choose the best management, and control the lesions to avoid their malignant transformation.

RESUMO Objetivo Verificar a incidência das lesões orais potencialmente malignas, e avaliar e correlacionar seus aspectos clínico-patológicos. Métodos A amostra foi composta pelos casos diagnosticados clinicamente como leucoplasia oral, eritroplasia oral, eritroleucoplasia, queilite actínica e líquen plano oral em um serviço de diagnóstico no período entre maio de 2012 e julho de 2013. Foram realizados testes estatísticos adotando-se nível de significância de 5% (p≤0,05). Resultados Dos 340 pacientes examinados, 106 (31,2%) se apresentaram com lesões orais potencialmente malignas; destes, 61 (17,9%) biópsias foram realizadas. A lesão mais frequente foi a queilite actínica (37,5%), e o sítio anatômico mais acometido foi o lábio inferior (49,6%). Entre os 106 pacientes da amostra, 48 (45,3%) relataram consumo de nicotina, 35 (33%) ingeriam bebidas alcoólicas e 34 (32,1%) trabalhavam expostos ao sol. Comparando o diagnóstico clínico com o histopatológico, as lesões que apresentaram maior compatibilidade foram a eritroplasia oral e a lesão ulcerada atípica (100% ambas). Conclusão Na maioria dos casos, houve compatibilidade do diagnóstico clínico com o histopatológico. Notou-se correlação entre a ocorrência de eritroplasia, leucoplasia e eritroleucoplasia com o hábito de fumar, e entre a queilite actínica com a exposição solar. A eritroleucoplasia foi a lesão que demonstrou maior grau de malignização neste estudo. Diante do exposto, recomenda-se maior atenção por parte dos cirurgiões-dentistas ao diagnóstico das lesões orais potencialmente malignas, para aplicação da melhor conduta e controle da lesão, impedindo sua transformação maligna.

Erythroplasia of Queyrat treated with topical 5-fluorouracil.

We report a 33-year-old male patient diagnosed with erythroplasia of Queyrat. The patient had an erythematous and eroded lesion affecting more than 50% of the glans associated with bleeding and local pain. Despite previous indication of penectomy, he was successfully treated with topical 5-fluorouracil.

Carcinoma in situ in a patient with erythroleukoplakia: challenges in the diagnosis and in the therapeutic choice / Carcinoma in situ in erythroleukoplakia

A 41-year-old Caucasian male smoker presented a red and white plaque on the left jugal mucosa suggestive of oral erythroleukoplakia (OEL). Biopsy followed by microscopic examination revealed carcinoma in situ. Since OEL is considered a precancerous lesion with a high malignant transformation potential, the present case set out to discuss the challenges in diagnosing the condition and choosing the most appropriate treatment. The discussion deals with issues such as whether there is a limit for choosing either a radical or a more conservative approach to treatment and the importance of using a procedure that allows a microscopic examination of the entire lesion. Carcinoma in situ associated with OEL made the treatment planning even more complex in the present case. In order to avoid a mutilating approach, multiple excisions with safety margins were performed, and the patient was instructed not to smoke. A strict 12-month follow-up shows no signs of recurrence of the OEL... (AU)

Caracterización de las lesiones premalignas y malignas de la cavidad bucal en pacientes de Amancio 2010-2012 / Characterization of pre-malignant and malignant lesions in the oral cavity in Amancio 2010-2012

Se realizó un estudio observacional descriptivo retrospectivo, para caracterizar las lesiones premalignas y malignas de la cavidad bucal en pacientes remitidos a la consulta de máxilo facial, de la clínica estomatológica del policlínico Luis Aldana Palomino, durante el período comprendido entre enero de 2010 a diciembre de 2012, en el municipio Amancio. El universo de estudio estuvo constituido por 63 personas remitidas al referido servicio. La muestra quedó conformada por los 32 pacientes diagnosticados con lesiones malignas y premalignas. Las variables estudiadas fueron: edad, sexo, tipo de lesión, factores de riesgo y localización anatómica de las mismas. Predominaron los pacientes del grupo de edad de 35-59 años, del sexo masculino, así como la lesiones premalignas; se comprobó que la totalidad de las lesiones malignas fueron carcinomas epidermoides y la mayoría de las lesiones premalignas leucoplasias; el factor de riesgo predominante fue el hábito de fumar y las lesiones se encontraron localizadas fundamentalmente en el labio inferior (AU)

An observational, descriptive and retrospective study was carried out to characterize the premalignant and malignant lesions of the buccal cavity in patients referred to the maxillofacial consultation of Luis Aldana Palomino Policlinic in Amancio, from January, 2010 to January, 2012. The universe was constituted by 63 persons who were referred to the maxillofacial consultation service; the sample was made up of 32 persons who were diagnosed with premalignant and malignant lesions. The variables were: age, sex, kind of lesion, risk factors, and anatomical location. There was a prevalence of male patients from 35 to 59 years old, and premalignant lesions; it was proved that all the malignant lesions were epidermoid carcinomas, and most of the premalignant ones were leukoplakias; the prevailing risk factor was smoking, and lesions appeared mainly in the lower lip (AU)