Analysis of a possible association between oral lichen planus and drug intake. A controlled study.

OBJECTIVES: To investigate whether daily systemic and/or topical medication contributes to the development of oral lichen planus (OLP) lesions. STUDY DESIGN: The study involved 110 OLP patients and 76 control subjects, matched by age, race and sex. The analyzed data included medical records, drug intake and topical medication. Criteria for analysis of drug intake included: (1) ATC-code drug classification; (2) number of different drugs used daily in the categories of monopharmacy (1 drug), minor polypharmacy (2-4 drugs), and major polypharmacy ( > 5 drugs); and (3) drugs implicated in lichenoid reactions (DILRs). RESULTS: Sixty (54.5%) of the 110 OLP patients reported daily medication (prior to the appearance of the OLP lesion) compared to 52 (68.4%) of the 76 control subjects. No statistical difference was found between the two groups in terms of systemic diseases, number of medicated individuals in the categories of mono- and polypharmacy, nor use of DILRs (P > 0.05). Regarding the clinical forms and site of involvement, a statistically significant difference was only found for the clinical erosive form of OLP, seen more frequently in non-DILR (P = 0.04) and nonmedicated OLP patients (P = 0.02) than in DILR OLP patients. Daily use of topical oral medication was reported by 2 (1.8%) OLP patients and 1 (1.3%) control subject. CONCLUSIONS: It seems that the use of systemic medication does not lead to a significant increase in the incidence of OLP lesions. For their part, lichenoid drug reactions are likely to occur only in a very low percentage of patients.

Oral lesions in 166 patients with cutaneous psoriasis: a controlled study.

OBJECTIVES: This study was aimed to test if the frequency of oral lesions bears statistical correlation or not with the condition of cutaneous psoriasis. STUDY DESIGN: Two groups were examined, one made up of 166 patients with skin psoriasis and the other with the same number of individuals with a negative history of skin diseases (control group), matched by age, race, and sex. Patients with psoriasis were grouped according to their having localized or generalized forms of the disease. The oral mucosa was thoroughly examined in both groups. Data were analyzed using chi-square test, Fisher's test, the odds ratio (OR) with a 95% confidence interval (CI), and the Ryan-Holm step-down Bonferroni procedure. The overall significance was set at P < or = 0.05. RESULTS: The oral lesions significantly associated with psoriasis were fissured tongue (FT, OR = 2.7; 95% CI: 1.3-5.6), and geographic tongue (GT, OR = 5.0; 95% CI: 1.5-16.8). Other factors analyzed, such as topical and/or systemic medication for treatment of psoriasis versus nontreated patients, and localized versus generalized forms of psoriasis presented no statistical association with the frequency of FT or GT lesions (p>0.05). CONCLUSIONS: Patients with psoriasis presented no specific oral lesion different from those seen in the control group. Although further investigation is warranted to establish whether or not either FT or GT can be characterized as an oral expression of psoriasis, the present investigation did find for both these types of lesions that the frequency of each bore a statistically significant relation with the presence of cutaneous psoriasis.

Risk factors for oral squamous cell carcinoma in young and older Brazilian patients: a comparative analysis.

OBJECTIVES: The aim of this study was to investigate risk factors and clinical aspects associated with oral squamous cell carcinoma (OSCC) in young patients as compared to older ones. STUDY DESIGN. Data was obtained by retrospective analysis of files of patients with OSCC, who were categorised into two groups: the young group (< or =40 years old) and the older group (> 40 years old). Clinical data, including habits, familial antecedents, medical records and occupation were collected. RESULTS: One hundred and twenty-one patients were found to have OSCC; 13 (10.7%) were young individuals and 108 (89.3%) older ones. Consumption of tobacco and/or alcohol was reported by 7 (53.8%) young patients and by 81 (75.0%) older patients, this difference not being statistically significant (P = 0.18). However, only 1 young patient (12.5%) was a heavy consumer of tobacco and alcohol as opposed to 49 (60.5%) of the older patients. Familial antecedents of malignant neoplasm were reported by 11 (84.6%) young patients and 32 (29.6%) older ones respectively, this difference being statistically significant (P = 0.0001). Medical records and patient's occupation did not show correlation with the aetiology of OSCC. CONCLUSION: Although the young and older patients share a similar habit for the consumption of tobacco and/or alcohol, the pattern of consumption and time of exposure to these two risk factors suggested that these etiologic factors are less clearly implicated in the development of oral cancer in the young patients than in older ones. Thus, for young patients with OSCC, the search for predisposing factors should assign greater weight to familial antecedents of malignant neoplasm.

Lichenoid reaction to carbamazepine in the oral mucosa: case report.

Lichenoid drug reactions are more common in skin, but they may also occur in the oral mucosa. It is difficult to diagnose these lesions due to their clinical similarity to the idiopathic oral lichen planus lesions. The present article reports a case of lichenoid reaction in oral mucosa associated to the use of carbamazepine, emphasizing the diagnostic process.

Reação liquenoide à carbamazepina em mucosa bucal: relato de caso / Lichenoid reaction to carbamazepine in the oral mucosa: case report

As reações liquenoides por drogas são mais comuns na pele, mas também podem ocorrer na mucosa bucal. Estas lesões são de difícil diagnóstico por causa de sua semelhança clínica com às do líquen plano oral idiopático. O presente artigo relata um caso de reação liquenoide em mucosa bucal, associado ao uso de carbamazepina, no qual o processo de diagnóstico é enfatizado.

Lichenoid drug reactions are more commom in skin, but they may also occur in the oral mucosa. It is difficult to diagnose these lesions due to their clinical similarity to the idiopathic oral lichen planus lesions. The present article reports a case of lichenoid reaction in oral mucosa associated to the use of carbamazepine, emphasizing the diagnostic process.

Carcinoma epidermóide oral em paciente jovem: relato de caso e revisão da literatura / Oral squamous cell carcinoma in a young patient: case report and literature review

O carcinoma epidermóide constitui a neoplasia maligna mais comum da boca, afetando principalmente indivíduos com mais de 50 anos. Sua ocorrência em jovens, com idade inferior a 40 anos, é rara (1 a 6 por cento dos casos). Descreve-se um caso de carcinoma epidermóide acometendo dorso e borda da língua, classificado como T2N1M0 (estádio III), em paciente do sexo feminino, leucoderma, 25 anos, não-fumante e não-etilista. A apresentação inicial do caso era de ulceração profunda com dor intensa. Fatores predisponentes locais e gerais, diagnóstico diferencial e prognóstico são discutidos, bem como a revisão da literatura referente a diversos aspectos do carcinoma epidermóide em jovens.