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Lee YP, Hwang MJ, Jin YT, Chiang CP. Traumatic ulcerative granuloma with stromal eosinophilia at the lateral border of the tongue. J Dent Sci 2024; 19:701-703. [PMID: 38303858 PMCID: PMC10829733 DOI: 10.1016/j.jds.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Indexed: 02/03/2024] Open
Affiliation(s)
- Yi-Pang Lee
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ming-Jay Hwang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan
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Sharma A, Hayes K, Roberts MB, Georgolios A. A Case of Traumatic Ulcerative Granuloma With Stromal Eosinophilia in a 55-Year-Old Woman. EAR, NOSE & THROAT JOURNAL 2023:1455613231215172. [PMID: 38093512 DOI: 10.1177/01455613231215172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Affiliation(s)
- Aayush Sharma
- Chicago Medical School, Rosalind Franklin University, North Chicago, IL, USA
| | - Kelsey Hayes
- Arkansas College of Osteopathic Medicine, Fort Smith, AR, USA
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Kacar S, Duprez T, Gheysens O, Schmitz S, Van Eeckhout P. Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE): Case report of a 63-year-old male patient with a rare self-healing oral mucosal lesion. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023:101514. [PMID: 37207961 DOI: 10.1016/j.jormas.2023.101514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/21/2023]
Abstract
Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE)/Riga Fede disease is a rare mucosal and submucosal benign reactive inflammatory process, usually involving the tongue. Trauma is believed to be a major factor amongst the multiple pathogenic mechanisms that have been hypothesized in TUGSE. The lesion presents as an isolated indurated or even ulcerated mass, which may mimic, clinically a squamous cell carcinoma (SCC). We herein report a case of TUGSE in a 63-year-old male referred by his treating physician for high suspicion of tongue malignancy. Histopathological examination confirmed the diagnosis of TUGSE, without any evidence of a neoplasic, infectious or hematologic process. TUGSE occurs in patients with an age range of 41-60 years. Sufficiently deep biopsies with comprehensive immunohistochemical and molecular analyses are mandatory to confirm the benign nature of the lesion and to, definitely, rule out malignancy. This report highlights the need for adequate histological differential diagnosis to avoid inappropriate heavy treatments in a benign condition.
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Affiliation(s)
- Serife Kacar
- Department of Pathology, Saint-Luc University Clinics, Université Catholique de Louvain, Belgium
| | - Thierry Duprez
- Department of Medical Imaging, Saint-Luc University Clinics, Université Catholique de Louvain, Belgium
| | - Olivier Gheysens
- Department of Nuclear Medicine, Saint-Luc University Clinics, Université Catholique de Louvain, Belgium
| | - Sandra Schmitz
- Department of Ear-Nose-Throat, Saint-Luc University Clinics, Université Catholique de Louvain, Belgium
| | - Pascal Van Eeckhout
- Department of Pathology, Saint-Luc University Clinics, Université Catholique de Louvain, Belgium.
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S Shah A, Kurago Z, Bindakhil M. Clinical considerations associated with traumatic ulcerative granuloma with stromal eosinophilia. Int J Dermatol 2021; 61:e272-e274. [PMID: 34171122 DOI: 10.1111/ijd.15732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Ashna S Shah
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta, GA, USA
| | - Zoya Kurago
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta, GA, USA
| | - Mohammed Bindakhil
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta, GA, USA
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Vargo RJ, Qureshi A. A painful ulceration of the buccal mucosa. J Am Dent Assoc 2020; 152:866-871. [PMID: 33158494 DOI: 10.1016/j.adaj.2020.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/12/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022]
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Clinical characteristics and risk factors of major oral ulcers in the mandibular retromolar region in children. Clin Oral Investig 2020; 25:3505-3512. [PMID: 33145696 DOI: 10.1007/s00784-020-03672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To describe the characteristics of major aphthous ulcers (MjOU) in children and analyze its potential risk factors. MATERIALS AND METHODS Data were collected from the National Clinical Research Center for Oral Diseases of China between 2012 and 2017. Children younger than 15 years old, who had a giant mucosa ulcer (≥ 1 cm in diameter) and met the diagnostic criteria for MjOU were included in this study. Differences were compared between two subgroups of patients based on the location of the ulcerous lesions. A measurement of ratio (TBR) between the length of the mandibular second molar tooth germ and the height of the mandible was performed in children with MjOU lesions located in the mandibular retromolar pad region (MjOU-P) and their age- and sex-matched controls. RESULTS A total of 1067 children were diagnosed with oral ulcers during the study period, of which 125 (11.7%, 95% CI: 9.8%-13.7%) met the diagnostic criteria for MjOU. More than half (n = 64, 51.2%) of the MjOU cases were MjOU-P, which had a male predilection (n = 52, 81.3%) with a significant majority at 7 to 9 years of age (n = 43, 67.2%). In comparison to the MjOU located in other regions, MjOU-P lasted longer in duration and had more comorbidities. Logistic regression analysis showed that MjOU-P was statistically significantly associated with TBR controlling age and gender. CONCLUSIONS MjOU-P is a predominant form of MjOU in children and is a distinct subgroup of major ulcers that is likely associated with the development of the mandibular second molars. CLINICAL RELEVANCE This study is the first to describe the demographic and clinical features of MjOU in children, which may facilitate the identification and treatment of these patients.
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Hannan TA, Umer M, Syed L, Anis‐Alavi MA. A case report of traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) in a 21-year-old. Clin Case Rep 2020; 8:2214-2216. [PMID: 33235761 PMCID: PMC7669417 DOI: 10.1002/ccr3.3188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 11/10/2022] Open
Abstract
We present an unusual case of a persistent solitary left palatoglossal ulcer with no history of trauma or associated risk factors. A TUGSE lesion, which mimics that of malignancy, must always be noted as a differential even in risk factor absence.
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Affiliation(s)
| | - Muhammed Umer
- Barts and The London School of Medicine and DentistryLondonUK
| | - Labib Syed
- Barts and The London School of Medicine and DentistryLondonUK
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Atarbashi-Moghadam S, Lotfi A, Ghaedsharafi Y, Atarbashi-Moghadam F, Sijanivandi S. A painless, indurated ulcer of the tongue. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:317-319. [PMID: 31866413 DOI: 10.1016/j.jormas.2019.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 12/11/2019] [Indexed: 11/30/2022]
Affiliation(s)
- S Atarbashi-Moghadam
- Department of Oral and Maxillofacial Pathology, School of dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Lotfi
- Department of Oral and Maxillofacial Pathology, School of dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Y Ghaedsharafi
- Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - F Atarbashi-Moghadam
- Department of Periodontology, School of dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - S Sijanivandi
- Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Setti G, Martella E, Mancini C, Vescovi P, Magnoni C, Bellini P, Giovannacci I, Meleti M. Self-healing CD30- T-clonal proliferation of the tongue: report of an extremely rare case. BMC Oral Health 2019; 19:186. [PMID: 31416455 PMCID: PMC6694504 DOI: 10.1186/s12903-019-0875-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 08/02/2019] [Indexed: 11/10/2022] Open
Abstract
Background The etiology of traumatic ulcerative granulomas with stromal eosinophilia (TUGSE) is not clear, traumatic irritation having advocated as the most likely cause. TUGSEs are typically self-limiting slow-healing lesions of the oral mucosa with unclear pathogenesis, commonly manifesting as a rapidly developing, long-lasting ulcer. Case presentation Here we report a controversial case of a self-healing lesion of the tongue in a 57 year-old woman. A clonal T-cell proliferation and CD30 negative immunohistochemical (IHC) profile could be documented. Discussion and conclusion In view of the very peculiar clinical and histological features, a retrospective diagnosis of a TUGSE with scarce eosinophilic infiltrate (possibly in regression), displaying CD30- T-clonal proliferation was eventually rendered. The patient did not report signs of recurrence after a 3-year follow-up period.
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Affiliation(s)
- Giacomo Setti
- Dipartimento di Medicina e Chirurgia, Reparto di Patologia e Chirurgia Orale Laser, Centro Universitario di Odontoiatria, Università di Parma, via Gramsci 14, 43126, Parma, Italy.
| | - Eugenia Martella
- Dipartimento Diagnostico, Unità Operativa Complessa di Anatomia e Istologia Patologica, Azienda Ospedaliero Universitaria di Parma, via Gramsci, 14, 43126, Parma, Italy
| | - Cristina Mancini
- Dipartimento Diagnostico, Unità Operativa Complessa di Anatomia e Istologia Patologica, Azienda Ospedaliero Universitaria di Parma, via Gramsci, 14, 43126, Parma, Italy
| | - Paolo Vescovi
- Dipartimento di Medicina e Chirurgia, Reparto di Patologia e Chirurgia Orale Laser, Centro Universitario di Odontoiatria, Università di Parma, via Gramsci 14, 43126, Parma, Italy
| | - Cristina Magnoni
- Dipartimento Chi.Mo.Mo., Struttura Complessa di Dermatologia, Università di Modena e Reggio Emilia, Largo del Pozzo 71, 41125, Modena, Italy
| | - Pierantonio Bellini
- Dipartimento Chi.Mo.Mo., Struttura Complessa di Odontoiatria e Chirurgia Oro-maxillofacciale, Università di Modena e Reggio Emilia, Largo del Pozzo 71, 41125, Modena, Italy
| | - Ilaria Giovannacci
- Dipartimento Chi.Mo.Mo., Struttura Complessa di Dermatologia, Università di Modena e Reggio Emilia, Largo del Pozzo 71, 41125, Modena, Italy
| | - Marco Meleti
- Dipartimento di Medicina e Chirurgia, Reparto di Patologia e Chirurgia Orale Laser, Centro Universitario di Odontoiatria, Università di Parma, via Gramsci 14, 43126, Parma, Italy
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Fantozzi PJ, Treister N, Shekar R, Woo SB, Villa A. Intralesional triamcinolone acetonide therapy for inflammatory oral ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:485-490. [PMID: 31466871 DOI: 10.1016/j.oooo.2019.07.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 07/17/2019] [Accepted: 07/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to report on the clinical indications and treatment outcomes of intralesional steroid therapy (IST) for oral ulcerative conditions in an oral medicine practice. STUDY DESIGN This was a retrospective single-center study of patients with oral ulcerative conditions treated with IST. Demographic data, clinical diagnosis of the oral condition, size of the ulcer, and pain were abstracted from patients' electronic medical records. RESULTS Ninety-three patients (51 females [54.8%]) were treated for persistent traumatic oral ulcers (n = 38 [40.8%]), ulcers in oral chronic graft-versus-host disease (n = 23 [24.7%]), oral lichen planus (n = 19 [20.4%]), and other conditions (14%). Complete resolution was achieved in 81.7% of patients in a median of 96 days (range 10-357 days), with 80% fully healed in a median of 84 days (range 10-140 days). Overall, patients received a median of 2 injections (range 1-5 injections) and a median dose of 12 mg per injection (range 2-36 mg). Nearly half the patients were also treated with concomitant topical steroid therapy. After the first injection, the median pain score reduced from 5 (range 1-10) to 1 (range 0-10; P < .001) and the median size of ulcers reduced from 1 cm (range 0.1-5 cm) to 0.3 cm (range 0-2 cm; P < .001). CONCLUSIONS IST may be an effective treatment for inflammatory and immune-mediated oral ulcers.
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Affiliation(s)
- Paolo J Fantozzi
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Revathi Shekar
- Consultant Oral Pathologist, and Oral Medicine Specialist, Bangalore, Karnataka, India
| | - Sook-Bin Woo
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
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12
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Fitzpatrick SG, Cohen DM, Clark AN. Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head Neck Pathol 2019; 13:91-102. [PMID: 30701449 PMCID: PMC6405793 DOI: 10.1007/s12105-018-0981-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 10/26/2018] [Indexed: 12/24/2022]
Abstract
Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.
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Affiliation(s)
- Sarah G Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA.
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Ashley N Clark
- Department of Diagnostic and Biomedical Sciences, University of Texas at Houston Health Science Center School of Dentistry, Houston, TX, USA
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Kuriyama Y, Shimizu A, Toki S, Endo Y, Yasuda M, Motegi SI, Ishikawa O. Two cases of chronic oral ulcers effectively treated with systemic corticosteroid therapy: Circumorificial plasmacytosis and traumatic ulcerative granuloma with stromal eosinophilia. J Dermatol 2018; 46:48-51. [DOI: 10.1111/1346-8138.14690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/01/2018] [Indexed: 12/14/2022]
Affiliation(s)
- Yuko Kuriyama
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Akira Shimizu
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Sayaka Toki
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Yukie Endo
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Masahito Yasuda
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Sei-ichiro Motegi
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
| | - Osamu Ishikawa
- Department of Dermatology; Gunma University Graduate School of Medicine; Maebashi Japan
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Anemia and hematinic deficiencies in oral mucosal disease patients with microcytosis. J Formos Med Assoc 2017; 116:505-511. [DOI: 10.1016/j.jfma.2017.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/03/2017] [Accepted: 02/07/2017] [Indexed: 11/21/2022] Open
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Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive and -negative recurrent aphthous stomatitis patients with anti-thyroid antibody positivity. J Formos Med Assoc 2017; 116:145-152. [DOI: 10.1016/j.jfma.2016.10.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 12/21/2022] Open
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Lin HP, Wu YH, Wang YP, Wu YC, Chang JYF, Sun A. Anemia and hematinic deficiencies in anti-gastric parietal cell antibody-positive or all autoantibodies-negative recurrent aphthous stomatitis patients. J Formos Med Assoc 2017; 116:99-106. [DOI: 10.1016/j.jfma.2016.10.006] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/09/2016] [Indexed: 01/17/2023] Open
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17
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Antigastric parietal cell and antithyroid autoantibodies in patients with recurrent aphthous stomatitis. J Formos Med Assoc 2017; 116:4-9. [DOI: 10.1016/j.jfma.2016.09.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 09/30/2016] [Indexed: 12/20/2022] Open
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Hematinic deficiencies and anemia statuses in recurrent aphthous stomatitis patients with or without atrophic glossitis. J Formos Med Assoc 2016; 115:1061-1068. [DOI: 10.1016/j.jfma.2016.10.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/08/2016] [Accepted: 10/14/2016] [Indexed: 01/18/2023] Open
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Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity. J Formos Med Assoc 2016; 115:1004-1011. [DOI: 10.1016/j.jfma.2016.09.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 09/22/2016] [Indexed: 01/23/2023] Open
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Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree. Int J Dent 2016; 2016:7278925. [PMID: 27781066 PMCID: PMC5066016 DOI: 10.1155/2016/7278925] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022] Open
Abstract
Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “oral ulcer,” “stomatitis,” and “mouth diseases.” Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression.
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