Primary oral tuberculosis : a case series from Bucharest, Romania

Tuberculosis (TB) is a chronic granulomatous disease that affects various systems of the body. Although the pulmonary form is most common, TB can also occur in the lymph nodes, kidneys, bones, and oral cavity. Oral TB is often a consequence of active pulmonary TB and is relatively rare. Here, we report a series of cases that emphasize the importance of considering oral TB in the differential diagnosis of mucosal lesions. In addition, although primary oral TB was previously considered a disease of the young, these cases demonstrate that it may occur in subjects of all age

Oral erythema multiforme: a 20 years clinical experience

Background: Erythema multiforme (EM) is a group of rare, acute, immune-mediated disorders which can affect the skin and/or the mucous membrane with a wide range of severity and extension. The development of EM has been linked by medical literature to numerous factors such as viral infections and drugs. The primary objective of this study is to present a retrospective multicenter case series describing sixty cases of patients affected by oral EM. Case summary: Our study revealed thirty one male (52%) and twenty-nine female with a mean (±SD) age at the time of diagnosis of the disease of 37.9 (± 18). The patient age range was 7–78 years, although over 70% of all subjects were between 20 and 50 years old. The age differences between male (36 ± 16) and female (40 ± 19.5) were not significant. The mean duration of EM outbreaks was 7 ± 6 days. Twenty nine patients (48%) had no previous outbreaks. Twenty two patients (37%) developed two or more previous outbreaks. Drugs were suspected as precipitants in twenty eight patients (46.7%). Herpes virus infections could have been the triggering factor in 18 patients (30%) though in two of these cases also a history of medication use was present. About the sites, in nine patients (15%) other mucosas were involved (5 genital, 3 ocular, 1 nasal) and twenty-five patients (42%) had also skin lesions. Fifty-one patients (85%) were classified as presenting minor EM, nine (15%) presented major forms of the disease. Conclusions: Our analysis revealed that medication use is the most triggering factor followed by herpes viral infections. The oral mucosa is the most frequently affected mucosal region in EM. In the oral cavity the buccal mucosa, the lips and the tongue are the most affected sites with a clinical presentation mainly represented by ulcerative forms with hematic crusts

Lesioni lichenoidi in età pediatrica : due casi clinici di pazienti in terapia ortodontica

Objectives Although lichen planus is a relatively common mucocutaneous disorder in the adult population, it is rare in childhood, and relevant reports in literature are still few. The aim of this work is to discuss the etiology, diagnosis, clinical aspects and possible treatment of oral lichenoid lesions in pediatric patients. Materials and methods Two cases of pediatric patients with oral lichenoid lesions affecting respectively the dorsum of the tongue and the buccal mucosa are reported. Both patients were in orthodontic therapy. Results and conclusions Despite the low incidence and the scarce literature, it is important, in pediatric patients, to consider lichen planus and lichenoid lesions in the differential diagnosis of hyperkeratotic and erosive lesions affecting the oral mucosa, as well as the planning of a periodic follow-up is strongly recommended to evaluate and monitor the evolution of these lesions

The controversial natural history of oral herpes simplex virus type 1 infection

The natural history of oral herpes simplex virus type 1 (HSV-1) infection in the immunocompetent host is complex and rich in controversial phenomena, namely the role of unapparent transmission in primary infection acquisition, the high frequency of asymptomatic primary and recurrent infections, the lack of immunogenicity of HSV-1 internalized in the soma (cell body) of the sensory neurons of the trigeminal ganglion, the lytic activity of HSV-1 in the soma of neurons that is inhibited in the sensory neurons of the trigeminal ganglion and often uncontrolled in the other neurons, the role of keratin in promoting the development of recurrence episodes in immunocompetent hosts, the virus\u2013host Nash equilibrium, the paradoxical HSV-1-seronegative individuals who shed HSV-1 through saliva, the limited efficacy of anti-HSV vaccines, and why the oral route of infection is the least likely to produce severe complications. The natural history of oral HSV-1 infection is also a history of symbiosis between humans and virus that may switch from mutualism to parasitism and vice versa. This balance is typical of microorganisms that are highly coevolved with humans, and its knowledge is essential to oral healthcare providers to perform adequate diagnosis and provide proper individual-based HSV-1 infection therapy