There are several oral lesions related with AIDS, such as candidiasis, hairy leukoplakia, Kaposi's sarcoma, aphthous stomatitis, lichen planus, and other opportunistic infectious diseases. Among the others, Kaposi's sarcoma, the most common malignant tumor associated with AIDS, is closely linked to the number of CD4+ T cell. Kaposi's sarcoma often occurs in palate, the most prone site, and has characteristic clinical features in most cases. Sometimes, the tumor induces underlying bone destruction at late stage. We report a case of a 27 year-old man with AIDS-associated Kaposi's sarcoma at left lower retromolar triangle, parapharyngeal area and discuss the management of AIDS patients in dentistry.
Candidiasis ; Communicable Diseases ; Dentistry ; Humans ; Leukoplakia, Hairy ; Lichen Planus ; Palate ; Sarcoma ; Sarcoma, Kaposi ; Stomatitis, Aphthous

Morsicatio is a condition caused by habitual chewing of the lips (labiorum), tongue (linguarum), or buccal mucosa (buccarum). Clinically, it often produces a shaggy white lesion caused by pieces of the oral mucosa torn free from the surface. The condition is generally found among people who are stressed or psychologically impaired. Most patients with this condition are not even aware of their biting habit. Clinically, morsicatio mimics hairy leukoplakia, and sometimes, it may be confused with other dermatologic diseases involving the oral cavity. It is rarely described in pathologic and dermatological textbooks. Histological features are distinctive, however, being careful to make a correct diagnosis can help one avoid providing inappropriate treatment. In this report we describe three cases of morsicatio, one that developed in the lower lip and the others that developed on the side of the tongue.
Bites and Stings ; Humans ; Leukoplakia, Hairy ; Lip ; Mastication ; Mouth ; Mouth Mucosa ; Tongue

OBJECTIVETo study the incidence rates, clinical characteristics of oral hairy leukoplakia (OHL) and its relation to the immune status in a sample of human immunodeficiency virus (HIV)-infected adults in Yunan, China.

METHODS1 060 adult patients with HIV from January 2008 to June 2010 were evaluated. The age, gender, education grade, diagnosis time of HIV-infected, route of transmission, xerostomia, oral candidiasis, high active antiretroviral therapy and CD4 lymphocytes counts. The occurrence of OHL was recorded by oral examination. The relationship of CD4 lymphocytes counts and the incidence of OHL were analyzed by statistical methods.

RESULTSThere were 94 OHL patients in 1 060 HIV patients (8.9%). The average age of the OHL patients was (39.33 +/- 10.45) years old. 90% OHL was found on the two lateral aspect of the tongue. The CD4 lymphocytes of 70.2% OHL patients were less than 200 mm-3.

CONCLUSIONOHL is a frequent finding in patients with indicates severe immunosuppression and associated with the reduction of CD4 lymphocytes.

Adult ; CD4 Lymphocyte Count ; Candidiasis, Oral ; China ; Female ; HIV Infections ; Humans ; Incidence ; Leukoplakia, Hairy ; Male

Tobacco smoking is one of the most important risk factors for the development of oral mucosal lesions such as leukoplakia and hairy tongue. Controversy exists in the literature, however, about the prevalence of oral lesions in smokers. The aim of this study was to evaluate oral lesions in male smokers compared with nonsmokers in Hamadan. A total of 516 male participants were assessed, 258 of whom were smokers and 258 of whom were healthy nonsmokers. The prevalence of lesions was evaluated by clinical observation and biopsy. We found that the most prevalent lesions among smokers were gingival problems and coated tongue; smokers had significantly more lesions than did nonsmokers. Malignant and premalignant lesions were found in a higher age range. Among all participants in our study, we found a large number of oral mucosal lesions in smokers that had a strong correlation with smoking. Dental services need to implement care and health education for smokers to promote health.
Biopsy ; Health Education ; Humans ; Leukoplakia ; Male ; Mouth ; Prevalence ; Risk Factors ; Smoke ; Smoking ; Tongue, Hairy

"Leukoplakia-like" plaque on the tongue is an uncommon skin manifestation of secondary syphilis. Skin lesions of secondary syphilis usually have numerous presentations, which mimic many other skin diseases, especially in the presence of HIV co-infection. Oral hairy leukoplakia (OHL) is characterized by corrugated whitish patches and plaques on the lateral border of the tongue. It is frequently and strongly associated with HIV but may appear in other diseases. A 47-year-old man with HIV and receiving HAART therapy developed a leukoplakia-like plaque on the tongue, which was first suggestive of OHL but was eventually diagnosed as secondary syphilis.
Antiretroviral Therapy, Highly Active ; Coinfection ; HIV* ; Humans ; Leukoplakia, Hairy ; Middle Aged ; Skin ; Skin Diseases ; Skin Manifestations ; Syphilis* ; Tongue*

OBJECTIVETo investigate the prevalence, age and gender distribution and clinical features of HIV/AIDS oral lesions in patients in Guangxi province, and to provide the epidemiological information for prevention and treatment of these diseases in the certain population.

METHODSA total of 64 HIV/AIDS patients were included in this study. All patients HIV serum-status was confirmed in Guangxi Center of Disease Control (GXCDC). Oral examination was carried out by standardized specialists. HIV/AIDS orofacial lesions were recorded and diagnosed using the EC Clearing House Criteria on Oral Problems related to HIV Infection (1992).

RESULTSAmong the total of 64 HIV/AIDS patients included in this study, there were 53 males and 11 females, with mean age of 36.1 years. Candidiasis was the most common lesion with the pseudomembranous type predominating. High prevalences of xerostomia, 11 oral ulceration and 7 HIV related periodontitis were noted. 6 Herpetic stomatitis and 3 herpes zoster, 2 oral hairy leukoplakia and 1 Kaposi's sarcoma and 1 lymphadentitis also were found.

CONCLUSIONThis study shows a high prevalence of candidiasis, salivary gland disease. Maybe oral ulceration prevalence is not increased, but lesion severity is increased with more severe heperiform or major RAU. It suggested that HIV/AIDS usually shows oral lesion and partly can appear in early phase.

Acquired Immunodeficiency Syndrome ; Adult ; Candidiasis, Oral ; China ; Female ; HIV Infections ; Humans ; Leukoplakia, Hairy ; Male ; Mouth Diseases ; Periodontitis ; Prevalence ; Sarcoma, Kaposi

Oral hairy leukoplakia (OHL) is caused by the reactivation of a previous Epstein-Barr virus (EBV) infection in the epithelium of the tongue. Most lesions are characterized by corrugated whitish patches on the lateral border of the tongue. It is frequently associated with AIDS, but cases in patients with other immunosuppressed states have also been reported. In leukemia patients, OHL is rarely encountered, and appears only after chemotherapy. We report a case of OHL which occurred as a presenting sign of acute myeloid leukemia (AML) in a previously healthy 15-year-old child. A 15-year-old boy presented with a whitish patch on the left lateral border of the tongue. The biopsy specimen revealed papillomatosis, hyperkeratosis, acanthosis and ballooning degeneration in the stratum spinosum. The patient was EBV seropositive, and PCR analysis of EBV DNA in the lesional tissue was positive. After the diagnosis of OHL in dermatologic department, the patient was referred to pediatrics due to the abnormal peripheral blood smear, and was diagnosed with AML.
Adolescent ; Biopsy ; Child ; DNA ; Epithelium ; Herpesvirus 4, Human ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; Leukoplakia, Hairy ; Papilloma ; Pediatrics ; Polymerase Chain Reaction ; Tongue

OBJECTIVETo investigate the features of oral lesions in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS).

METHODSA total of 127 HIV-seropositive patients were interviewed for health information and examined for their HIV-related oral lesions according to the EC Clearing House Criteria on Oral Problems related to HIV-Infection (1992). The examinations were conducted by dental specialist and HIV specialist. The CD4 T cell count in peripheral blood of the patients was tested by flow cytometry. The patients were divided into HIV- infected group (42) and AIDS group (85) according to CDC Classification System for HIV- Infected Adults and Adolescents (revised in 1993). Chi-square test was used to test the relationship between systemic disease and oral lesions, and the difference of the prevalence of oral lesions between the two groups.

RESULTSAmong the 127 patients, oral candidiasis (51/127), oral hairy leukoplakia (24/127) were common oral manifestation. There was no relationship between the oral manifestation and systemic disease (P = 0.397). The occurrence of oral lesions and oral candidiasis was significantly different between the two groups (χ² = 7.684, P = 0.006; χ² = 14.410, P < 0.001). The CD4 count was related to the prevalence of oral lesions (P = 0.006) and oral candidasis (P = 0.003).

CONCLUSIONSMost oral lesions appeared before the appearance of systemic disease. Oral candidiasis and oral hairy leukoplakia were the most common lesions.Oral lesions had no relationship with systemic disease but could be still an indicator for disease progress.

Acquired Immunodeficiency Syndrome ; complications ; CD4 Lymphocyte Count ; CD4-Positive T-Lymphocytes ; Candidiasis, Oral ; epidemiology ; China ; epidemiology ; HIV Infections ; Humans ; Leukoplakia, Hairy ; Mouth Diseases ; complications ; epidemiology ; Prevalence

OBJECTIVES: The objective of this study was to investigate the presence of oral lesions in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in a descriptive cross-sectional study, and to establish their presence according to levels of CD4+ cells (including the CD4+/CD8+ cell ratio). MATERIALS AND METHODS: A total of 75 patients infected with HIV were included. Oral lesions were observed and classified using World Health Organization classification guidelines. Potential correlations between the presence and severity of oral lesions and CD4+ cells, including the CD4+/CD8+ cell ratio, were studied. RESULTS: The most frequent oral lesion detected was oral pseudomembranous candidiasis (80.0%), followed by periodontal disease (40.0%), herpetic lesions (16.0%), hairy leukoplakia (16.0%), gingivitis (20.0%), oral ulceration (12.0%), Kaposi's sarcoma (8.0%), and non-Hodgkin's lymphoma (4.0%). The CD4+ count was <200 cells/mm³ in 45 cases (60.0%), between 200–500 cells/mm³ in 18 cases (24.0%), and >500 cells/mm³ in 12 cases (16.0%). The mean CD4+ count was 182.18 cells/mm³. The mean ratio of CD4+/CD8+ cells was 0.26. All patients showed at least one oral manifestation. CONCLUSION: There was no correlation between the CD4+/CD8+ cell ratio and the presence of oral lesions. The severity of the lesions was more pronounced when the CD4+ cell count was less than 200 cells/mm³.
Acquired Immunodeficiency Syndrome ; Adult* ; Candidiasis ; CD4 Lymphocyte Count ; Classification ; Clinical Study* ; Cross-Sectional Studies ; Gingivitis ; HIV* ; Humans* ; Leukoplakia, Hairy ; Lymphoma, Non-Hodgkin ; Oral Manifestations ; Oral Ulcer ; Periodontal Diseases ; Sarcoma, Kaposi ; World Health Organization

Defective Viruses ; metabolism ; Epstein-Barr Virus Infections ; diagnosis ; prevention & control ; therapy ; Herpesvirus 4, Human ; isolation & purification ; Histiocytosis, Non-Langerhans-Cell ; diagnosis ; Humans ; Infectious Mononucleosis ; diagnosis ; Leukoplakia, Hairy ; diagnosis ; Lymphoproliferative Disorders ; diagnosis ; Vaccination ; Virus Latency