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.

Oral leukoplakia-epidemiological survey and histochemical analysis of 107 cases in Brazil.

OBJECTIVE: To perform an epidemiological survey comparing the cell proliferative activity of 107 cases of oral leukoplakia with their clinical and histopathological characteristics. MATERIALS AND METHODS: A cross-sectional, observational, and histological-histochemical study. The cases came from the Histopathological Diagnostic Service of UPF/RS and the School of Dentistry of Araçatuba FOA/UNESP/SP (1986-2016). The histopathological sections were stained using the silver staining (AgNOR) technique and the nuclei of 100 epithelial cells selected randomly were recorded to count the number of nucleolar organizer regions (NORs). The mean NORs per lesion were correlated to clinical and histological characteristics using ANOVA, at 5% significance. RESULTS: Most of the cases included men (62.62%), white (64.49%), and with an average age of 53.94 years. The most probable etiological factors were smoking (44.7%) and alcohol consumption (9.85%). The evolution time of most lesions was fast (33.65%), manifesting mainly in the form of plaques (70.37%) and without symptoms (58.88%). They were located mainly in the cheek mucosa (26.62%) and presented white color (66.35%), well-defined edges (59.81%), firm consistency (47.5%), and keratinized surface (49.53%). Etiological factor (p = 0.003), evolution time (p = 0.006), symptoms (p = 0.029), location (p = 0.020), consistency (p = 0.047), histopathological characteristics (p = 0.004), and superficial keratinization (p = 0.001) were statistically significant regarding the mean NORs of the leukoplakias studied. CLINICAL RELEVANCE: Oral leukoplakias caused by alcohol consumption and/or tobacco use, considering an evolution time of fewer than 12 months, asymptomatic, located in the lower lip or tongue, and with a firm consistency and increased superficial keratinization should be treated more aggressively by the clinician to avoid cancerization.

High-risk human papillomavirus in patients with oral leukoplakia and oral squamous cell carcinoma-A multi-centre study in Sweden, Brazil and Romania.

OBJECTIVES: Although causal associations between oral leukoplakia (OL), oral squamous cell carcinoma (OSCC) and high-risk human papillomavirus (HR-HPV) have been speculated upon in several reports, conclusive evidence has not been presented. This study investigates whether the number of cases of HR-HPV in OL has increased over time and whether the prevalence of HR-HPV-positive OL differs in various parts of the world. PATIENTS AND METHODS: A total of 432 patients with OL from Sweden, Brazil and Romania were analysed. Patients were divided into historical (1992-2002) and contemporary (2011-2017) cohorts from the respective countries. Seventeen patients with OL developed oral squamous cell carcinoma (OSCC). A real-time PCR assay, targeting HPV sub-types 6,11,16,18,31,33,35,39,45,52,56,58 and 59, was performed to detect HR-HPV in patients with OL. RESULTS: In the Swedish and Romanian cohorts, none of the investigated HPV sub-types were detected. In the Brazilian cohorts, five patients with OL (3%) were positive for HR-HPV, including four patients from the contemporary cohort (HPV 16, 31, 33) and one from the historical cohort (HPV 11). All the cases of OL that transformed into OSCC were HR-HPV-negative, as were the corresponding tumours. CONCLUSIONS: In summary, the prevalence of HR-HPV in OL is low in all the tested countries, and the incidence has not changed over time. HR-HPV in OL does not seem to be a driver of oncogenesis.

Malignant transformation of oral leukoplakia: a multicentric retrospective study in Brazilian population.

BACKGROUND: Among the oral potentially malignant disorders, leukoplakia stands out as the most prevalent. The purpose of this study was to analyse the clinical-pathological features of oral leukoplakia in groups of patients from three major pathology centers in two different regions of Brazil, in order to determine which factors would be associated to the clinical risk of malignant transformation. MATERIAL AND METHODS: A total of 148 patients was analyzed, and data regarding gender, age, site, classification of the clinical subtype, harmful habits such as use of tobacco and alcohol, time of evolution and presence of dysplasia were collected. The association between risk factors and malignant transformation was investigated using the chi-square test and Fischer's exact test for correlation of variables. A significance level of 5% (p≤0.05) was used. RESULTS: The mean age of the patients was 60 years, and 56% were female. Most of the lesions (34,5%) were located in the lateral and ventral regions of the tongue. Of the 148 patients, ninety had clinical follow-up. Malignant transformation occurred in 13 patients (8.8%), with an average of 44 months of follow up. CONCLUSIONS: Non-smoker, nonhomogeneous clinical presentation, location at the tongue, and the presence of high degree of dysplasia were statistically relevant factors associated with a higher risk of transformation transformation.

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.

Prevalencia de lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la Universidad de los Andes: periodo 2015-2018 / Prevalence of oral lesions in soft tissue found in the Clinic of Stomatology of the Faculty of Dentistry of the University of los Andes: 2015-2018 period

Introducción: La epidemiología sobre alteraciones en tejidos blandos bucales es limitada cuando se compara con caries, enfermedades periodontales y maloclusiones, por lo que su estudio representa un paso adelante en la odontología más allá de los dientes. Objetivo: Describir la prevalencia de las lesiones bucales en tejido blando encontradas en la Clínica de Estomatología de la Facultad de Odontología de la ULA, del 2015 al 2018, con la finalidad de proporcionar una fuente de datos actualizada, que oriente a una mejor prevención y oportuno diagnóstico. Material y métodos: Se realizó una investigación descriptiva, documental, retrospectiva y multivariable. Resultados: De 1,000 fichas clínicas estudiadas, las patologías más frecuentes fueron: lengua saburral (50.6%), queilitis (33.4%), traumatismo de la mucosa de los carrillos (27.6%), várices linguales (18.3%), anquiloglosia (13.7%) y agrandamiento de rugas palatinas (11.7%). La zona con mayor alteración fue la lengua (92.1%), mientras que el paladar fue la menos afectada (29%). De los hábitos predisponentes a la formación de lesiones, el mordisqueo de mucosa fue el más común (16.5%). En cuanto a los factores locales asociados, una higiene oral regular/ deficiente resultó el principal (53.8%). Conclusión: La educación del paciente sigue siendo considerada la clave para disminuir la aparición de patologías y su evolución a entidades más graves (AU)

Introduction: Epidemiological studies on soft tissue alterations in the mouth are limited when compared with caries, periodontal diseases and malocclusions, so their study represents a step forward in dentistry beyond the teeth. Objective: To describe the prevalence of soft tissue oral lesions found in the Stomatology Clinic of the ULA School of Dentistry, from 2015 to 2018, in order to provide an up-to-date data source, to guide better prevention and timely diagnosis. Material and methods: A descriptive and documentary, retrospective and multivariable research was carried out. The statistical package IBM SPSS Statistics v 23 was applied for the analysis. Results: 1,000 clinical records studied, the most frequent pathologies were: saburral tongue (50.6%), cheilitis (33.4%), traumatism of the cheek mucosa (27.6%), lingual varices (18.3%), ankyloglossia (13.7%) and enlargement of palatal rugas (11.7%). The tongue was the most affected (92.1%), while the palate was the least affected (29%). Of the predisposing habits to the formation of lesions, mucosal nipping was the most common (16.5%). Regarding the associated local factors, a regular / deficient oral hygiene was the main one (53.8%). Conclusion: Patient education is still considered the key to diminish not only the appearance of pathologies but their evolution to more serious entities (AU)

Caracterización clínica y epidemiológica de pacientes con leucoplasia bucal / Clinical epidemiological characterization of patients with oral leukoplakia

Introducción: La leucoplasia bucal se presenta clínicamente de múltiples formas. Actualmente se considera que puede ser homogénea o no homogénea. Objetivo: Caracterizar pacientes con leucoplasia bucal según variables seleccionadas. Métodos: Se realizó un estudio descriptivo y transversal de 30 pacientes con leucoplasia, atendidos en la consulta del Programa de Detección del Cáncer Bucal, pertenecientes al área de salud del Policlínico Universitario Carlos Juan Finlay de Songo La Maya, provincia de Santiago de Cuba, durante el 2016. Se analizaron las siguientes variables: edad, sexo, color de la piel, factores de riesgo, formas clínicas de presentación de la leucoplasia, localización, número de lesiones, tiempo de consumo del tabaco y transformación maligna. Resultados: Predominaron el grupo etario de 45-64 años, el sexo masculino y los mestizos. La localización anatómica más afectada fue el reborde alveolar residual. La mayoría de los afectados presentó una sola lesión con forma clínica homogénea, y ninguna transformación maligna después de su intervención. El tabaquismo fue el factor de riesgo de mayor prevalencia. Conclusiones: La detección temprana de las lesiones del complejo bucal depende de que el paciente sea examinado a tiempo. Se debe realizar un diagnóstico certero para lograr una reducción significativa de la morbilidad y la mortalidad e incrementar la curación y la supervivencia.

Introduction: The oral leukoplakia is clinically presented in multiple forms. At the moment it is considered that can be homogeneous or non homogeneous. Objective: To characterize patients with oral leukoplakia according to selected variables. Methods: A descriptive and cross-sectional study of 30 patients with leukoplakia was carried out, they were assisted in the Program of Detection of Oral Cancer service, belonging to the health area of Carlos Juan Finlay University Polyclinic in Songo La Maya, Santiago de Cuba, during 2016. The following variables were analyzed: age, sex, skin color, risk factors, clinical forms presentation of leukoplakia, localization, number of lesions, time of nicotine addiction and malignant transformation. Results: The 45-64 age group, male sex and persons of mixed race prevailed. The most affected anatomical localization was the residual alveolar edge. Most of those affected presented a single lesion with homogeneous clinical form, and any malignant transformation after their intervention. Nicotine addiction was the most prevalent risk factor. Conclusions: The early detection of the oral complex lesions depends on the patient's examination on time. An accurate diagnosis should be carried out to achieve a significant reduction of the morbidity and mortality and to increase cure and survival.

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)

Caracterización clínico e histopatológica de la leucoplasia bucal / Clinical and histopathological description of oral leukoplakia

Fundamento: la detección precoz de la leucoplasia, como la lesión premaligna más común de la cavidad oral, y cuya presencia supone un marcador de aumento del riesgo de cáncer bucal, se incluye entre las nuevas perspectivas en el diagnóstico precoz de este cáncer. Objetivo: caracterizar la leucoplasia bucal. Métodos: se realizó un estudio observacional descriptivo transversal, el universo estuvo compuesto por 114 pacientes diagnosticados con leucoplasia bucal y la muestra quedó conformada por similar número de pacientes. Los datos obtenidos procedentes de las boletas de biopsia fueron recogidos en un formulario a propósito de la investigación. Resultados:predominaron los pacientes entre 50 y 59 años. El hábito de fumar se encontró en 58 pacientes mientras que el consumo de alcohol solo en 10. En los pacientes menores de 50 años la aparición de displasia estuvo influenciada por el consumo de tabaco, se encontró asociación entre el tamaño igual o mayor a tres centímetros y la aparición de manifestaciones clínicas cuando se trató de lesiones únicas. Conclusiones: en la mayoría de los pacientes estudiados se constató hábito de fumar y al examen clínico no mostraron síntomas. El tamaño se asoció a la aparición de manifestaciones clínicas en los pacientes con lesiones únicas y no así en aquellos con lesiones múltiples. En un grupo de pacientes se detectó la presencia de alteraciones microscópicas con predominio de la displasia leve(AU)

Background: early detection of leukoplakia, the most common premalignant lesion of the oral cavity, and whose presence is a marker of increased risk of oral cancer, is included among the new perspectives in the early diagnosis of this cancer. Objective: to characterize the oral leukoplakia.Methods: a cross-sectional analytical study was carried out, the universe was composed of 114 patients clinically diagnosed with oral leukoplakia and the sample was composed of equal numbers of patients. The data obtained from biopsy ballots was collected in a form about the investigation. Results: patients were predominantly between 50 and 59 years. Smoking was found in 58 patients while alcohol only in 10. In patients younger than 50 years, the development of dysplasia was influenced by the consumption of tobacco; it was found association between the size equal to or greater than three centimeters and the appearance of clinical symptoms when treated with single lesions.Conclusions: most of the studied patients had smoking habits and they were clinically asymptomatic. The size was associated with the onset of clinical manifestations in patients with single lesions and not in those with multiple injuries. In a group of patients, the presence of microscopic alterations with prevalence of mild dysplasia was detected(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.

Study of the TP53 codon 72 polymorphism in oral cancer and oral potentially malignant disorders in Argentine patients.

The aim of this work was to evaluate the prevalence of TP53Arg72Pro mutations and their possible relationship with oral carcinoma and oral potentially malignant disorders in Argentine patients. A cross-sectional study was performed on 111 exfoliated cytologies from patients with oral cancer (OC), oral potentially malignant disorders (OPMD) and controls. The TP53Arg72Pro mutations were determined using conventional PCR. We evaluated univariate and multivariate study variables, setting p < 0.05. We found: (a) a low frequency of Pro72 variant in control group and a high frequency in OC and OPMD, as well in OC and oral leukoplakia (OL) diagnosis; (b) multivariate association among the TP53CC genotype and females over 45 years with no tobacco nor alcohol habits with oral lichen planus pathology; (c) multivariate association between the TP53GC genotype and males with alcohol and tobacco habits and OC and OL pathologies. Our results showed that the wild-type Arg72variant was related to control patients and Pro72variant was related to OC and OPMD, in Argentine patients.

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.

Oral leukoplakia in patients with Fanconi anaemia without hematopoietic stem cell transplantation.

BACKGROUND: Fanconi anaemia is a genetic disease characterized by congenital abnormalities, progressive bone marrow failure, and a higher predisposition of oral squamous cell carcinoma. The purpose of this study was to evaluate the prevalence of oral mucosa lesions in patients with Fanconi anaemia without hematopoietic stem cell transplantation (HSCT). PROCEDURE: Patients with Fanconi anaemia who had not undergone HSCT was cross-sectional evaluated for the presence of oral lesions. RESULTS: The sample was composed of 78 male and 60 female patients, with a median age of 9 years. Of the 138 patients, approximately 45% manifested at least one oral mucosa abnormality: 35 patients (25%) presented with traumatic injuries, and 16 (12%) exhibited leukoplakia. The following lesions were observed in low prevalence: aphthous ulcers, atrophic tongue, petechiae and hematomas, gingival hyperplasia, mucoceles, herpes, hyperpigmentation, haemangioma, non-neoplastic proliferative lesions, neutropenic ulcers, papilloma, and candidiasis. CONCLUSION: There was a high prevalence of oral leukoplakias in patients with Fanconi anaemia who had not undergone HSCT. It highlights the need of regular oral screenings in this cohort of concern for head and neck malignancies and suggests that oral leukoplakias should be further investigated as part of the syndrome phenotype.

Estudio epidemiológico y clínicopatológico de la leucoplasia oral / Epidemiologic and clinicopathologic study of oral leucoplakia

La leucoplasia oral es la lesión cancerizable más abundante en la cavidad bucal, que con mucha frecuencia puede transformarse en un cáncer bucal; por eso es necesario estudiar desde el punto de vista epidemiológico y clínicopatológico esta entidad. Se realizó un estudio observacional transversal en la población objeto de estudio, que asistió a la consulta de Cirugía Maxilofacial desde junio de 2013 hasta marzo de 2014. El estudio incluyó un total de 24 pacientes con diagnóstico de leucoplasia oral, basado en un interrogatorio, examen físico y biopsia. La investigación tuvo el objetivo de caracterizar desde el punto de vista epidemiológico y clínicopatológico la leucoplasia oral en los pacientes perteneciente a la Clínica Estomatológica Docente Provincial Ismael Clark Mascaró, para así describir su comportamiento en esa población. Los grupos de edades más afectados fueron de 35 años en adelante y pertenecientes al sexo masculino. La localización más frecuente fue el labio inferior y en su mayoría no presentaron ningún grado de displasia. El tipo de leucoplasia oral más frecuente fue la homogénea. Todos los pacientes con diagnóstico de leucoplasia oral eran fumadores. Se concluye que la leucoplasia es una lesión cancerizable, frecuente en la cavidad bucal, que afecta a pacientes de la cuarta década de vida, principalmente del sexo masculino y fumadores. El labio inferior fue el sitio más afectado, predominó la forma homogénea y sin displasia(AU)

Oral leukoplakia is the cancerous lesion most frequently found in the oral cavity and it is very likely to transform itself into an oral cancer; therefore it is a matter of study from the epidemiologic and clinic-pathological point of view. A descriptive and observational study was carried out in the population under study, which attended the Maxillofacial Surgery Consultation from June 2013 to March 2014. The study included 24 patients diagnosed with oral leucoplakia based on the interrogatory, the physical examination and the biopsy. The investigation aimed at characterizing oral leucoplakia in the population attending Ismael Clark Mascaró Odontological Clinic from the epidemiological and clinic-pathological point of view that may allow an assessment of the population´s behavior. The affected age groups were from 35 years on and belonging to the masculine sex. The most frequent position of the lesion was in the lower lip and most patients under study presented no dysplasia. Homogeneous oral leucoplakia was the most frequent type and all the patients diagnosed with oral leucoplakia were smokers. The conclusion showed that oral leucoplakia is a frequent cancerous lesion in the oral cavity that affects patients in the fourth decade of life, mainly masculine smokers. The lower lip was the most frequent site of the lesion and homogeneous oral leukoplakia, without dysplasia predominated(AU)

Avaliação clínica e histopatológica e hábitos associados ao surgimento de leucoplasias e eritroplasias orais / Clinical and histopathological evaluation and habits associated with the onset of oral leukoplakia and erythroplakia

Objective: This research aims to establish the prevalence, factors associated with the onset, and clinical and histopathological features of oral leukoplakia and erythroplakia, so that these data can contribute to the prevention of these lesions and, consequently, of oral cancer. Material and method: A retrospective study was conducted at a reference service of Universidade Federal do Rio Grande do Norte (UFRN) from 2000 to 2012. To verify the association of variables, Pearson's chi-squared test and Fisher's exact test (p ≤ 0.05) were used. Results: Among 6,560 investigated records, 54 cases were selected, of which 44.4% were male and 55.6% female, with mean age of 56.93 years. Regarding habits, 72.2% were smokers and 25% were alcohol users; 17.9% showed association of both habits. Oral leukoplakia lesions were the most prevalent (0.65%) and oral erythroplakia showed greater association with malignancy in the histopathological presentation (p = 0.001). Most lesions showed no symptoms (p = 0.004). The most frequent was oral leukoplakia in smoking women, with mean age of 57 years. Conclusion: Knowledge of associated factors and clinical characteristics of oral leukoplakia and erythroplakia is essential for establishing the correct diagnosis and treatment...

Objetivo: Esta pesquisa objetiva estabelecer a prevalência, os fatores associados ao surgimento e as características clínicas e histopatológicas das leucoplasias e eritroplasias orais, a fim de que estes dados possam contribuir na estratégia de prevenção ao desenvolvimento dessas lesões e, consequentemente, do câncer oral. Material e método: Foi realizado estudo retrospectivo em um serviço de referência da Universidade Federal do Rio Grande do Norte (UFRN) no período de 2000 a 2012. Para verificar a associação das variáveis foi utilizado o teste qui-quadrado e o exato de Fisher (p ≤ 0,05). Resultados: Foram investigados 6.560 prontuários, tendo sido selecionados 54 casos, dos quais 44,4% do sexo masculino e 55,6% do feminino, com idade média de 56,93 anos. Com relação aos hábitos, 72,2% eram fumantes e 25% usuários de álcool, sendo que 17,9% exibiam associação dos dois hábitos. As leucoplasias orais foram as lesões mais prevalentes (0,65%), e as eritroplasias orais apresentaram maior associação com apresentação maligna no diagnóstico histopatológico (p = 0,001). A maioria das lesões não apresentou sintomatologia (p = 0,004). A leucoplasia oral foi mais frequente em mulheres fumantes com média de idade de 57 anos. Conclusão: O conhecimento dos fatores associados e das características clínicas das eritroplasias e leucoplasias orais é essencial para o estabelecimento do correto diagnóstico e tratamento...

Comportamiento clínico-epidemiológico de la leucoplasia oral en el Hospital Guevara durante el período de enero a diciembre, 2010 / Epidemiologic and Clinical Behaviour of Oral Leukoplakia in Guevara Hospital from January to December, 2010

Se realizó un estudio descriptivo de corte transversal, con el objetivo de caracterizar el comportamiento clínico-epidemiológico de la leucoplasia oral, en los pacientes remitidos del Programa de Detección del Cáncer Bucal (PDCB) al servicio de Cirugía Máxilo Facial del Hospital Ernesto Guevara, en el período de enero a diciembre del 2010. El universo de estudio lo formaron los pacientes de 15 y más años, portadores de alguna lesión blanquecina, y la muestra quedó conformada por 160 pacientes, a los que se les diagnosticó la leucoplasia, según criterios clínicos. El procesamiento de los datos arrojó que el 71,3 por ciento de los pacientes remitidos eran del sexo masculino y el grupo de edad más afectado fue el de 35-59 años (59,4 por ciento). La región anatómica más afectada fue el labio inferior (63,1 por ciento). Predominaron las leucoplasias homogéneas en 149 (93,1 por ciento) pacientes y el hábito de fumar (75 por ciento) como factor predisponente. Histopatológicamente, la leucoplasia sin displasia (95 por ciento) fue el hallazgo más común. Se confirmó a la leucoplasia como la lesión predominante, con un 93,1 por ciento de correspondencia entre el diagnóstico clínico e histopatológico (AU)

A descriptive and cross-sectional study was carried out from January to December, 2010 in the Maxillofacial Surgery Department of General Teaching Hospital Dr. Ernesto Guevara de la Serna of Las Tunas province, with the objective of characterizing the clinical and epidemiological behaviour of oral leukoplakia from the Oral Cancer Detection Program (OCDP). The universe was made up by 15 and older patients who presented oral white lesions and the sample were formed by 160 patients diagnosed with oral leukoplakia, according to clinical criteria. The results showed that 71,3 percent of the patients were males, and the group between 35 to 59 years of age was the most affected one. The most affected anatomical area was the lower lip (63,1 percent). The homogenous oral leukoplakia predominated and the tobacco was the most common risk factor, present in the 75 percent of patients. According to the histopathology, leukoplakia without dysplasia was the most common discovery. Leukoplakia was confirmed as the predominant lesion, with a 93,1 percent of link between the clinical and the histopathological diagnosis (AU)

Leucoplasia bucal: levantamento epidemiológico dos casos encontrados no Serviço de Diagnóstico Histopatológico do Instituto de Ciências Biológicas da Universidade de Passo Fundo / Oral leukoplakia: epidemiological survey of cases found at the Histopathologic Diagnosis Service of the Institute of Biological Sciences, University of Passo Fundo

Objetivo: O presente estudo teve como objetivo realizar um estudo epidemiológico observacional transversal dos casos de leucoplasia bucal registrados no Serviço de Diagnóstico Histopatológico do Instituto de Ciências Biológicas (ICB) da Universidade de Passo Fundo (UPF).Materiais e Métodos: Foram considerados os casos diagnosticados como “leucoplasia bucal” entre os anos de 1989 e 2011. Os dados que dizem respeito à idade, sexo eraça dos pacientes, bem como os dados de localização da enfermidade na cavidade bucal foram obtidos das requisições de exame histopatológico de cada paciente. Foram observados a presença de hábitos deletérios nos pacientes acometidos e as características clínicas das lesões levantadas. Os dados coletados foram analisados por meio de estatística descritiva de frequência e expressos em tabelas e/ou gráficos, a fim de serem confrontados com os dados da literatura. Resultados e conclusão: Pôde-se inferir que a época da vida mais afetada pela leucoplasia foi a 7ª década da vida, a cor branca foi predominante, o sexo masculino o mais afetado e a região mais acometida foi a mucosa jugal na linha de oclusão. Exposição solar, trauma e fumo foram as principais causas encontradas no estudo, porém houve muitos laudos incompletos, o que leva à dúvida quanto aos demais casos (a maior parte neste estudo). O tempo de evolução das lesões foi relativamente rápido, a maioria aparecendo de 0-6 meses em boca, e normalmente assintomáticas. A coloração branca, sem presença de displasia, foi predominante e as características das lesões se assemelharam em todos os casos.

Objective: This study aimed to conduct a transversal observational epidemiological study in reported cases of oral leukoplakia in the Department of Diagnostic Histopathology of the Institute of Biological Sciences (ICB), University of Passo Fundo (UPF). Materials and Methods: We considered the cases that were diagnosed as “oral leukoplakia” between the years 1989 and 2011. The data pertaining to age, sex and race of patients, as well as the location data of the disease in the oral cavity were obtained from histopathological examination of requests for each patient. We observed the presence of harmful habits in affected patients and the clinical features of raised lesions. The collected data were analyzed using descriptive statistics and expressed as frequency tables and/or graphics in order to be compared with data found in literature. Results and conclusion: It might be inferred that the period of life most affected by leukoplakia was the 7th decade of life, was predominantly white, male sex the most affected and most affected region was the buccal mucosa in the line of occlusion. Sun exposure, smoking and trauma were the main causes in the study, but there were many reports are incomplete, which leads to doubt as to the other cases (most of this study). The time evolution of the lesions was relatively quick, most appearing tomouth from 0-6 months, and usually asymptomatic. The white color, without the presence of dysplasia was predominant and lesion characteristics were similar in all cases.