Humans ; Leukoplakia, Oral/therapy*

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

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

Humans ; Leukoplakia, Oral ; diagnosis ; Mouth Diseases ; diagnosis

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

Dyskeratosis congenita is a rare multisystemic genodermatosis of ectodermal dysplasia, and is characterized by the diagnostic triad consisting of reticulated hyperpigmentation, dystrophic nails, and leukoplakia. Complications such a malignancy and bone marrow involvement will be predisposition. A 44-year-old male was presented with reticulated hyperpigmentation, nail dystrophy, oral leukoplakia, mild hyperkeratosis of the palms and soles, and short stature. His brothers were presented with reticulated hyperpigmentation and nail dystrophy, and underwent a surgical operation due to oral cavity cancer. The histopathological findings taken from the reticulated lesion showed epidermal thinning and a mild inflammatory cell infiltration with melanophages in the dermis. We report a typical case of dyskeratosis congenita in a male with family history.
Adult ; Bone Marrow ; Dermis ; Dyskeratosis Congenita* ; Ectodermal Dysplasia ; Humans ; Hyperpigmentation ; Leukoplakia ; Leukoplakia, Oral ; Male ; Mouth ; Siblings

BACKGROUND AND OBJECTIVES: Cancer of the oral cavity is a disease of the head and neck that is difficult to treat. Periodic observation and biopsy are important for its early diagnosis once a premalignant lesion in the oral cavity is confirmed. The purpose of this study was to determine the importance of early excisional biopsy by investigating the histological features of oral leukoplakia and the rate of malignant change in the oral cavity. SUBJECTS AND METHOD: A total of 327 patients who underwent punch biopsy of oral cavity from January 2011 to December 2017 were reviewed retrospectively for the presence of initial gross lesions and for their biopsy results. The histological findings of 6 initial gross lesion groups were compared. Additional excisional biopsies were performed in the seven oral cavity subsites. RESULTS: There were 33 cases of oral leukoplakia. The punch biopsies of 3 of these cases (9.1%) showed malignancy. Additional excisional biopsies were performed in 6 cases, 4 of which were malignant (66.7%). Additional excisional biopsies of the tongue were performed in 14 cases (9.0%), 5 of which (35.7%) were malignant. The rate of atypia in leukoplakia (9.1%) was higher than in other atypia groups. Additional excisional biopsies were performed in 3 cases (100%) of atypia of leukoplakia, all of which were assessed to be malignant. CONCLUSION: For tongue leukoplakia, performing an early excisional biopsy rather than an incisional biopsy is recommendable. Moreover, additional excisional biopsies are needed when the initial biopsy is suggestive of hyperkeratosis, parakeratosis, or atypia.
Biopsy ; Early Diagnosis ; Head ; Humans ; Leukoplakia ; Leukoplakia, Oral ; Methods ; Mouth ; Neck ; Parakeratosis ; Retrospective Studies ; Tongue

Oral immunosuppression caused by smoking creates a microenvironment to promote the occurrence and development of oral mucosa precancerous lesions. This study aimed to investigate the role of metabolism and macrophage polarization in cigarette-promoting oral leukoplakia. The effects of cigarette smoke extract (CSE) on macrophage polarization and metabolism were studied in vivo and in vitro. The polarity of macrophages was detected by flow cytometric analysis and qPCR. Liquid chromatography-mass spectrometry (LC-MS) was used to perform a metabolomic analysis of Raw cells stimulated with CSE. Immunofluorescence and flow cytometry were used to detect the polarity of macrophages in the condition of glutamine abundance and deficiency. Cell Counting Kit-8 (CCK-8), wound-healing assay, and Annexin V-FITC (fluorescein isothiocyanate)/PI (propidium iodide) double-staining flow cytometry were applied to detect the growth and transferability and apoptosis of Leuk-1 cells in the supernatant of Raw cells which were stimulated with CSE, glutamine abundance and deficiency. Hyperkeratosis and dysplasia of the epithelium were evident in smoking mice. M2 macrophages increased under CSE stimulation in vivo and in vitro. In total, 162 types of metabolites were detected in the CSE group. The metabolites of nicotine, glutamate, arachidic acid, and arginine changed significantly. The significant enrichment pathways were also selected, including nicotine addiction, glutamine and glutamate metabolism, and arginine biosynthesis. The results also showed that the supernatant of Raw cells stimulated by CSE could induce excessive proliferation of Leuk-1 and inhibit apoptosis. Glutamine abundance can facilitate this process. Cigarette smoke promotes oral leukoplakia via regulating glutamine metabolism and macrophage M2 polarization.
Animals ; Glutamine ; Leukoplakia, Oral ; Macrophages ; Mice ; Smoking ; Tumor Microenvironment

Objective: To evaluate the inter-observer agreement of the severity of oral epithelial dysplasia in oral leukoplakia, providing a theoretical basis for the development of a more objective grading system. Methods: This study included 60 digital pathological slides of oral leukoplakia from Oral Medicine Department of West China Hospital of Stomatology, Sichuan University, and 239 tissue microarray images of oral leukoplakia from State Key Laboratory of Oral Diseases, Sichuan University, to evaluate the agreement of grading. Besides, 1 000 patches were generated from the 60 digital pathological slides and were divided into 500 small-sized patches (224 pixel×224 pixel) and 500 large-sized patches (1 024 pixel×1 024 pixel), to evaluate the agreement of feature detection. Gradings and feature detections were completed by three pathological experts from the oral pathology departments of two Grade 3, Class A stomatological hospitals in China. Kappa coefficient was used to quantify the inter-observer agreement among pathologists. Results: Minimal agreement was found in the grading of oral epithelial dysplasia among pathologists (Kappa=0.30 in the pathological slide group, Kappa=0.30 in the tissue microarray group). None agreement was found in feature detection within the small-sized patches group (median Kappa=0.14 for architectural features, median Kappa=0.18 for cytological features), and minimal agreement was found in feature detection within the large-sized patches group (median Kappa=0.25 for architectural features, median Kappa=0.25 for cytological features). Conclusions: Generally, the agreement of grading and feature detection of oral epithelial dysplasia in oral leukoplakia is poor. Development of a more objective grading system of oral epithelial dysplasia based on artificial intelligence may be helpful to improve the agreement.
Artificial Intelligence ; China ; Humans ; Leukoplakia, Oral ; Observer Variation ; Precancerous Conditions