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      Oral White Lesions: An Updated Clinical Diagnostic Decision Tree

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          Abstract

          Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “mouth disease”, “oral keratosis”, “oral leukokeratosis”, and “oral leukoplakia”. Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

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          Oral Potentially Malignant Disorders: An Overview of More than 20 Entities

          Hamed Mortazavi, Maryam Baharvand, Masoumeh Mehdipour (2014)
          Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oralPMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities. The aim of this article is to update and improve the knowledge of healthcare providers about oral PMDs.
          Article 0 comments Cited 65 times – based on 0 reviews     Review now
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            Clinical and microbiological diagnosis of oral candidiasis

            Laura Coronado-Castellote, Yolanda Jiménez-Soriano (2013)
            Introduction: Candidiasis or oral candidiasis is the most frequent mucocutaneous mycosis of the oral cavity. It is produced by the genus Candida, which is found in the oral cavity of 53% of the general population as a common commensal organism. One hundred and fifty species have been isolated in the oral cavity, and 80% of the isolates correspond to Candida albicans, which can colonize the oral cavity alone or in combination with other species. Transformation from commensal organism to pathogen depends on the intervention of different predisposing factors that modify the microenvironment of the oral cavity and favor the appearance of opportunistic infection. The present study offers a literature review on the diagnosis of oral candidiasis, with the purpose of establishing when complementary microbiological techniques for the diagnosis of oral candidiasis should be used, and which techniques are most commonly employed in routine clinical practice in order to establish a definitive diagnosis. Materials and methods: A Medline-PubMed, Scopus and Cochrane search was made covering the last 10 years. Results: The diagnosis of oral candidiasis is fundamentally clinical. Microbiological techniques are used when the clinical diagnosis needs to be confirmed, for establishing a differential diagnosis with other diseases, and in cases characterized by resistance to antifungal drugs. Biopsies in turn are indicated in patients with hyperplastic candidiasis. Staining (10% KOH) and culture (Sabouraud dextrose agar) are the methods most commonly used for diagnosing primary candidiasis. Identification of the individual species of Candida is usually carried out with CHROMagar Candida®. For the diagnosis of invasive candidiasis, and in cases requiring differentiation between C. albicans and C. dubliniensis, use is made of immunological and genetic techniques such as ELISA and PCR. Key words:Clinical, oral candidiasis, microbiology.
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              Chronic mucocutaneous candidiasis disease associated with inborn errors of IL-17 immunity

              Satoshi Okada, Anne Puel, Jean-Laurent Casanova … (2016)
              Chronic mucocutaneous candidiasis (CMC) is characterized by recurrent or persistent infections affecting the nails, skin and oral and genital mucosae caused by Candida spp., mainly Candida albicans. CMC is an infectious phenotype in patients with inherited or acquired T-cell deficiency. Patients with autosomal-dominant (AD) hyper IgE syndrome (HIES), AD signal transducer and activator of transcription 1 (STAT1) gain-of-function, autosomal-recessive (AR) deficiencies in interleukin (IL)-12 receptor β1 (IL-12Rβ1), IL-12p40, caspase recruitment domain-containing protein 9 (CARD9) or retinoic acid-related orphan receptor γT (RORγT) or AR autoimmune polyendocrinopathy–candidiasis–ectodermal dystrophy (APECED) develop CMC as a major infectious phenotype that is categorized as Syndromic CMC. In contrast, CMC disease (CMCD) is typically defined as CMC in patients in the absence of any other prominent clinical signs. This definition is not strict; thus, CMCD is currently used to refer to patients presenting with CMC as the main clinical phenotype. The etiology of CMCD is not related to genes that cause severe combined immunodeficiency or combined immunodeficiency, nor to genes responsible for Syndromic CMC. Four genetic etiologies, AR IL-17 receptor A, IL-17 receptor C and ACT1 deficiencies, and AD IL-17F deficiency, are reported to underlie CMCD. Each of these gene defects directly has an impact on IL-17 signaling, suggesting their nonredundant role in host mucosal immunity to Candida. Here, we review current knowledge focusing on IL-17 signaling and the genetic etiologies responsible for, and associated with, CMC.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Dent J (Basel)
                Journal ID (iso-abbrev): Dent J (Basel)
                Journal ID (publisher-id): dentistry
                Title: Dentistry Journal
                Publisher: MDPI
                ISSN (Electronic): 2304-6767
                Publication date (Electronic): 07 February 2019
                Publication date Collection: March 2019
                Volume: 7
                Issue: 1
                Electronic Location Identifier: 15
                Affiliations
                [1 ]Oral Medicine Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran; mortazavi.h@ 123456sbmu.ac.ir (H.M.); drjafari@ 123456sbmu.ac.ir (S.J.); fahimeh.anbari@ 123456sbmu.ac.ir (F.A.); s_rahmani@ 123456sbmu.ac.ir (S.R.)
                [2 ]Oral and Maxillofacial Radiology Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran; Safiy2018@ 123456sbmu.ac.ir
                Author notes
                [* ]Correspondence: m-baharvand@ 123456sbmu.ac.ir ; Tel.: +98-21-26708415
                Article
                Publisher ID: dentistry-07-00015
                DOI: 10.3390/dj7010015
                PMC ID: 6473409
                PubMed ID: 30736423
                SO-VID: fd84ffd5-a3d3-4f97-b875-b47bc1e7a87b
                Copyright © © 2019 by the authors.
                License:

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 23 November 2018
                Date accepted : 18 January 2019
                Categories
                Subject: Review

                Keywords: mouth disease,oral keratosis,oral leukokeratosis,oral leukoplakia
                Data availability:
                Keywords: mouth disease, oral keratosis, oral leukokeratosis, oral leukoplakia

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