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Paget disease is an intraepithelial neoplastic proliferation, commonly occurring in the breast and apocrine‐rich areas, often associated with an underlying internal malignancy. Extramammary Paget disease (EMPD) of the oral cavity is exceedingly rare, with only eight reported cases, four of which were associated with an underlying internal malignancy. Here, we report a case of oral EMPD involving the buccal mucosa and gingiva of an 81‐year‐old male with no known underlying internal malignancy. The Paget cells were positive for CK7, CK20, CAM5.2, and androgen receptor, but negative for SOX10 and p63. The immunophenotype, association with internal malignancies, and treatment approaches for oral EMPD are reviewed. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective This study aimed to verify oral candidiasis, identify the causative species, and investigate the antifungal susceptibility of yeasts isolated from liver transplant patients. Methods A descriptive analysis of 97 patients who underwent liver transplantation was conducted at a hospital. Two clinical examinations (Collections A and B) of the oral cavity were performed. Oral material was collected from all patients, inoculated in Sabouraud Dextrose Agar, and incubated at 35℃ for 48 hours. Samples were identified by molecular sequencing of the internal trascribed space region of rDNA. Results An antifungal susceptibility test with fluconazole, amphotericin B, and micafungin was performed using the Clinical and Laboratory Standards Institute yeast broth microdilution method. Among the patients, 15 presented with oral candidiasis: eight in Collection A and seven in Collection B. The primary type of candidiasis was atrophic, followed by pseudomembranous candidiasis. The most prevalent species was Candida albicans (nine), followed by Candida glabrata (three), Candida tropicalis (two), and Candida dubliniensis (one). Regarding susceptibility to fluconazole, of the 15 samples, 11 were susceptible, three were susceptible in a dose-dependent manner, and one was resistant. Conclusion The most commonly identified type of candidiasis was atrophic, with C. albicans and C. glabrata being the most prevalent causative species. One fluconazole-resistant isolate each of C. tropicalis and C. albicans were identified.

Abstract The pathogenic nature of infections caused by Candida spp. underscores the necessity for novel therapeutic agents. Extracts of Schinopsis brasilienses Engl are \ a promising source of agents with antifungal effects. This study aimed to assess the antifungal potential of the leaf extract of S. brasilienses. The antifungal activity was evaluated by determining the minimum inhibitory concentrations and fungicide concentrations (MIC and MFC). The antibiofilm potential was assessed by counting colony-forming units/mL. The study examined the inhibition kinetics of fungal growth and potential synergism between gallic acid or the extract and nystatin using the Checkerboard method. Cytotoxicity was evaluated through the MTT assay. The extract exhibited antifungal effect against all tested strains, with MIC and MFC ranging from 31.25–250 μg/mL. Gallic acid, the main isolated compound, displayed a MIC of 2000 μg/mL. The extract of S. brasilienses at 31.25 μg/mL inhibited the formation of biofilm by C. albicans and significantly reduced the mass of mature biofilm after 24 and 48 h (p < 0. 05). At a concentration of 125 μg/mL, the extract demonstrated significant inhibition of fungal growth after 6 hours. The combination of gallic acid or extract with nystatin did not exhibit synergistic or antagonistic effect. Furthermore, the extract did not induce cytotoxicity to a human cell line. The extract of S. brasiliensis demonstrates antifungal activity against Candida, generally exhibiting fungicidal action and capacity to inhibit biofilm formation as well as reduce mature biofilms. Additionally, the extract showed low cytotoxicity to human cells.

Introduction: The successful treatment of oral candidiasis depends on three essential principles, namely: early and accurate diagnosis, correlation with predisposing factors or underlying diseases that compromise immunity, and appropriate use of antifungal drugs. Objectives: To determine the minimum inhibitory concentration of carvacrol against Candida albicans and to develop and evaluate the in vitro antifungal activity (diameter of inhibition zone) and physical properties (foaming capacity, spreadability and cleaning capacity) of an experimental dentifrice containing carvacrol. Methods: The carvacrol was incorporated into a dentifrice base at different concentrations and tested for its minimum inhibitory concentration and agar diffusion against Candida albicans and the physical properties. Data were analysed by ANOVA. Results: The minimum inhibitory concentration of carvacrol was 1041.67 ± 360.84 µg/mL. The dentifrice containing carvacrol C1 e C2 produced an inhibition zone of 27.50 ± 2.12 mm and 36.66 ± 2.08 mm, respectively (p

Aims: Oral candidosis is common in patients with end-of-life cancer; however, its prognosis is unclear. We aimed to assess oral candidosis and Candida species as prognostic indicators in palliative care for these patients., Methods: We consecutively included palliative care patients, assessed for candidosis via microbiological techniques, and classified into three groups by the extent of oral lesions. The association between oral candidosis and overall survival was assessed using a Cox proportional hazards model adjusted by performance status (PS)., Results: We studied 142 patients (median age 77; 52.8% women) with a 76.1% oral candidosis prevalence. Candida albicans (80.6%) was the most common species. Oral lesions were classified as none, grade 1 (28.7%), or ≥ grade 2 (14.8%). During follow-up, Cox models identified ≥grade 2 lesions (aHR = 2.04; 95% CI: 1.18-3.54; p = .011) and Candida tropicalis (aHR = 2.38; 95% CI: 1.03-5.55; p = .044) as predictors., Conclusion: The extent of oral candidosis lesions or the presence of C. tropicalis may serve as prognostic indicator in patients with end-of-life cancer. Therefore, solely concentrating on the prevalence and frequency of fungal species may be insufficient for predicting life prognosis; it is advisable to assess these parameters through both visual examination and culture., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Abstract Here, the prevalence of oral candidiasis and denture stomatitis among diabetic patients compared to healthy ones was summarized through a systematic review with meta-analysis. Medline, Scopus, Web of Science, Lilacs, Cochrane Library, Embase, and the grey literature were searched without restriction, until May 2020. Eligibility criteria were established, data were extracted, and quality assessment was conducted by two trained examiners. Qualitative synthesis was based on the recommendations of Fowkes and Fulton. Two meta-analyses were performed on studies investigating patients with: a) oral candidiasis and b) denture stomatitis. Out of 6034 screened studies, seven were eligible for qualitative and quantitative synthesis; of these, three evaluated oral candidiasis and four evaluated denture stomatitis. Qualitative synthesis showed that the main methodological problems of the studies included sample size, source of controls, matching, and randomization. Diabetic patients had a similar chance of developing oral candidiasis to non-diabetic patients (OR1.40 [0.96; 2.04], p = 0.08, I2 = 94%). However, diabetic patients had a higher chance to present denture stomatitis compared to non-diabetic patients (OR 1.92 [1.42, 2.59] p < 0.0001, I2 = 0%). Therefore, diabetic patients have a higher chance of developing denture stomatitis compared to non-diabetic patients. However, for all analyses, the certainty of the evidence was considered to be very low.

Abstract: BACKGROUND: Candidiasis is the most common opportunistic fungal infection of the oral cavity caused by fungi of the genus Candida and usually associated with immunosuppressed individuals. OBJECTIVES: To evaluate the presence of oral candidiasis and identify the presence of Candida spp. in liver transplant recipients and assess the association between the presence of the fungus and sociodemographic variables, dietary habits and environmental exposure. METHODS: A cross-sectional study was performed with 49 patients who had undergone liver transplants at Hospital São Vicente de Paulo in Passo Fundo - RS. Patient information was collected to obtain sociodemographic data, eating habits and environmental exposure. Fungal infections were screened by oral clinical examination and the presence of Candida spp by the collection of oral samples with a sterile swab, seeded in Sabouraud Dextrose Agar, incubated at 25°C and observed at 48 hours. To identify Candida albicans, the germ tube test was performed. RESULTS: In 49 patient samples, 39% had the yeast of the genus Candida isolated and, of these patients, 12% had candidiasis, 66% of atrophic type and 34% pseudomembranous. Eleven yeast species were (58%) Candida non-albicans and eight (42%) Candida albicans. STUDY LIMITATIONS: The present study presents as a limitation the inclusion of patients in different stages of immunosuppression. CONCLUSION: The high incidence of Candida non-albicans in the oral cavity of transplant patients with a long period of transplantation is warning to a more effective control of the health of these individuals, especially those with older age.

Here, the prevalence of oral candidiasis and denture stomatitis among diabetic patients compared to healthy ones was summarized through a systematic review with meta-analysis. Medline, Scopus, Web of Science, Lilacs, Cochrane Library, Embase, and the grey literature were searched without restriction, until May 2020. Eligibility criteria were established, data were extracted, and quality assessment was conducted by two trained examiners. Qualitative synthesis was based on the recommendations of Fowkes and Fulton. Two meta-analyses were performed on studies investigating patients with: a) oral candidiasis and b) denture stomatitis. Out of 6034 screened studies, seven were eligible for qualitative and quantitative synthesis; of these, three evaluated oral candidiasis and four evaluated denture stomatitis. Qualitative synthesis showed that the main methodological problems of the studies included sample size, source of controls, matching, and randomization. Diabetic patients had a similar chance of developing oral candidiasis to non-diabetic patients (OR1.40 [0.96; 2.04], p = 0.08, I2 = 94%). However, diabetic patients had a higher chance to present denture stomatitis compared to non-diabetic patients (OR 1.92 [1.42, 2.59] p < 0.0001, I2 = 0%). Therefore, diabetic patients have a higher chance of developing denture stomatitis compared to non-diabetic patients. However, for all analyses, the certainty of the evidence was considered to be very low. [ABSTRACT FROM AUTHOR]

Background/Aim. Denture stomatitis (DS) is one of the most common oral health problems among elderly population with removable dentures. Despite the high prevalence, etiology of the disease is not completely understood. It appears to be multifactorial, with a predominance of local factors. The aim of the study was to determine the prevalence and risk factors that contribute to the development of DS in upper removable denture wearers. Methods. This clinical study comprised three groups of subjects with upper removable dentures: the DS group, and the positive and negative control groups. Swab samples were taken from the tongue and palatal mucosa for microbiological examination. Data of denture age, dentures night wearing, unstimulated salivary flow rate (USFR) and saliva pH values were evaluated for all the participants. Results. The prevalence of DS was found to be 26.5%. Significantly higher values of overnight wearing (p = 0.000) and the mean age of dentures (p = 0.022) were found in the DS group compared to the controls. In relation to the positive mycological finding, a borderline significance difference among the groups was confirmed (p = 0.053). No significant association was found between DS and gender, age, the type of dentures, USFR, pH of saliva and bacteria findings. The patients who wore dentures at night had 26 times more chances to get DS compared to the patients who did not wear them overnight. Conclusion. This study confirms similar characteristics of DS prevalence in elderly population of Vojvodina compared to European. Continuous (overnight) wearing of dentures is considered to be major direct risk factor for DS development, while secondary role is attributed to denture age and oral Candida infection.

Background/Aim. Oral candidiasis frequently causes discomfort in patients treated for malignant diseases, acting as well as a potential source of systemic infection. This disease may present itself through different clinical manifestations of both acute or chronic type. The aim of this study was to identify different Candida species from oral cavities of patients suffering from malignant diseases. Methods. Thirty patients admitted to the hospital for diagnostics/treatment of malignant diseases were included in this investigation. All subjects had visible changes of oral mucosa in the form of pseudomembranes and inflammation corresponding to oral candidiasis. Control group included 30 non-hospitalized patients diagnosed with candidiasis. Diagnosis of oral candidiasis was confirmed in all patients by microbiological analysis of tongue swabs. For microbiota identification, three different tests were used: germination test, fungal growth test on corn meal agar, and biochemical identification with commercially available ID 32 C kit (bio-Merieux, Marcy-l´Etoile, France). Results. Out of 30 isolates collected from hospitalized patients, 90% was related to Candida albicans, 7% was identified as Candida kefyr, and 3% as Candida famata. In samples collected from non-hospitalized controls, we isolated Candida albicans in 90% of the cases, in 7% Candida kefyr, while in 3% we identified Candida glabrata. Conclusion. Based on this investigation, oral candidiasis in patients treated with radiotherapy and chemotherapy is mainly caused by Candida albicans. It is to be expected that Candida albicans will remain the most significant causative agent of oral candidasis, although we must bear in mind the possibility of other pathogenic species.

Objectives: To assess 52-week safety and efficacy of bimekizumab in patients with active psoriatic arthritis (PsA) and prior inadequate response/intolerance to tumour necrosis factor inhibitors., Methods: Patients completing the 16-week phase III double-blind, placebo-controlled BE COMPLETE (NCT03896581) study entered the open-label extension, BE VITAL (NCT04009499). All patients in BE VITAL received 160 mg bimekizumab every 4 weeks. Safety and efficacy are reported to week 52., Results: A total of 347/400 (86.8%) patients completed week 52. To week 52, the exposure-adjusted incidence rate/100 patient-years for ≥1 treatment-emergent adverse event (TEAE) was 126.0, and was 7.0 for serious TEAEs. The most frequent TEAEs were SARS-CoV-2 (COVID-19), oral candidiasis, nasopharyngitis and urinary tract infection. All fungal infections were mild or moderate in severity and localised; two patients discontinued the study due to oral candidiasis. No cases of active tuberculosis, uveitis or inflammatory bowel disease were reported. One sudden death occurred. Sustained efficacy was observed with bimekizumab from week 16 to ‍52 across clinical and patient-reported outcomes. At week 52, 51.7% bimekizumab-randomised and 40.6% placebo/bimekizumab patients (receiving bimekizumab from week 16 to 52) had ≥50% improvement in the American College of Rheumatology criteria. Complete skin clearance (Psoriasis Area and Severity Index 100) was achieved by 65.9% bimekizumab and 60.2% placebo/bimekizumab patients at week 52. Minimal disease activity was achieved by 47.2% bimekizumab and 33.1% placebo/bimekizumab patients at week 52., Conclusions: Bimekizumab demonstrated a safety profile consistent with previous reports; no new safety signals were identified. Sustained efficacy was observed from week 16 to 52., Competing Interests: Competing interests: LCC: Grants/research support from AbbVie, Amgen, Celgene, Eli Lilly, Gilead, Janssen, Novartis, Pfizer and UCB Pharma; consultant for AbbVie, Amgen, BMS, Boehringer Ingelheim, Celgene, Domain, Eli Lilly, Galapagos, Gilead, Janssen, Moonlake Pharma, Novartis, Pfizer and UCB Pharma; speaking fees from AbbVie, Amgen, Biogen, Celgene, Eli Lilly, Galapagos, Gilead, GSK, Janssen, medac, Novartis, Pfizer and UCB Pharma. Associate Editor of RMD Open. RL: Consultancy fees from AbbVie, AstraZeneca, BMS, Eli Lilly, Novartis, Pfizer and UCB Pharma; research grants from AbbVie, Pfizer, Novartis, and UCB Pharma; owner of Rheumatology Consultancy BV, an AMS company under Dutch law. On the Editorial Board of RMD Open. IBM: Consulting fees and honoraria from AbbVie, AstraZeneca, BMS, Boehringer Ingelheim, Cabaletta, Causeway Therapeutics, Celgene, Eli Lilly, Evelo, Janssen, Moonlake Pharma, Novartis and UCB Pharma; research support from BMS, Boehringer Ingelheim, Celgene, Janssen, Novartis and UCB Pharma. On the Editorial Board of RMD Open. PJM: Research grants from AbbVie, Amgen, BMS, Eli Lilly, Gilead, Janssen, Novartis, Pfizer, Sun Pharma and UCB Pharma; consultancy fees from AbbVie, Acelyrin, Aclaris, Amgen, BMS, Boehringer Ingelheim, Eli Lilly, Galapagos, Gilead, GSK, Janssen, Moonlake Pharma, Novartis, Pfizer, Sun Pharma and UCB Pharma; speakers’ bureau for AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer and UCB Pharma. CTR: Research for AbbVie; consultant for AbbVie, Amgen, Eli Lilly, Gilead, Janssen, Novartis, Pfizer and UCB Pharma. YT: Speaking fees and/or honoraria from AbbVie, AstraZeneca, BMS, Boehringer Ingelheim, Chugai, Eisai, Eli Lilly, Gilead, GSK, Pfizer, Taiho and Taisho; received grants from Chugai, Eisai, Mitsubishi-Tanabe and Taisho. On the Editorial Board of RMD Open. AA: Honoraria and/or research grants from AbbVie, Amgen, BMS, Boehringer Ingelheim, Eisai, Eli Lilly, Janssen, Kyowa Kirin, LEO Pharma, Maruho, Mitsubishi Tanabe Pharma, Novartis, Pfizer, Sun Pharma, Taiho Pharma, Torii Pharmaceutical Co. and UCB Pharma. FB: Consultant and/or speaker and/or investigator for AbbVie, Affibody, Amgen, BMS, Boehringer Ingelheim, Celgene, Chugai, Eli Lilly, Genzyme, GSK, Janssen, MoonLake Pharma, MSD, Novartis, Pfizer, Roche, Sandoz and Sanofi. DDG: Consultant and/or received grant support from AbbVie, Amgen, BMS, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer and UCB Pharma. LG: Grants from AbbVie, Biogen, Eli Lilly, Novartis, Sandoz and UCB Pharma; personal fees from AbbVie, Amgen, BMS, Celltrion, Eli Lilly, Galapagos, Janssen, MSD, Novartis, Pfizer, Sandoz and UCB Pharma. AMO: Research grants to Johns Hopkins University from AbbVie, Amgen, and Janssen; consulting fees from BMS, Janssen, Sanofi and UCB Pharma. ABG: Received research/educational grants from AnaptypsBio, BMS, Highlights Therapeutics, Janssen, Moonlake Immunotherapeutics AG, Novartis and UCB Pharma, (all paid to Mount Sinai School of Medicine); Received honoraria as an advisory board member and consultant for Amgen, AnaptypsBio, Avotres Therapeutics, BMS, Boehringer Ingelheim, Dice Therapeutics, Eli Lilly, Highlights Therapeutics, Janssen, Novartis, Sanofi, UCB and Xbiotech. RBW: Consulting fees from AbbVie, Almirall, Amgen, Arena, Astellas, Avillion, Biogen, BMS, Boehringer Ingelheim, Celgene, Eli Lilly, GSK, Janssen, LEO Pharma, Novartis, Pfizer, Sanofi and UCB Pharma; research grants to his institution from AbbVie, Almirall, Janssen, LEO Pharma, Novartis and UCB Pharma; honoraria from Astellas, DICE Therapeutics, GSK and Union Therapeutics. BI: Shareholder of AbbVie, GSK and UCB Pharma; employee of UCB Pharma. RB and JC: Employees and shareholders of UCB Pharma. VS: Employee of UCB Pharma. JFM: Consultant and/or investigator for AbbVie, Amgen, Biogen, BMS, Dermavant, Eli Lilly, Janssen, LEO Pharma, Pfizer, Novartis, Regeneron, Sanofi, Sun Pharma and UCB Pharma., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Permanent immunosuppression is necessary to prevent rejection after kidney transplantation. However, it may predispose patients to different conditions and diseases including oral lesions. The most common benign oral lesions in kidney transplant recipients are gingival hyperplasia, oral candidiasis, hairy leukoplakia and saburral tongue. Oral form of Kaposi sarcoma, although rarely, can also be seen in kidney transplant patients. In this review, we present the incidence, etiology, clinical findings, diagnosis and treatment options for these lesions. For kidney transplant recipients, it is important to maintain good oral hygiene and care, as well as regular professional control by the dentist. This approach can reduce the number and severity of oral lesions.