Ana Cristina Coelho Dal Rio

Linear Epidermal Nevus of the Oral Cavity: A Rare Diagnosis

Linear epidermal nevus is an uncommon diagnosis of benign lesions of the oral cavity. It is characterized by a congenital malformation arising from the ectoderm cells, which are arranged according to a typical linear configuration known as Blaschkos lines. We report a case of linear epidermal nevus of oral cavity in a 51-year-old lady or woman. The linear epidermal nevus of the oral cavity, although rare, can be considered a differential diagnosis of oral papillomatosis (OP). The histopathological studies and detailed description are the center of the diagnostic and clinical evolution.

Oral Focal Mucinosis: A Painful Lesion of the Palate

Abstract: Background: Oral focal mucinosis (OFM) is a rare disease of unknown etiology, in which the connective tissue undergoes a focal myxoid degeneration. It was first described in 1974 by Tomich. Its pathogenesis is related to overproduction of hyaluronic acid by fibroblasts during the collagen production, resulting in focal myxoid degeneration. It has no distinctive features and diagnosis depends on histological analysis. Case: This paper reports a case of a 30 years old female treated at the Ambulatory of Stomatology of the Clinical Hospital - CH/UNICAMP, with a lesion growth and progressive pain in the palate, after performing dental treatment and discusses the clinical characteristics and differential diagnosis of myxomatous lesions of the oral cavity. Discussion: Since oral focal mucinosis has no distinguishing clinical features and the diagnostic is based on a histopathological examination, we ratify the importance of this procedure to confirm the diagnosis. This article is based on literature review and reports a case of oral focal mucinosis, its clinical and surgical outcome and demonstrates the importance of biopsy and pathological examinations in differential diagnosis of nodular masses in the oral cavity.

Arrabidaea chica for oral mucositis in patients with head and neck cancer: a protocol of a randomised clinical trial

Introduction Oral mucositis is an iatrogenic condition of erythematous inflammatory changes which tends to occur on buccal and labial surfaces, the ventral surface of the tongue, the floor of the mouth and the soft palate of patients receiving chemotherapy. This protocol of ongoing randomised parallel group clinical trial aims to access the therapeutic effect of an herbal gel containing 2.5% Arrabidaea chica Verlot standardised extract on oral mucositis in patients with head and neck cancer compared with low-level laser therapy. Methods and analysis Patients with head and neck cancer held at Clinics Hospital of University of Campinas, Sao Paulo, who develop early signs/symptoms of oral mucositis are eligible. Baseline characteristics of participants include oral mucositis grade and quality of life assessments. Enrolment started in November 2017 with allocation of patients to one of the study groups by means of randomisation. Patients will be treated either with Arrabidaea chica or laser until wound healing. Monitoring includes daily assessment of mucositis grade and diameter measurement by photographs and millimetre periodontal probe. Treatments will be concluded once mucositis is healed. A blinded assessor will evaluate mucositis cure after referred by the study team. At this point, the gel tube will be weighed to indirectly assess patient’s compliance. At close-out, data will be analysed by a blinded researcher following the procedures described in the statistical analyses. Ethics and dissemination This clinical trial was approved by the ethics committee of research in humans at the Faculty of Medical Sciences of University of Campinas (report no. 1,613,563/2016). Results from this trial will be communicated in peer-reviewed publications and scientific presentations. Trial registration number RBR-5×4397.

Herpetic Oral Manifestation In Acute Myeloid Leukemia: case report

Viral infections in the oral cavity are frequent complications in patients with immunosuppression. The herpes simplex virus is among the most frequent causes of these infections. In immunocompromised patients the presentation may be atypical, with more extensive lesions, painful and with slower recovery. The goal of this article is to present a illustrative case of herpes oral infection in an immunosuppressed patient. Case report: Female patient, 43 years old, 32 days after the start of chemotherapy for acute myeloid leukemia, began complaining of odynophagia and painful emergence of lesions in the oral cavity. She presented multiple whitish ulcerated lesions with an erythematous halo, measuring around 0.5 cm in diameter across the mouth and the posterior wall of oropharynx. Treated with acyclovir with rapid improvement of symptoms and lesions. Cytological changes were found compatible with herpes simplex. Discussion: In most cases of infection with herpes simplex the presentations are self-limited but severe infections may occur and atypical in immunosuppressed individuals. Additional exams help in diagnosis as diagnostic cytology, ELISA and direct immunofluorescence. Acyclovir is the drug of choice for the treatment recommended dose of 1 g/day for a minimum period of 10 days. Conclusion: The oral lesions of herpes virus in immunosuppressed patients may have varied presentations and can often go unnoticed, as in mild or asymptomatic cases. However, due to the possibility of systemic spread of infection and the occurrence of severe manifestations, one should be highly suspected before the appearance of any oral lesion in the immunosupressed patients.

Foreign Body in Jugal Mucosa

Introduction Foreign body in the oral cavity may be asymptomatic for long time and only sometimes it can lead to a typical granulomatous foreign body reaction. Some patients may complain of oral pain and present signs of inflammation with purulent discharge. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes and filled with fibroblasts and collagen. Nowadays, the increase of cosmetic invasive procedures such as injection of prosthetic materials in lips and cheeks may lead to unusual forms of inflammatory granulomas. Objectives Describe an unusual presentation of a foreign body reaction in the buccal mucosa due to previous injection of cosmetic agent. Resumed Report A 74-year-old woman was referred to the Department of Otorhinolaryngology, Head and Neck Surgery to investigate the presence of multiple painless, bilateral nodules in the buccal mucosa, with progressive growth observed during the previous 2 months. The histologic results showed a foreign body inflammatory reaction. Conclusion Oral granulomatosis lesions represent a challenging diagnosis for clinicians and a biopsy may be necessary. Patients may feel ashamed to report previous aesthetic procedures, and the clinicians must have a proactive approach.