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Herpetic geometric glossitis is a unique morphologic variant of HSV (herpes simplex virus) type 1 infection on the dorsum of the tongue that presents as an extremely painful linear central lingual fissure with a branched pattern. in the center of the tongue; there is a branched pattern of fissures that extend bilaterally from the central linear fissure. Herpetic geometric glossitis has been reported in 11 patients; 8 of these individuals were immunocompromised. Medical conditions and immunosuppressive medication treatment (7 patients) or only medical disorders (3 patients) or neither (1 patient) were present. HSV type 1 infection was diagnosed by viral culture in (7 patients), Tzanck preparation (2 patients) or clinically (2 patients). Mucocutaneous HSV infection at non-lingual locations--including the lips, labial mucosa, face and chest--were observed in 5 patients. All patients' symptoms and lesions responded to treatment with oral antiviral therapy: acyclovir (9 patients), famciclovir (1 patient) or valacyclovir (1 patient). The lingual pain and dorsal tongue fissures completely resolved completely within two to 14 days. In summary, herpetic geometric glossitis is a unique HSV type 1 infection, usually in immunocompromised patients, that occurs on the dorsal tongue and responds completely after treatment with orally administered antiviral therapy.

Vitamin B12 is essential for various bodily functions, and its deficiency may cause hematological manifestations. We report a case of a previously healthy 65-year-old female who was admitted to our hospital with reduced sense of taste and painful tongue. The serum level of vitamin B12 was decreased. However, her complete blood count did not show any evidence of macrocytosis, instead, her mean corpuscular volume was low. Gene sequencing indicated an β-thalassemia minor and that probably masked the megaloblastic features of vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]

Introduction The risk of degenerative diseases in the elderly is higher due to aging and decreased body function. This process affects both systemic conditions and locally in the oral cavity. Aside from aging, degenerative disease itself can trigger the incidence of soft tissue abnormalities. Aging can cause structural and functional changes in the systemic vasculature, resulting in a degenerative disease such as hypertension. Elderly who suffers from hypertension can develop oral mucosa abnormalities and most of them are found on the tongue. This study was aimed to identify the prevalence of normal variant lesions on the tongue in the elderly with hypertension. Methods This was an observational descriptive study with a cross-sectional design done in January–March 2020. Samples were elderly obtained from several public health centers in Surabaya that matched the inclusion criteria. Subjective and clinical examinations were performed by oral medicine residents and specialists. Results A total of 401 elderly were screened and 147 elderly (36.65%) met the inclusion criteria which are having hypertension and willing to participate in this study. Those who met the criteria, mainly were female from the 60 to 74 years old age group. Normal variants of tongue obtained from the examination were fissured tongue (90.48%), coated tongue (63.95%), crenated tongue (33.33%), lingual varices (12.24%), and benign migratory glossitis (4.08%). Conclusion From this study, we figured out that fissured tongue was the most common normal variant lesion of the tongue in the elderly with hypertension. Coexistence between hypertension and tongue lesions can be developed from pathological changes of disease or as side effects of medication taken such as antihypertensive drugs. [ABSTRACT FROM AUTHOR]

Key Clinical Message: We present a case of parenchymatous glossitis with unilateral severe inflammation of the hyoglossus muscle, resulting in laryngeal edema. The route of inflammation was unique. Contrast‐enhanced CT was useful for diagnosis. Administration of sensitive antibiotics led to improvement. Creatine phosphokinase may be an indicator of diagnosis and treatment response. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the problems patients perceive during orthodontic treatment with removable and myofunctional appliances. Study Design: Cross-sectional study. Place and Duration of Study: Prosthodontic Department, College of Dentistry, University of Kerbala, from March 2021 to July 2021. Methodology: A total of 210 orthodontic patients who had been wearing removable and myofunctional orthodontic appliances for at least four months were included in the study. Patients were divided into two groups aged between 10 to 40 years. A questionnaire comprising 11 items covering physical, functional, psychological, and social problems associated with wearing removable and myofunctional orthodontic appliances was used to analyze the outcome variables. Patients were interviewed at Kerbala University. Results: In this study, 107 (51%) patients were male, and 103 (49%) were female, with ages ranging from 10 to 40 years. Forty-four (21%) patients reported reeling pain after insertion of removable and myofunctional appliances. A relatively higher percentage of male patients (44.5%) believed the appliance was effective, and 40% found it comfortable. Difficulty in speaking (36.7%) was the most frequent problem reported by the patients in the studied population. Conclusion: Despite a few problems, wearing removable and myofunctional orthodontic appliances remained an effective and viable treatment option for uncomplicated malocclusions. [ABSTRACT FROM AUTHOR]

Oral Mucosal Lesions (OMLs) are conditions of the oral mucosa that cause alterations in their presentation and pain in the affected patient, highlighting their importance for study. The aim of this research is to determine the prevalence of oral lesions in the Ecuadorian Austro. Descriptive statistics were used to associate variables, yielding statistically significant findings based on oral lesions, sex, and geographical environment. This study was conducted under the appropriate bioethical permissions. The results obtained correspond to the prevalence of lesions by province. Morona Santiago displays a rate of 17% for abscesses, surpassing the provinces of Azuay (13.50%) and Cañar (10.67%). However, gingivitis for pathology, Azuay stands out with 13.17%, while Cañar and Morona Santiago present 10.50% and 8.33%, respectively. There is also a predominant occurrence of abscesses in rural areas (41.17%) compared to urban ones (26.33%). Regarding sex, girls show a higher percentage of abscesses (41.17%) compared to boys who have a clear tendency to present GUM lesions (22.33%). The data indicates that in the studied provinces, geographical environment and sex are key variables to understand the distribution of oral lesions. These findings encourage us to continue pursuing this type of research, which contributes to improving the quality of life for children. [ABSTRACT FROM AUTHOR]

Sporotrichosis is a mycotic infection of the cutaneous and subcutaneous tissues caused by Sporothrix spp. that can also cause extracutaneous manifestations. This study aimed to characterize cutaneous and extracutaneous sporotrichosis lesions in cats. Over 1 year, 102 cats rescued by the Zoonoses Control Center of Belo Horizonte, Brazil, euthanized with clinical suspicion of feline sporotrichosis were evaluated. After euthanasia, the animals were evaluated by macroscopic, cytological, histopathological, and immunohistochemistry (IHC) examinations; fungal culture; and polymerase chain reaction (PCR). Sporothrix infection was identified by at least one diagnostic technique in all cats (n = 102) evaluated by postmortem examination, including 26/28 cases (93%) evaluated by IHC, 66/90 cases (73%) evaluated by cytology, 70/102 cases (68.6%) evaluated by histopathology, and 62/74 cases (84%) evaluated by fungal culture. Two cats had positive results only by fungal culture. Cytology and histopathology examinations were effective in diagnosing sporotrichosis, although IHC was needed to confirm the diagnosis in cats with low fungal loads. Sporothrix brasiliensis was confirmed by the sequencing of 3 samples. Skin lesions were characterized mainly by pyogranulomatous to granulomatous dermatitis (frequently with subcutaneous inflammation) with different intensities of Sporothrix spp. yeast. Extracutaneous findings associated with sporotrichosis included rhinitis or rhinosinusitis, lymphadenitis, pneumonia, meningitis, periorchitis, conjunctivitis, and glossitis. Extracutaneous infections were observed in 74/102 cases, and a possible association between the chronicity of the disease and the higher pathogenicity of this fungal species in cats requires further investigation. [ABSTRACT FROM AUTHOR]

Canine leishmaniosis, caused by the protozoan Leishmania infantum, is an endemic vector‐borne disease in Europe. From a diagnostic point of view, the disease can sometimes be a real challenge for the clinician, due to the variability of clinical presentations in a sick dog. These clinical signs can be classified, based on the frequency of presentation, in typical and atypical signs. In dogs is common to find different clinical presentations of cutaneous disease and systemic involvement, while clinical presentations in mucosa are not so common. A 6‐year‐old, entire, male German shepherd crossbred dog was examined for evident nodular lesions on the tongue. The most important laboratory alteration detected was hyperglobulinemia with an increase in the gamma fraction classified as polyclonal gammopathy. High anti‐Leishmania antibodies were detected by ELISA. Tongue biopsy samples were obtained from the lesions with the presence of a diffuse inflammatory infiltrate characterised by macrophages and neutrophils with no compatible forms of Leishmania parasites. However, the presence of Leishmania amastigotes was confirmed by specific immunohistochemistry. A good clinical response to the anti‐Leishmania based on meglumine antimoniate and allopurinol was observed after meglumine antimoniate administration. This clinical case describes the presentation of proliferative papulo‐nodular glossitis in an L. infantum‐positive dog as the most evident clinical finding reported. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Veterinary Journal / Revue Vétérinaire Canadienne is the property of Canadian Veterinary Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The causes of vitamin B12 (B12) deficiency are varied and mainly related to gastric disorders. Glossitis is a common oral manifestation of B12 deficiency and is often first seen by dentists. This study aimed to investigate the correlation between B12 deficiency‐related glossitis (B12‐def glossitis) and gastric serum biomarkers [gastrin‐17(G17), pepsinogen I (PGI), pepsinogen II (PGII), and anti‐Helicobacter pylori (H. pylori) antibodies], and preliminarily discuss the etiology of B12‐def glossitis. Methods: A cross‐sectional study was conducted in patients complaining of glossodynia, burning sensation, or severe recurrent oral ulcers, but patients with a history of gastrectomy were excluded. All subjects underwent a uniform oral examination and hematological tests. Results: Of 243 patients, 133 with B12‐def glossitis were in the case group, and 110 with other oral mucosal diseases (non‐glossitis) and normal B12 levels were in the control group. In the case group, 84.2% (112/133) showed high G17 and low PGI levels (G17hi PGIlow). Univariate logistic regression showed that G17hi PGIlow was a high‐risk factor for B12‐def glossitis (OR: 92.44; 95% CI: 35.91, 238.02). Subgroup analyses in the case group showed that the G17hi PGIlow group presented with lower B12 levels and a lower positive rate of anti‐H. pylori antibodies compared to the non‐G17hi PGIlow group. Conclusion: Gastric serum biomarkers in patients with B12‐def glossitis generally showed G17hi PGIlow, suggesting possible atrophy of gastric corpus and fundus mucosa. The G17hi PGIlow and non‐G17hi PGIlow groups may represent different etiologies of B12 deficiency. [ABSTRACT FROM AUTHOR]

A 9-year-old spayed female 18.8 kg mixed breed boxer dog was referred for evaluation of a 7-month history of difficulty swallowing and prehending food, regurgitation, hypersalivation, and an abnormal dorsiflexion of the tongue. Prior to referral, a barium study was performed, which revealed a mildly dilated esophagus. Treatment with sucralfate, cisapride, and prednisone was initiated. Physical examination revealed bilateral, symmetric atrophy of the temporalis muscles, dorsiflexion of the distal aspect of the tongue with concurrent muscle atrophy, and a reduced gag reflex. Electrodiagnostic examinations revealed spontaneous electrical activity in the muscles of mastication and tongue. Biopsies from the right temporalis, tongue, and biceps femoris muscles were collected. An immune-mediated myositis with fibrosis, scattered CD3, CD4, and CD8+ T-lymphocytes, and upregulation of markers for major histocompatibility antigens were observed in the tongue and temporalis muscles. The dog was treated with a tapering course of prednisone over 2 months and cyclosporine long-term. The dog was maintained on cyclosporine alone for > 2 years and clinical signs remained static, although multiple episodes of aspiration pneumonia occurred. Ultimately, euthanasia was performed due to chronic kidney disease with associated anemia, lethargy, and anorexia.

Background The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. Many notable structural and functional alterations can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. Methods The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 to February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed on the tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend their tongue out. Medical history, drug history, and social history were recorded. Results The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were mostly in the anterior two-thirds (4.2%) of the tongue. Functional abnormalities of the tongue were noted in 8.7% of the study participants. Conclusions The results of the present study showed that structural and functional abnormalities of the tongue were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkups. This shall help in the prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

Actinomycosis is an uncommon, subacute to chronic, suppurative bacterial infection caused by Actinomyces Israelii. About 3% of all actinomycosis cases occur in the tongue, often affecting adult patients (mean age, 50 years). The clinical characteristics of actinomycosis can resemble malignant or benign tumors, and other infectious diseases. A 56-year-old woman was referred presenting an ulcerated lesion on the tongue 1 year ago. Intraoral examination revealed an edematous nodular lesion with an ulcerated surface, slightly symptomatic, on the midline dorsum of posterior tongue, suggesting nodular median rhomboid glossitis. Cytology smear was negative for fungus. After excisional biopsy, histopathological examination showed a chronic inflammatory infiltrate supported by a fibrovascular connective tissue stroma, and at the deepest part, broad basophilic areas surrounded by neutrophils, containing numerous filamentous bacilli, which were highlighted by Gram and Groccott-Gomori staining. The final diagnosis was lingual actinomycosis. Oral amoxicillin treatment (8/8 h for 2 weeks) was started, and after 1-month complete resolution was observed. Lingual actinomycosis is a rare lesion that must be recognized by dentists, because its early diagnosis and correct treatment reduce the possibility of a clinical complication that compromises the patient's quality of life. Noteworthy, when located on the midline dorsum of posterior tongue, actinomycosis can simulate nodular median rhomboid glossitis, expanding its spectrum of clinical differential diagnosis. [ABSTRACT FROM AUTHOR]

Background The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. Many notable structural and functional alterations can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. Methods The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 to February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed on the tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend their tongue out. Medical history, drug history, and social history were recorded. Results The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were mostly in the anterior two-thirds (4.2%) of the tongue. Functional abnormalities of the tongue were noted in 8.7% of the study participants. Conclusions The results of the present study showed that structural and functional abnormalities of the tongue were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkups. This shall help in the prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

Oral ulcer is a frequent condition that commonly affects the tongue and in which 75% of the patients experience pain, and 25% report taste changes. The available therapies are not sufficiently effective for rapid and complete healing of tongue ulcers. We previously annotated the metabolites of Thymus satureioides (TS) aerial parts and reported their antioxidant, dermacosmeceutical and hepatoprotective properties. In this study, we performed in silico analysis, by applying network pharmacology and molecular docking, followed by experimental validation of the effect of local application of T. satureioides (TS) gel at two different concentrations on the healing of acetic-acid-induced tongue ulcer in rats. Salvianolic acid A, phloretic acid caffeate, rosmarinic acid, apigenin, and luteolin were the top bioactive ingredients of TS extract. Network pharmacology showed that the most relevant targets of these active constituents were TLR4, COX-2, MMP-9, TNF-α, and Caspase-3. Molecular docking showed that rosmarinic acid and salvianolic acid had a relatively strong binding affinity, compared to the other compounds, toward all the target proteins. Experimental validation in tongue ulcer model in rats and immunohistochemistry experiments showed that application of a gel containing TS extract (5 and 10%) was effective in healing the tongue ulcer via downregulation of COX-2, TNF-α, MMP-9, and Caspase-3. This study suggests that T. satureioides extract could act as a topical treatment for tongue ulcers by combating inflammation, apoptosis, and proteolysis. The possible treatment potential of some constituents including rosmarinic acid and salvianolic acid in oral ulcerations awaits further investigations to confirm their potency. [ABSTRACT FROM AUTHOR]

Background: Early studies have highlighted the possible development of dysgeusia and anosmia in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and these manifestations should be considered a potential indication of coronavirus disease 19 (COVID-19). As potential contributors to these symptoms, dentists should perform careful oral and oropharyngeal examinations and document suspicious oral lesions in patients with COVID-19, especially in those who complain of loss of taste and smell. The study's objective was to assess the prevalence of oral manifestations among ambulatory unvaccinated symptomatic patients with suspected COVID-19 during the acute phase of the disease. Methods: This cross-sectional study evaluated oral manifestations in adults (aged ≥ 18 years) with suspected and confirmed SARS-CoV-2 infection. Chi-square and Fisher's exact tests were used to compare data between the groups (rRT-PCR-positive and rRT-PCR-negative patients). Results: One hundred thirty-six participants were included. Most were female (n = 79; 58.1%), with a mean age of 39.53 (± 14.17) years. Of these, 54 (39.7%) had a positive rRT-PCR test, and 82 (60.3%) had negative rRT-PCR results. Oral manifestations were observed in 40 participants (74.1%) in the rRT-PCR-positive group and 67 participants (81.7%) in the rRT-PCR-negative group. The most common oral manifestations were xerostomia (n = 85; 62.5%) and dysgeusia/ageusia (n = 57; 41.9%). Different rates of gingivitis (n = 12; 22.2% vs. n = 5; 6.1%; p = 0.005) and halitosis (n = 7; 13.0% vs. n = 1; 1.2%; p = 0.007) were observed between the rRT-PCR-positive and -negative groups, respectively. Mouth ulcers, glossitis, tongue coating, and petechiae were reported in both groups without significant differences. Conclusions: A high prevalence of oral manifestations was observed in symptomatic patients with suspected or confirmed COVID-19. Clinical Relevance: This study highlights the importance of routine oral examinations by dentists as part of the multidisciplinary care of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the therapeutic effectiveness of low-intensity laser irradiation in the treatment of patients with oral mucosal diseases in association with rheumatoid arthritis, according to parameters of Doppler ultrasonography of blood flow of lingual arteries. Materials and Methods: An examination of 25 patients with geographic tongue and concomitant rheumatoid arthritis and 12 practically healthy persons of the control group was carried out. In the main group (13 patients) the complex treatment of glossitis was carried out with non-contact laser irradiation of the affected tongue areas. Patients in the comparison group (12 persons) underwent standard treatment. Treatment effectiveness of patients in both groups was determined by the parameters of Doppler blood flow study of lingual arteries. Results: In the main group of patients, after diode laser therapy, a significant decrease in linear blood flow parameters (Vmax by 19.7%, TAMAX by 19.6%), an identical increase in volume velocity (Q by 21%) and an improvement in vascular tone and peripheral resistance (Pourcelot index by 12.5%, Gosling index by 13.1%) were observed. At the same time, a slight increase in the linear and volume velocity characteristics of blood circulation in lingual arteries during treatment of patients in the comparison group was not statistically significant (p>0.05) and with a high degree of probability differed from the control group. Conclusions: The use of low-intensity laser irradiation in the management of patients with oral mucosal diseases associated with rheumatoid arthritis contributes to the normalization of hemodynamics and the functional state in the vascular bed of the tongue. [ABSTRACT FROM AUTHOR]

Background: The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. There are a number of notable structural and functional alterations that can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the present study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. Methods: The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 and February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed pertaining to tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend the tongue out. Medical history, drug history and social history were recorded. Results: The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were most in the anterior two thirds (4.2%) of the tongue. Conclusions: The results of the present study showed that tongue lesions were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkup. This shall help in prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

A complete postmortem examination, including a computed tomography scan “virtopsy” (virtual necropsy), gross necropsy, cytology, histology, and molecular diagnostics were performed to investigate the cause of death of a deceased adult male Atlantic spotted dolphin (Stenella frontalis) that stranded on Pensacola Beach, Florida, USA in February 2020. Significant findings included chronic inflammation of the meninges, brain, and spinal cord with intralesional protozoa (identified as Sarcocystis speeri via 18S rRNA and ITS-1 sequences), suppurative fungal tracheitis and bronchopneumonia (identified as Aspergillus fumigatus via ITS-2 gene sequence) and ulcerative bacterial glossitis (associated with a novel Treponema species, Candidatus Treponema stenella, identified via 23S rRNA gene sequence). This is the first reported case of S. speeri in a marine mammal. Little is understood about the epidemiology of S. speeri, including the identity of its intermediate hosts. The findings of this case suggest that S. frontalis may be a capable aberrant host and experience morbidity and mortality from this parasite. It is suspected that the novel Treponema and Aspergillus fumigatus infections were opportunistic or secondary to immunosuppression, either due to S. speeri infection or other co-morbidities.

Background: Geographic Tongue (GT) is a benign inflammatory disorder of unknown etiology, which is characterized by the loss of epithelium due to the atrophy of filiform papillae. It usually occurs on the dorsum of the tongue and may extend to its lateral edges. It appears as an erythematous area surrounded by whitish and slightly elevated margins. In most cases, the condition is asymptomatic, although some individuals may report symptoms that include a burning sensation of the tongue. Objective: Assess whether there was a change in the clinical aspect of Geographic Tongue (GT) during the COVID-19 pandemic. Methods: Thirty-two participants were recruited from Dentistry School Universidade Federal Fluminense. Anamnesis and oral examination were performed to collect medical history. The participants were split into two groups: control group (no GT) n = 20 and test group (with GT) n = 12. In the second step, nine participants from a 12 (75%) of the test group were contacted by phone and answered a questionnaire about changes in the signs and symptoms of GT during the pandemic. The subjects were subdivided into two groups: GT with and without signs and symptoms exacerbation. Results: In the first phase of the research, no statistical difference between control and test groups was observed regarding clinical criteria such as age (p + 0.72), gender (p = 0.24), and systemic diseases (p = 0.58). In the second phase, there was a statistical difference between GT groups with or without symptom exacerbation in terms of age and stress as a factor of the oral symptoms (p = 0.3 and 0.2), respectively. Younger patients showed a worsening of the oral lesions related to GT (p = 0.3) and reported stress during the pandemic (p = 0.02). Conclusion: Younger patients were more susceptible to stress and presented more exacerbation of the oral lesions related to GT. [ABSTRACT FROM AUTHOR]

A 3-year-old, intact female mixed-breed dog, weighing 7 kg, was presented with generalised swelling of the tongue, leading to impaired deglutition and episodes of dyspnoea. From the age of 2 years, the dog had been under immunosuppressive therapy due to atopic dermatitis. Multiple nodular lesions at the apex of the tongue were noted as well as mandibular and retropharyngeal lymph node enlargement. Serum biochemistry results showed inflammatory changes. The results of several biopsies taken over 7 months indicated persistent pyogranulomatous and necrotising glossitis despite ongoing antimicrobial treatment, first with amoxicillin/clavulanic acid and then pradofloxacin. No foreign material, acid-fast bacteria or fungal hyphae were detected throughout. The final diagnosis of Mycobacterium avium subsp. hominissuis (Mah) was reached after PCR and bacterial culture were carried out on the third biopsy sample. Therapy was initiated with rifampicin, clarithromycin and doxycycline, leading to complete remission of the lesions. Severe chronic pyogranulomatous and necrotising glossitis associated with infection by Mah. This report describes challenges in the diagnosis and therapy of a localised Mah infection in an iatrogenically immunocompromised dog. Successful treatment was only achieved with a specific combination of antibiotics administered long-term. AF: Acid-fast; ALP: Alkaline phosphatase; CT: Computed tomography; MAC: Mycobacterium avium complex; Mah: Mycobacterium avium subsp. hominissuis [ABSTRACT FROM AUTHOR]

Background: Existing studies have reported the significant association between atrophic glossitis (AG) and hematinic deficiencies, including iron, folate and vitamin B12 deficiency. However, these findings were inconsistent. AG can be graded as partial or complete atrophy. It is still unclear whether hematinic deficiencies are associated with the grading of AG. Methods: 236 AG patients and 208 sex- and age-matched healthy controls were enrolled in this study. Hematological tests including complete blood count, and serum levels of folate, ferritin and vitamin B12 were performed. The AG group was divided into those with partial AG and those with complete AG according to the extent of papillary atrophy. Statistical analysis was performed to assess whether hematinic deficiencies are risk factors for AG and its grading. Results: Compared with the healthy controls, AG patients had significantly higher frequencies of vitamin B12 deficiency (68.22%), ferritin deficiency (13.98%) and anemia (21.61%). The differences in hematinic deficiencies and anemia between AG patients and healthy controls changed according to gender and age. The frequencies of serum vitamin B12 deficiency and anemia in the complete AG subgroup were significantly higher than those in the partial AG subgroup. Logistic regression analysis revealed that vitamin B12 deficiency and anemia were significantly correlated with AG and its grading. The AG patients with vitamin B12 deficiency responded well to supplement therapy. Conclusion: AG could be an important clinical indicator for potential vitamin B12 deficiency, especially when the degree of tongue atrophy more than 50% and complete atrophy. Vitamin B12 deficiency might play an etiological role in the development of AG. [ABSTRACT FROM AUTHOR]

: Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, and 11.9% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, and hyperhomocysteinemia, respectively. This study mainly evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 224 younger (≤50 years old) and 840 older (>50 years old) AG patients. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, and homocysteine levels in 224 younger and 840 older AG patients were measured and compared with the corresponding levels in 112 younger (≤50 years old) and 420 older (>50 years old) healthy control subjects (HCSs), respectively. We found that 224 younger AG patients had significantly lower mean blood Hb and serum iron levels than 112 younger HCSs. Moreover, 840 older AG patients had significantly lower mean blood Hb and serum iron levels and a significantly higher mean serum homocysteine level than 420 older HCSs. In addition, 224 younger AG patients had significantly lower mean serum vitamin B12 and folic acid levels, a lower mean serum homocysteine level (marginal significance, P = 0.056), a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than 840 older AG patients. The younger AG patients do have significantly lower mean serum vitamin B12 and folic acid levels, a significantly higher frequency of serum iron deficiency, and a significantly lower frequency of hyperhomocysteinemia than the older AG patients. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Adverse events following immunization (AEFIs) remain under recognized, particularly when the symptoms experienced are uncommon and mimic natural disease. In the context of the worldwide effort to provide protection against SARS-CoV-2 using multiple doses of vaccination and with the availability of multiple vaccines, the early recognition and prompt treatment of AEFIs has increased importance, as does the ability to carefully select an alternative after an AEFI occurs. Case Report: A 60-year-old woman presented for clinical immunology review with a 9-month history of glossitis and xerostomia. Onset of symptoms occurred following her first vaccination with a COVID-19 vaccine (BNT162b2). After partial interval improvement, her symptoms progressively worsened after a second vaccination and third booster vaccination with BNT162b2. While undergoing reviews from multiple specialists for possible underlying connective tissue disease, and with other causes of her symptoms being excluded, the patient’s symptoms progressed, with worsening tongue swelling with new fissuring and xerostomia. The patient experienced an unintentional weight loss of 8 kg due to oral discomfort. It was only after this time that an AEFI was considered the cause of her presentation, after all other diagnostic considerations were considered unlikely. Targeted, symptomatic, localized treatment with topical oral corticosteroids was initiated, followed by a gradual tapering regimen, with excellent response. Conclusions: This case highlights the need to consider AEFIs early in the differential diagnosis of unusual presentations and the importance of considering a trial of targeted symptomatic treatment for patients, even if diagnostic uncertainty remains. [ABSTRACT FROM AUTHOR]

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Abstract Background Nutritional deficiencies are common worldwide and is most notable in low and middle income countries. In the early weeks of September 2018, oral sores mostly affecting the tongue were reported in three central schools under Tsirang district, Bhutan. A total of 204 students were affected in the three central schools. All the affected students have been assessed on the outbreak and nutritional survey was conducted in the three schools. Methods A total of 204 students who complained of different oral lesions in the affected three schools were screened by the dental surgeon for clinical assessment and administered questionnaire for nutritional assessment by the nutritionist. Twenty-one students randomly selected were sent for blood tests for micronutrient assays and complete blood count. 41 students were tested for Exfoliative cell cytology to test for fungal elements. The collected data was double entered and validated using Epi-Data version 3.1 and analysed using Stata 15 IC. The characteristics of the participants are presented as frequencies, percentages, mean and standard deviation (SD). Results Almost all the affected students in all the three schools had complaints of Burning Sensation (n = 158) followed by Pain (n = 153), Impaired Taste Sensation (n = 100) and Intolerance to Spicy Food (n = 95). Nutritional assessment analysis suggested schools not meeting the Recommended Dietary Allowance (RDA) for all components of Vitamin B complexes and Iron. Conclusion Clinical assessments and nutritional survey analysis found inadequate vitamin rich dietary intakes among all the three schools. Implementation of a strict school feeding program with a balanced diet has been suggested accordingly.

A 35- year- old woman presented with massive enlargement of the tongue. She had suffered this problem since a week ago when her tongue became enlarged with a sudden onset and eventually did not fit her mouth. Chronic tongue enlargement since childhood is noted. Patient had history of mental problems, namely cerebral palsy, and as she is not able to walk, she uses a wheelchair. Furthermore, due to severe scoliosis, right lung was atelectatic.Soon after initial assessments, she was carried to surgery room and as she could not lie down to supine position, was intubated in sitting position with a rigid laryngoscope. During the whole process, patient was sedated. Afterwards, tracheostomy was per- formed.After 5 days, no improvement in the size of tongue was observed. Diagnosis was revised in a medical commission and despite inflammatory pathology, the bulging tongue was resected.After recovery, patient could bear oral feeding and was dismissed with good general health. After a week, the devised airway created by tracheostomy was removed with- out any complication. During one-year follow up, no sequelae were observed.

Abstract This study evaluated the presence of oral lesions in patients with COVID-19 hospitalized in an intensive care unit (ICU). Data included demographic, clinical, and laboratory information. Clinical assessment of the oral cavity was performed on the 2 nd and 5 th days of orotracheal intubation. Thirty-eight patients were evaluated and 16 (42.1%) presented oral lesions during their ICU stay. The median age and length of stay were 75 years and 15 days, respectively. Among the patients with oral lesions, ulcerative oral lesions were reported in 14 (87.5%) patients, of which 11 (78.6%) were found on the lips. This study highlights the importance of oral examination for patients admitted to the ICU with COVID-19.

This article discusses a case report of a Japanese woman in her 50s who developed glossitis, an inflammation of the tongue, along with autoimmune gastritis and pernicious anemia. The patient had a history of type 1 diabetes mellitus and Hashimoto's thyroiditis, and her glossitis worsened over time, leading to anemia. Gastrointestinal endoscopy revealed advanced atrophic gastritis primarily affecting the gastric corpus. The patient was diagnosed with Hunter's glossitis, pernicious anemia, and autoimmune gastritis, and was treated with vitamin B12 injections, resulting in improvement. The article emphasizes the importance of considering vitamin B12 deficiency and autoimmune gastritis in patients with glossitis and autoimmune thyroid diseases or type 1 diabetes mellitus. [Extracted from the article]

Our previous study found that 19.0%, 16.9%, 5.3%, 2.3%, 11.9%, and 26.7% of 1064 atrophic glossitis (AG) patients have anemia, serum iron, vitamin B12, and folic acid deficiencies, hyperhomocysteinemia, and serum gastric parietal cell antibody (GPCA) positivity, respectively. This study evaluated the anemia, hematinic deficiencies, and hyperhomocysteinemia in 150 male and 914 female AG patients. The blood hemoglobin (Hb) and serum iron, vitamin B12, folic acid, homocysteine, GPCA levels in 150 male and 914 female AG patients were measured and compared with the corresponding levels in 75 male and 457 female healthy control subjects (HCSs), respectively. We found that 150 male AG patients had significantly lower mean blood Hb, serum iron, vitamin B12, and folic acid levels, and significantly higher mean serum homocysteine levels than 75 male HCSs. Moreover, 914 female AG patients had significantly lower mean blood Hb and serum iron levels and significantly higher mean serum homocysteine level than 457 female HCSs. In addition, 150 male AG patients had significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiency and hyperhomocysteinemia than 914 female AG patients. The male AG patients do have significantly higher mean blood Hb and serum homocysteine levels, significantly lower mean serum vitamin B12 and folic acid levels, and significantly higher frequencies of Hb, vitamin B12, and folic acid deficiencies and hyperhomocysteinemia than the female AG patients. [ABSTRACT FROM AUTHOR]

Vitamins are organic compounds present in low concentrations in food, performing vital and specific cell metabolism functions. Vitamin B12 is essential for red blood cell formation in the bone marrow and its deficiency is caused, mainly, by gastrointestinal malabsorption. In addition to systemic manifestations, oral signs and symptoms have also been associated to this condition such as glossitis, papillary atrophy, painful erythema areas, burning sensation, dysgeusia, lingual paresthesia and itching. This study aims to report four cases of oral manifestations caused by vitamin B12 deficiency. All patients presented oral mucosa lesions. Vitamin B12 deficiency was diagnosed based in clinical characteristics and complementary exams. Oral supplementation for vitamin B12 deficiency was conducted/realized in three patients, while one patient was treated with parenteral doses. All of them showed partial or total remission of the signs and symptoms. [ABSTRACT FROM AUTHOR]

Migratory stomatitis (MS) is an uncommon inflammatory condition with unclarified etiology, which despite its benign nature, may raise concerns for patients and diagnostic difficulties for professionals. This case report aims to describe the clinical features of a patient who presented with MS in conjunction with benign migratory glossitis (BMG), and its diagnostic process and management. The patient, a 25-year-old man, sought diagnosis of an oral condition, with cyclic behavior, which had been causing him great discomfort for a year. The patient presented erythematous patches on his lower lips and right side of the buccal mucosa, surrounded by a slightly elevated halo with a concomitant classical picture of BMG. After analysis of his entire symptomatology, the diagnosis of MS associated with BMG was concluded. The patient received clear explanations and symptomatic treatment. The diagnosis of MS may be challenging, even to oral medicine practitioners, especially if it occurs alone. MS with concurrent manifestation of BMG may make the conditions easier to diagnose, but it does not exclude the need to apply a complete process of differential diagnosis to rule out other similar possibilities. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory dermatological disease that affects approximately 2% of the population. It is related to geographic tongue (GT) because both present similar clinical, histopathological, and genetic patterns, suggesting that GT could represent an oral manifestation of psoriasis. The objective of this study is to assess the possible relationship between psoriasis and its possible oral manifestations such as GT and/or fissured tongue (FT). A search for the articles on psoriasis and tongue or oral mucosa was performed in the next electronic databases: PubMed (MEDLINE and Cochrane Library), Web of Science, and Spanish Medical Index (SMI). From 175 potentially eligible articles, 151 were excluded for the several reasons: articles without full-text availability (119) and studies without clinical or usable data (32). Finally, 24 studies were included in this meta-analysis. The data were analyzed using the statistical software RevMan 5.4 (The Cochrane Collaboration, Oxford, UK). For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (OR) with 95% confidence intervals. Among patients with psoriasis, 8.6% had a GT and 28.2% had a FT. Psoriasis patients were more likely to present both GT (OR: 3.61, P < 0.001) or FT (OR: 2.84, P < 0.001). Regarding the expression of histocompatibility antigens, patients with psoriasis and GT more frequently expressed type B13 and B57 antigens, whereas controls without psoriasis or GT showed more types B15, B17, B40, B58, C04, Cw6, DR5, and DRw6 antigens. Geographical tongue and FT are most often observed in patients with psoriasis.

Introduction: Chronic mucocutaneous candidiasis (CMC) is characterized by the occurrence of chronic or recurrent infections caused by yeasts of the genus Candida. Infections can affect the skin and mucous membranes, mainly the oral mucosa. We report the case of a patient with CMC with recurrent oral damage associated with a heterozygous gain-of-function mutation in the STAT1 gene. Observation: A young Morrocan 30-year-old was referred to oral surgery department following the occurrence of recurrent oral ulcers leading to difficulty in tooth brushing and dysphagia. The patient had been followed since the age of 2 for mycobacterial and viral infections. Exome sequencing identified a heterozygous gain-of-function mutation in the STAT1 gene confirming the diagnosis of CMC with oral involvement. Comments: CMC usually starts in early childhood and can lead to fungal, bacterial and viral infections, as well as carcinomas. Mucosal-cutaneous fungal infections mainly affect the oral mucosa. Mutations in the gene encoding the signal transducer and activator of transcription protein-1 (STAT1) are the most commonly reported cause of CMC. The treatment is multidisciplinary. The goal is to treat Candida infection and its repercussions especially on the oral cavity.

This study evaluated the presence of oral lesions in patients with COVID-19 hospitalized in an intensive care unit (ICU). Data included demographic, clinical, and laboratory information. Clinical assessment of the oral cavity was performed on the 2nd and 5th days of orotracheal intubation. Thirty-eight patients were evaluated and 16 (42.1%) presented oral lesions during their ICU stay. The median age and length of stay were 75 years and 15 days, respectively. Among the patients with oral lesions, ulcerative oral lesions were reported in 14 (87.5%) patients, of which 11 (78.6%) were found on the lips. This study highlights the importance of oral examination for patients admitted to the ICU with COVID-19. [ABSTRACT FROM AUTHOR]

Atrophic glossitis is a common disease in oral mucosal diseases. The Current studies have found the human oral cavity contains numerous and diverse microorganisms, their composition and diversity can be changed by various oral diseases. To understand the composition and diversity of oral microbiome in atrophic glossitis is better to explore the cause and mechanism of atrophic glossitis. The salivary microbiome is comprised of indigenous oral microorganisms that are specific to each person, exhibits long-term stability. We used llumina MiSeq high-throughput sequencing based on the V3-V4 region of the bacterial 16S rRNA gene and the internal transcribed spacer (ITS) region of fungal rRNA genes from saliva in atrophic glossitis patients and healthy individuals to explore the composition and diversity of oral microbiome. In our reports, it showed a lower diversity of bacteria and fungi in atrophic glossitis patients than in healthy individuals. The data further suggests that Lactobacillus and Saccharomycetales were potential indicators for the initiation and development of atrophic glossitis. Moreover, we also discuss the relationship between the oral microbial ecology and atrophic glossitis. [ABSTRACT FROM AUTHOR]