Bilateral congenital oral mucous extravasation cysts.

This report documents the bilateral presentation of oral mucous extravasation cysts on the left mucobuccal fold and right buccal mucosa of a neonate. The lesions were noted at birth and subsequently enlarged to the point that they interfered with eating. The left lesion ruptured but persisted as an exophytic fibrotic mass. Both lesions were surgically removed at eight months and the diagnosis was confirmed by histopathologic examination. Post-operative follow-up after nine months shows no recurrence. The presentation and diagnostic considerations are discussed.     

A retrospective study of the management of oral mucous membrane pemphigoid with dapsone.

OBJECTIVE: The purpose of this retrospective study was to investigate the efficacy of dapsone therapy in the management of mucous membrane pemphigoid. STUDY DESIGN: The charts of 29 patients who had been diagnosed with mucous membrane pemphigoid by means of routine histologic analysis and direct immunofluorescence were reviewed. The oral features were graded according to severity of disease from 1 to 3. Each patient was assigned to one of 4 groups according to his or her response to therapy. RESULTS: Nine patients were treated successfully with topical corticosteroids alone. Eleven patients with moderate to severe disease who were treated initially with topical steroids showed minimal improvement; after dapsone was added, 7 of the 11 had total resolution of their lesions and 4 had greater than 75% improvement. Two patients had to discontinue dapsone because of side effects. CONCLUSIONS: In this group of 20 patients with moderate to severe mucous membrane pemphigoid, the use of dapsone in combination with topical corticosteroids caused greater than 75% resolution of oral lesions in all patients studied.     

Pigmented nevi of the oral mucosa: a clinicopathologic study of 32 new cases and review of 75 cases from the literature. Part I. A clinicopathologic study of 32 new cases.

Pigmented nevi are much less common in the oral cavity than they are in the skin. The present study adds thirty-two new cases to the literature. The most common type of nevus was found to be the intramucosal, followed in decreasing order by the common blue nevus, compound nevus, and junctional nevus. The clinical and histologic features of the nevi are analyzed and discussed.     

Pigmented nevi of the oral mucosa: a clinicopathologic study of 36 new cases and review of 155 cases from the literature. Part I: A clinicopathologic study of 36 new cases

Pigmented nevi are uncommon oral lesions. This study adds data on 36 new cases. The most common type of nevus was the intramucosal type (20 cases), followed by the common blue nevus (11 cases). Only three cases were of the compound type and only two were of the junctional type. The hard palate was the most frequent location for the blue nevus, whereas the buccal mucosa was the most frequent site for the intramucosal nevus. One nevus (intramucosal type) was located on the tongue, and to our knowledge, this is the first reported example of pigmented nevus at this site. The individual data on the 36 cases are presented and compared with a previous study on oral nevi from the University of California at San Francisco. The previously unpublished clinical details on the 32 nevi from the previous study are also presented.     

Peripheral osteoma of the oral and maxillofacial region: a study of 35 new cases.

PURPOSE: The purpose of this article was to present 35 new cases of peripheral osteoma of the oral and maxillofacial region with an analysis of the literature. PATIENTS AND METHODS: We performed a search of our files for the past 5 years for peripheral osteoma of the oral and maxillofacial region. The criteria used to diagnose osteoma included the radiographic and histologic features. RESULTS: The 35 patients, which included 23 males (65%) and 12 females (35%), ranged in age from 14 to 58 years, with a mean age of 29.4 years. Most of the osteomas were located in frontal bone (28.57%), mandible (22.85%), and maxilla (14.28%). CONCLUSION: Peripheral osteomas of the jaw bones are uncommon, and accordingly, patients with osteoma should be evaluated for Gardner's syndrome. In addition, it is appropriate to provide both clinical and radiographic follow-up after surgical excision of a peripheral osteoma.     

Basement membrane changes under neoplastic oral mucous membrane. Ultrastructural observations, review of the literature, and a unifying concept.

This study explores the morphologic nature of the basement membrane under neoplastic oral mucous membrane. Of particular interest is the progression of changes associated with dysplasia, carcinoma in situ, and invasive carcinoma. On the basis of a critical review of the literature and our own ultrastructural observations, we present a unifying concept for the development of these basement membrane changes. This concept proposes that neoplastic epithelial cells may produce a collagenolytic enzyme which is released into the epithelial intercellular spaces. This enzyme permeates to the basement membrane, causes breaks in the basement membrane, and focal loss of stromal area contiguous with intercellular spaces. The neoplastic basal cells develop pseudopodia that eventually extend through the breaks in the basement membrane. This concept suggests that the basement membrane changes herald the progression of carcinoma in situ to invasive carcinoma.     

Fordyce granules on the prolabial and oral mucous membranes of a selected population.

Fordyce granules are commonly seen on the prolabial and oral mucous membranes of adults. According to Sewerin there is a prevalence of 80% on the prolabial mucous membranes and 95% on the oral mucous membranes and reaches a peak between 20 and 29 years of age. Experienced clinicians find that these figures are too high for the South African population. In order to accept or reject this hypothesis, it was decided to determine the prevalence of Fordyce granules in a selected population of adult South-Africans of all the age groups, but mainly between 20 and 29 years of age. In this study, the prevalence of ectopic sebaceous glands (Fordyce granules) on the prolabial and oral mucous membranes of a selected South African population, was 62.07% and 57.25% in adult males and females, respectively. This is significantly lower than the prevalence reported by Sewerin. This study also revealed that Fordyce granules are mostly seen on the lips (vermillion), labial mucosa and the corresponding parts of the alveolabial sulcus. The buccal mucosa is the second most common site, and there is no significant difference in the prevalence between males and females.     

Superficial melanomas of oral mucous membranes.

In accordance with microscopic and clinical criteria established for superficial melanomas of the skin (superficial spreading melanoma, lentigo maligna melanoma, acral-lentiginous melanoma), three oral lesions have been evaluated. The literature on oral melanomas has also been reviewed, with special attention given to those cases that had pre-existing melanosis. One patient with a diagnosis of superficial spreading melanoma eventually died of his untreated lesion 11 years after its first appearance. Two patients had lesions diagnosed as acral-lentiginous melanoma (a group which also includes volar and subungual melanomas) that exhibited aggressive, recurrent behavior. These lesions had microsocpic features similar to lentigo maligna melanoma but did not behave in a manner consistent with that diagnosis. Electron microscopic study of one acral-lentiginous melanoma demonstrated malenosomes and premelanosomes that were like those seen in normal melanocytes and nevus cells. The superficial or radial growth phase of many oral melanomas has apparently gone unrecognized. Melanosis has been reported to be a common feature of invasive oral melanomas but has not generally been related to the natural history of these lesions. Oral lesions with a prolonged intra-epithelial or radial growth phase would be expected to have a better prognosis than nodular melanomas, but meaningful survival data are not available because of the infrequency with which oral melanomas have been subclassified.