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To compare the efficacy of intraoral (IOPBM) and extraoral photobiomodulation (EOPBM) protocols in the management of oral mucositis (OM) in pediatric patients. This is a randomized, blinded clinical trial. Ten pediatric oncology patients were included and randomized into 2 groups: the IOPBM group (n = 5) received intraoral PBM using low-level laser, and the EOPBM group (n = 5) received extraoral PBM using defocused high-power laser. PBM therapy was administered to all patients, with a mean follow-up period of 8.8 days. Patients were evaluated daily, and OM was classified according to the World Health Organization and National Cancer Institute (NCI) scales. Additionally, oral pain, functional scores (chewing, dysphagia, fluid intake, and dysgeusia), and comfort with the procedure were assessed. Eight boys and 2 girls were included, with an average age of 8.4 years. Diagnoses included 50% acute lymphoblastic leukemia, 30% lymphomas, and 20% osteosarcoma. OM was classified by World Health Organization as grade 0 (10%), 1 (30%), 2 (50%), and 3 (10%). No patient experienced grade 4 OM. The mean duration of grade 2 OM was 2.2 days, and grade 3 was 1 day. No differences were observed between groups regarding OM grades, duration of OM, functional score, and comfort. Pain scores were similar between groups on days 3, 10, and 14. On Day 7, EOPBM exhibited a pain score of 2.2, which was higher than IOPBM (P =.018). EOPBM could be considered as effective as IOPBM in the prevention and treatment of OM in pediatric oncology patients. [ABSTRACT FROM AUTHOR]

Background: Although the paracoccidioidomycosis (PCM) is endemic in Brazil, the occurrence in most states from the North and Northeastern Brazil is very unusual. The aim of this study was to evaluate the clinicopathologic features of a case series of oral PCM in a non-endemic region from Brazil (Northeastern region), discussing the clinical and histopathological differential diagnoses of the oral manifestations of the disease., Material and Methods: Between 2000 and 2017, all cases of oral PCM were retrieved from the Oral Pathology Laboratory, Universidade Federal de Pernambuco, located at Northeastern Brazil. Clinical data, such as age, gender, origin, occupation, site, symptoms, time of complaints, clinical presentation, number of lesions, and clinical hypotheses of diagnosis, were collected from the clinical charts. All cases were histologically reviewed in hematoxylin-eosin and Gomori-Grocott staining., Results: Six cases were identified. All patients were male, with a mean age of 53.8 years (ranging from 40 to 73 years). Four cases appeared as multiple ulcers and two presented single lesions (buccal mucosa and hard palate). Clinically, in five cases, squamous cell carcinoma was considered in the differential diagnosis. The common histopathological features consisted of hyperplastic epithelium, intraepithelial microabscesses, and formation of granulomatous chronic inflammatory reaction in a fibrous connective tissue with severe chronic inflammatory reaction. Yeasts were observed either inside of multinucleated giant cells or extracellularly., Conclusions: Although rare in non-endemic regions, oral PCM should be considered in the differential diagnosis of oral chronic ulcers, mainly those multiple. Key words: Oral mucosa, mycology, paracoccidoidomycosis, ulcer., Competing Interests: Conflict of interest statement:The authors declare no conflict of interest., (Copyright: © 2019 Medicina Oral S.L.)