Achados bucais e laboratoriais em pacientes com lúpus eritematoso sistêmico

INTRODUÇÃO: O lúpus eritematoso sistêmico (LES) é uma doença inflamatória crônica caracterizada por manifestações clínicas variadas. Os poucos trabalhos existentes na literatura relatam uma prevalência entre 6,5% e 21% de acometimento bucal. OBJETIVO: Investigar os achados bucais e laboratoriais em pacientes com LES. MATERIAL E MÉTODO: Foram analisados 155 pacientes com diagnóstico de LES, segundo critérios do American College of Rheumatology (ACR). O índice de dentes cariados, perdidos e obturados (CPO-D) foi registrado e avaliou-se a necessidade de tratamento periodontal por meio do índice periodontal comunitário (IPC). Foram realizados esfregaços e biópsias das lesões e bordas laterais de língua para exames citopatológicos. Exames laboratoriais foram correlacionados com os achados bucais destes pacientes. RESULTADOS: Dos 155 pacientes, 94,1% eram mulheres. Altos níveis de anticorpos circulantes (FAN-Hep2) foram observados em todos os pacientes, sendo 41,9% positivos para a pesquisa de anticorpos anti-DNA de fita dupla. O índice CPO-D médio correspondeu a 18,5 e de acordo com o IPC, 18% apresentaram bolsas periodontais de 4-5 mm e 5,9% de 6 mm ou mais. Foram biopsiadas oito lesões bucais, mas somente três casos foram considerados compatíveis com a indicação clínica de LES. Os principais sítios acometidos foram dorso de língua, mucosa jugal e lábios. A prevalência de candidíase correspondeu a 20,1% e a de leucoplasia pilosa oral a 3,7%. CONCLUSÃO: Pacientes com LES apresentam condição periodontal precária e baixa prevalência de lesões bucais e, além disso, a citopatologia mostrou-se importante no diagnóstico de infecções relacionadas com imunossupressão, como candidíase e leucoplasia pilosa oral.

The deep mycoses in HIV infection

The deep mycoses are uncommon infections, usually acquired from the inhalation or ingestion of fungal spores, sometimes from the soil in areas of endemicity, such as in the Americas and south-east Asia, or from decaying vegetable matter. They are also seen in immunocompromised persons and, increasingly, in HIV-infected persons. Respiratory involvement is frequent, with granuloma formation, and mucocutaneous involvement may be seen. Oral lesions of the deep mycoses are typically chronic but non-specific, though nodular or ulcerative appearances are common. Person-to-person transmission is rare. In HIV disease, the most common orofacial involvement of deep mycoses has been in histoplasmosis, cryptococcosis, aspergillosis and zygomycosis. Diagnosis is usually confirmed by lesional biopsy although culture may also be valuable. Treatment is with amphotericin or an azole.

Interdisciplinary approach to treat dyskeratosis congenita associated with severe aplastic anemia: A case report

This paper reports on a 4-year-old male who had dyskeratosis congenita and who acquired severe aplastic anemia. The patient developed hyperpigmentation of the face, neck and chest region, arms, shoulders and legs. In addition, he had dry skin, deformed fingernails and toenails, sparse hair and eyebrows and hyperkeratosis of the dorsum of the hands and feet. Laboratory and histological analysis revealed severe pancytopenia and dyserythropoiesis of red blood cells, hypocellularity of white blood cells and decreased megakaryocytes with dysplasia. The intraoral examination identified bleeding gums; petechiae of the palate, tongue and cheek mucosa; and an atrophic, smooth and shining dorsal surface of the tongue. There were deep carious lesions in the deciduous mandibular molars and maxillary anterior teeth; as well as mobility of mandibular left canine, which had bone loss. The treatment for oral lesions included diet changes, improved oral hygiene, and extraction of the deciduous teeth destroyed by caries.

Mandible metastasis as the first sign from primary adenocarcinoma of the lung

Adenocarcinoma of the lung that metastasizes to the mandible is very uncommon; only a few cases have been described in the English-language literature. This article presents a metastasis from adenocarcinoma of the lung affecting the mandible of a 64-year-old woman, in which the first discovered metastatic lesion was detected before the primary tumor. The immunoreactivity for human thyroid transcription factor-1 (TTF-1) in the oral lesion was essential for determining the site and type of the primary tumor, as the patient showed no clinical or radiographic evidence of a tumor in the thyroid gland. After the primary tumor in the lung was diagnosed, radiotherapy and chemotherapy were initiated; unfortunately, the patient died two months after the start of treatment. This article emphasizes the importance of a well-conducted examination for diagnosing metastatic oral lesions.

Tonsilar metastases of melanoma in an older person

We presented a rare case of metastasis of melanoma in palatine tonsils alerting healthcare professionals to this diagnose in black oral lesions. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Determinação das lesões orais e das estruturas anatônicas ósseas odontológias mandibulares e maxilares utilizando a tomografia computadorizada em gato-do-mato-pequeno (Leopardus tigrinus) e gato-mourisco (Puma yagouaroundi)

Pós-graduação em Medicina Veterinária - FMVZ

Expressão do PCNA e p53 em leucoplasias de mucosa jugal com diferentes graus de queratinização (Graus I, II, e III de Grinspan)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Atenção ao câncer de boca no estado de Mato Grosso

Pós-graduação em Odontologia Preventiva e Social - FOA

Uso do LED vermelho em mucosite induzida por quimioterapia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Espectroscopia FT-Raman no diagnóstico do carcinoma espinocelular de mucosa bucal: estudo ex vivo em humanos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Variações de normalidade e patologias bucais em crianças com deficiência, assistidas em um Centro Odontológico Especializado do Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Antioxidant activity of apple extract protects against rat tongue carcinogenesis induced by 4-nitroquinoline 1-oxide

Several studies have shown that apple (Malus sp.) has many components able to exert chemopreventive activity. The aim of this study was to evaluate the chemopreventive potential of apple extract following medium-term oral carcinogenesis assay induced by 4-nitroquinoline 1-oxide (4NQO) by means of histopathological analysis and gene expression of antioxidant enzymes, such as CuZnSOD, MnSOD and catalase. A total of 30 male Wistar rats were distributed into five groups, as follows (n = 6 per group): Group 1 - negative control group (non-treated group); Group 2 - received 4NQO during 8 weeks in drinking water and treated with apple extract by gavage between the 1st and 4th weeks daily (initiation phase); Group 3 - received 4NQO for 8 weeks in drinking water and treated with apple extract by gavage between the 5th and 8th weeks daily (promotion phase); Group 4 - received apple extract by gavage for eight consecutive weeks only; and Group 5 - received 4NQO for 8 weeks in drinking water daily. Histopathological analysis revealed that apple extract protect oral lesions induced by 4NQO at initiation or promotion phase. Higher gene expression of CuZnSOD and MnSOD enzymes were noticed in groups treated with apple extract as well. Taken together, our results demonstrate that the apple extract is able to modulate medium-term oral carcinogenesis assay as a result of antioxidant activity.

An isolated phlebolith on the lip: an unusual case and review of the literature

Background. Calcified thrombi are a common finding, especially in the pelvic veins. There are generally multiple thrombi, and they are generally associated with vascular malformations. Design. Herein we report a rare case of a single labial phlebolith, not associated with any other vascular lesion. We aim to alert clinicians to the possibility of the occurrence of vascular thrombi in the mouth and to describe the clinical and histological characteristics of such lesions in order to simplify the diagnosis and treatment. Furthermore, we have reviewed the English-language literature published since 1970 reporting oral (including masticatory muscles) phleboliths. Results. Twenty-nine cases of phleboliths have been reported in the literature since 1970. Only three of the reported phleboliths were solitary and not associated with other vascular lesions, as in the case presented here. Conclusion. Although phleboliths not associated with other vascular lesions are not common, clinicians should be aware of the existence of this pathology and include it as differential diagnosis of oral lesions.

Pemphigus vulgaris in adolescence: a case report

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)