Bruna Lavinas Sayed Picciani

Oral candidiasis in patients with psoriasis: correlation of oral examination and cytopathological evaluation with psoriasis disease severity and treatment.

BACKGROUNDnInfections are known to trigger and exacerbate psoriasis. Although oral candidiasis is often clinically diagnosed, it is not always confirmed by laboratory tests such as oral cytopathology.nnnOBJECTIVESnThe aims of this study were to determine the prevalence of oral candidiasis in patients with psoriasis through clinical and cytopathological diagnosis and to investigate the association between oral candidiasis and psoriasis with regards to the severity of the clinical presentation and the type of treatment for psoriasis.nnnMETHODSnA total of 140 patients with psoriasis and 140 healthy control subjects received an oral examination. Scrapings of the tongue were also obtained for a cytopathological examination.nnnRESULTSnThe oral examination and the results of the cytopathological smear revealed 37 (26%) cases of candidiasis in the patients with psoriasis and no cases of candidiasis in the healthy control subjects. There was no correlation between the type of psoriasis treatment and the presence of oral candidiasis (P = .616). There was a statistically significant association (P = .033) between the clinical severity of psoriasis and the presence of Candida.nnnLIMITATIONSnThis study was limited by the small number of subjects and the lack of follow-up to determine the development of psoriasis after treatment for oral candidiasis.nnnCONCLUSIONSnThe presence of oral candidiasis is higher in patients with psoriasis and it is associated with disease severity. This increased presence of oral candidiasis was apparent despite any type of treatment for the psoriasis. Cytopathology to rule out oral candidiasis should be used in the routine medical workup of patients with psoriasis.

Prevalence of oral manifestations in 203 patients with psoriasis

ous treatment. Female patients with failure of isotretinoin treatment had been included only in two studies. Furthermore, this was the first study to our knowledge which assessed the response to spironolactone of the acne located in the back. In literature, some of the studies specify that the patients included have a facial acne; only one of them describes that 32 patients out of 47 included in the study have acne located on the trunk; but the therapeutic response for this zone is not assessed. As reported in the literature, the rates of effectiveness of spironolactone in the treatment of acne vary a lot in different studies and probably depend on the main endpoint chosen. In our study, patients with isotretinoin treatment failure respond to the treatment noticeably with an improvement of facial acne in 50% of the cases and of the acne of the back in 37.5% of the cases. In conclusion, spironolactone is a therapeutic alternative in case of treatment failure with isotretinoin in adult women with acne. The efficacy in the case of back lesions is one of the novel aspects of our study.

Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review

Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue.

A possible relationship of human leucocyte antigens with psoriasis vulgaris and geographic tongue.

Geographic tongue (GT) is the most frequent oral lesion in psoriatic patients (PP), and genetic involvement in these conditions has been described. The association of psoriasis with GT is still not clear, and the study of human leucocyte antigen (HLA) may help clarify this relation.

Environmental factors in benign migratory glossitis and psoriasis: Retrospective study of the association of emotional stress and alcohol and tobacco consumption with benign migratory glossitis and cutaneous psoriasis

The association between benign migratory glossitis (BMG) and psoriasis (PS) has been reported in the literature.

Investigation of the clinical features of geographic tongue: unveiling its relationship with oral psoriasis

Few studies have examined the clinical features of geographic tongue (GT), an inflammatory lesion, making diagnosis and the investigation of oral psoriasis difficult.

Fissured tongue in patients with psoriasis

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Lingual amyloidosis associated to long-term hemodialysis: Two case reports

The β2-microglobulin amyloidosis is a newly recognized type of systemic amyloidosis, which occurs in patients with chronic renal failure undergoing long-term hemodialysis. The dialysis-related amyloidosis (DRA) of the tongue is an uncommon and late complication, which occurs in patients undergoing chronic hemodialysis for more than 20 years. The aim of this paper is to report two cases of lingual amyloidosis associated with long-term hemodialysis. Two patients were referred to the Oral Medicine Clinic due to the presence of multiple nodules on the tongue and macroglossia. The patients had history of chronic renal failure and had been dialysed for more 20xa0years with bio-incompatible cellulose membrane. Biopsies of the lesions were performed and the histopathological features and Congo red stain revealed oral amyloidosis. Both patients remain in clinical follow-up after 12 and 6xa0months, respectively. Recognition of the amyloidosis tongue lesions can minimize the complications caused by this condition such as obstruction of the upper airways, making it imperative to carry out early treatment. Furthermore, in patients with oral amyloidosis, lesions in areas of trauma may ulcerate and cause pain and dysphagia becoming necessary periodic surgical removal and regular follow-up of these patients.

Perfil demográfico e odontológico de pacientes atendidos no Centro Odontológico para Pacientes com Necessidades Especiais da Associação Brasileira de Odontologia - Rio de Janeiro

Objective: to evaluate the demographic and dental profile of patients with special needs met in a Reference Center in the state of Rio de Janeiro, showing their main needs and the possibility of outpatient care. Material and Methods: the sample consisted of 410 patients, from whom demographic and clinical data were obtained. All the studied variables were entered in a database for descriptive statistical analysis. Results: two hundred and twenty-seven (55%) patients were male, 70% were white, and their average age was 34 years old. Inconclusive diagnosis, followed by autism spectrum disorder and intellectual disabilities, were the most found diagnoses. Most patients (78%) was from the metropolitan region. Regarding complaints and dental procedures, the main complaint was prevention (28%), and 2,902 procedures were performed. Concerning oral hygiene habits, 264 (64%) patients did not floss and 215 (52%) underwent toothbrushing three times a day. Only 57 (14%) cases required the use of sedative methods to carry out the dental treatment. Conclusion: there is a great demand for preventive and restorative treatments for patients with special needs, highlighting the need for daily strengthening practices of oral health promotion. In addition, we can see that most treatments performed were in the outpatient level, showing that the use of appropriate approach is essential for dental management, thus demystifying the care of these patients.

Geographic tongue and atopy: is there an association?

Objective: this systematic literature review aimed to find data to clarify a controversy about the association between geographic tongue and atopic diseases/atopy. With emphasis on the relationship between these conditions. Material and Methods: data extracted include information on age and sex, family and personal history of atopy, geographic tongue prevalence, immunoglobulin E (IgE) serum levels, and skin tests. Results: 08 articles were selected and read in full text and information in articles used in this study. During a review, there was difficulty in standardizing the findings due to lack of details in the diagnosis of atopy and geographic tongue; and the lack of separate analysis of the conditions of asthma, rhinitis or atopic dermatitis. Limitation: low number of publications on the subject. Conclusion: based on the literature, more data are available to confirm the relationship between geographic tongue, atopic diseases / atopy, new ones with larger sample sizes, adequate diagnosis of atopy / atopic diseases and geographic tongue, IgE serum levels determined simultaneously oral examination and skin tests.