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Dos Santos ES, Rocha AFL, Leite AA, Gallagher KPD, Penafort PVM, Cintra ML, Vargas PA. A crateriform lesion on the upper lip. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:446-450. [PMID: 38519297 DOI: 10.1016/j.oooo.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Erison Santana Dos Santos
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Audrey Foster Lefort Rocha
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, Universidade Estadual Paulista (UNESP), São Paulo, Brazil
| | - Amanda Almeida Leite
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | | | - Maria Letícia Cintra
- Pathology Department, Dermatopathology Division, School of Medical Sciences, UNICAMP, Sao Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
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Zakariaei Z, Fakhar M, Bari S, Derakhshani M, Banimostafavi ES, Soleymani M. Nasal Leishmaniasis Misdiagnosed With Intranasal Polyp in a Patient Candidate for Rhinoplasty. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2023; 16:11795476231186913. [PMID: 37799763 PMCID: PMC10548795 DOI: 10.1177/11795476231186913] [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: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 10/07/2023]
Abstract
Mucosal leishmaniasis (ML) is a chronic and rare form of leishmaniasis that causes malignant lesions in the mucosa of the nasal, pharyngeal, and laryngeal regions. We describe a 29-year-old woman who had been suffering from an intranasal polyp for 3 years. The polyp recurred annually after surgical removal, and was diagnosed as nasal leishmaniasis.
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Affiliation(s)
- Zakaria Zakariaei
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahdi Fakhar
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Simin Bari
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Majid Derakhshani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elham Sadat Banimostafavi
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mostafa Soleymani
- Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
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3
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Rocha R, Pereira A, Maia C. A global perspective on non-autochthonous canine and feline Leishmania infection and leishmaniosis in the 21st century. Acta Trop 2023; 237:106710. [DOI: 10.1016/j.actatropica.2022.106710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/19/2022]
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Non-Endemic Leishmaniases Reported Globally in Humans between 2000 and 2021—A Comprehensive Review. Pathogens 2022; 11:pathogens11080921. [PMID: 36015042 PMCID: PMC9415673 DOI: 10.3390/pathogens11080921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Leishmaniases are human and animal parasitic diseases transmitted by phlebotomine sand flies. Globalization is an important driver of the burden and in the current dynamics of these diseases. A systematic review of articles published between 2000 and 2021 was conducted using the PubMed search engine to identify the epidemiology and clinical management of imported human leishmaniases as a fundamental step to better manage individual cases and traveler and migrant health from a global perspective. A total of 275 articles were selected, representing 10,341 human imported cases. Identified drivers of changing patterns in epidemiology include conflict and war, as well as host factors, such as immunosuppression, natural and iatrogenic. Leishmania species diversity associated with different clinical presentations implies diagnostic and treatment strategies often complex to select and apply, especially in non-endemic settings. Thus, diagnostic and management algorithms for medical clinical decision support are proposed. Increased surveillance of non-endemic cases, whether in vulnerable populations such as refugees/migrants and immunocompromised individuals or travelers, could improve individual health and mitigate the public health risk of introducing Leishmania species into new areas.
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Fleissig Y, Dan-Gur M, Michael-Gayego A, Maly A, Tabib R, Jaffe CL, Korem M. A trespasser from a foreign land? A case report of primary mucosal leishmaniasis. BMC Infect Dis 2022; 22:212. [PMID: 35241005 PMCID: PMC8892399 DOI: 10.1186/s12879-022-07169-w] [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: 10/21/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We report a clinically challenging and unusual case of L. donovani oral mucosal leishmaniasis. CASE PRESENTATION Israeli resident with a former travel to central and North Africa, with no documented or prior cutaneous lesions presented with oral lesions of the maxillary gingiva and the upper lip. A delay in diagnosis and treatment have led to progression of the maxillary gingival lesions towards the hard palatal and the soft palate that could have potentially compromised the upper airway. CONCLUSIONS This case highlights the importance of early diagnosis of leishmaniasis in patients with oral lesions and the laboratory workup necessary to appropriately characterize and treat the disease.
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Affiliation(s)
- Yoram Fleissig
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem, 9112102, Israel. .,Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel.
| | - Mary Dan-Gur
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,National Center for Leishmaniasis, Kuvin Center for Study of Tropical and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Ayelet Michael-Gayego
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Alexander Maly
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Pathology, Hadassah Medical Center, Jerusalem, Israel
| | - Rami Tabib
- Faculty of Dental Medicine, Hebrew University of Jerusalem, PO Box 12272, Jerusalem, 9112102, Israel.,Department of Oral and Maxillofacial Surgery, Hadassah Medical Center, Jerusalem, Israel
| | - Charles L Jaffe
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,National Center for Leishmaniasis, Kuvin Center for Study of Tropical and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
| | - Maya Korem
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Clinical Microbiology and Infectious Diseases, Hadassah Medical Center, Jerusalem, Israel
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6
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Botelho MCB, Ferreira LL, Fikaris S, Prado-Ribeiro AC, Soubhia AMP, Biasoli ER, Miyahara GI, Bernabé DG. Tongue Nodule as Primary Manifestation of American Cutaneous Leishmaniasis in an Immunocompetent Patient. Head Neck Pathol 2021; 15:1069-1073. [PMID: 33372239 PMCID: PMC8384968 DOI: 10.1007/s12105-020-01253-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/17/2020] [Indexed: 01/01/2023]
Abstract
Leishmaniasis is a parasitic disease considered an endemic public health problem in developing countries, where it is a reportable disease. Isolated oral manifestation is rare, and its clinical manifestations are variable. In this paper we describe an unusual case of an immunocompetent patient, 57-year-old man with a painless reddish submucosal nodule located on the tongue dorsum. Microscopical analysis showed chronic inflammatory infiltrate with macrophages containing leishmania in cytoplasmic vacuoles. PCR assays confirmed the diagnosis and patient was treated with meglumine antimoniate for 30 days. Absence of the parasite was confirmed by PCR. Thirteen years after treatment, a scar fibrosis persisted on the tongue dorsum. The case reported reveals that leishmaniasis should be considered in the diagnosis of tongue nodules in immunocompetent patients.
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Affiliation(s)
- Maria Clara Bertolini Botelho
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Lígia Lavezo Ferreira
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Stelios Fikaris
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Ana Carolina Prado-Ribeiro
- Dental Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), University of São Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Ana Maria Pires Soubhia
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Eder Ricardo Biasoli
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Glauco Issamu Miyahara
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, School of Dentistry, São Paulo State University (Unesp), 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, 1193 José Bonifácio St, Araçatuba, São Paulo, 15050-015, Brazil.
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Dos Santos RLO, Tenório JR, Fernandes LG, Moreira Ribeiro AI, Pinho Costa SA, Trierveiler M, Lemos CA, Sugaya NN. Oral leishmaniasis: Report of two cases. J Oral Maxillofac Pathol 2020; 24:402. [PMID: 33456261 PMCID: PMC7802832 DOI: 10.4103/jomfp.jomfp_306_18] [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: 12/05/2018] [Revised: 05/11/2020] [Accepted: 05/18/2020] [Indexed: 11/04/2022] Open
Abstract
Leishmaniasis is a chronic inflammatory disease caused by several species of the parasite Leishmania that is transmitted by insects of the genus Phlebotomus spp. or Lutzomyia spp. This disease can affect skin, mucous membranes and viscera being classified as cutaneous, mucocutaneous and visceral leishmaniasis, depending on the spectrum of clinical manifestations. Diagnosis can be achieved through biopsy, microscopical analysis, Montenegro intradermoreaction and/or ELISA. The dentist plays an important role in the diagnosis of this disease due to frequent involvement of oral mucosa. This article reports two clinical cases of leishmaniasis with oral mucosa involvement, their diagnosis workup and treatment.
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Affiliation(s)
| | | | | | | | | | - Marília Trierveiler
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Celso Augusto Lemos
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Norberto Nobou Sugaya
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Sánchez-Romero C, Júnior HM, Matta VLRD, Freitas LM, Soares CDM, Mariano FV, de Almeida OP, Nascimento de Aquino S. Immunohistochemical and Molecular Diagnosis of Mucocutaneous and Mucosal Leishmaniasis. Int J Surg Pathol 2019; 28:138-145. [PMID: 31566041 DOI: 10.1177/1066896919876706] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leishmaniasis is a parasitic infection transmitted by the bite of infected female sandflies. It principally affects the skin, and the frequency of mucosal involvement is about 5% to 20%. Considering the rarity of leishmaniasis affecting the upper aerodigestive tract mucosa, we evaluated the characteristics of mucocutaneous leishmaniasis and mucosal leishmaniasis and the diagnostic difficulty when the parasites are scarce in tissue samples. The clinical, histopathological, histochemical, immunohistochemical, and molecular features of 17 cases of mucocutaneous leishmaniasis and mucosal leishmaniasis were assessed. Mucosal disease was principally found in the soft palate, oropharynx, and nose, manifesting mainly as a solitary ulcer. In hematoxylin and eosin-stained sections, 10 cases revealed abundant amastigotes within the macrophages. Giemsa staining was not shown to be helpful to confirm the diagnosis in 6 cases with scarce or nondetectable amastigotes. Immunohistochemistry (IHC) showed high sensitivity by positive staining in 14 out of 17 cases (82.3%). Polymerase chain reaction was shown to be more sensitive than IHC with 13 out of 14 (92.8%) positive cases, including the 3 IHC negative cases; however, this technique is not available in many endemic regions. In summary, we suggest that the IHC is a simple technique with rapid results and relatively low cost, when compared with other laboratorial procedures; thus, IHC is a helpful tool that should be implemented in the routine diagnosis of leishmania.
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Affiliation(s)
- Celeste Sánchez-Romero
- University of Campinas (UNICAMP), Piracicaba, Brazil.,Universidad de la República, Montevideo, Uruguay
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Falcão GGVSC, Lins-Kusterer L, Leite-Ribeiro PM, Sarmento VA. Orofacial manifestations of mucocutaneous leishmaniasis: a case series from Brazil. F1000Res 2019; 8:756. [PMID: 33042516 PMCID: PMC7527865 DOI: 10.12688/f1000research.19056.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2020] [Indexed: 11/20/2022] Open
Abstract
Dentists play a fundamental role in the early diagnosis of oral leishmaniasis. Although these lesions are rare at oral mucosa, this is one of the manifestations sites of the disease This study reports seven clinical cases of orofacial mucocutaneous leishmaniasis. All had leishmaniasis diagnosis confirmed by laboratory tests, with orofacial involvement. Five out of the seven cases were males, and in four cases, patients had associated comorbidities. Late diagnosis was observed, resulting in treatment delay and increased hospitalization stay. One patient had severe psychological consequences due to facial deformity. The lack of differential diagnosis due the great variability of clinical presentation of the lesions and frequent unspecific histopathology represent a challenge for the dentist. In two reported cases, there were unspecific biopsy results. This series of cases highlights the importance of a multidisciplinary approach in the diagnosis and treatment of oral and perioral leishmaniasis. Patients with atypical lesions, originating from or living in endemic regions, should be investigated for leishmaniasis. These procedures could avoid delays in diagnosis and decrease the risk of disease dissemination.
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Affiliation(s)
| | - Liliane Lins-Kusterer
- Professor Edgard Santos Hospital, Federal University of Bahia, Salvador, BA, 40110060, Brazil
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Mohammadpour I, Motazedian MH, Handjani F, Hatam GR. Lip leishmaniasis: a case series with molecular identification and literature review. BMC Infect Dis 2017; 17:96. [PMID: 28122496 PMCID: PMC5264488 DOI: 10.1186/s12879-016-2178-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mucocutaneous leishmaniasis (MCL), a protozoan infectious disease, is very rare in Iran despite the endemicity of both cutaneous and visceral forms. It is transmitted by the Phlebotomus sand fly. The lip is considered one of the extraordinary sites. Lesions usually initiate with erythematous papules, slowly enlarges and then it ulcerates. The diagnosis of MCL encompasses epidemiological, clinical and laboratory aspects. Usually, the combination of some of these elements is necessary for the final diagnosis. So, lip leishmaniasis lesions can be challenging to diagnose. CASE PRESENTATION We presented seven rare cases of lip leishmaniasis. Tissue impression smear, culture, PCR and phylogenetic analysis were carried out for explicit diagnosis. Skin scraping investigation showed several Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for L. major, L. tropica, and L. infantum. Differential diagnosis includes orofacial granulomatosis, basal cell carcinoma, squamous cell carcinoma, and mesenchymal tumors. The cases were treated with systemic meglumine antimoniate (Glucantime®). No relapses were observed during 1 year of follow-up. Early detection of the infection are necessary in order to start effective treatment and prevent more serious complications. CONCLUSIONS In this paper, we reported seven rare cases of lip leishmaniasis in Iran, emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic kinship of isolated parasites, and reviewed the literature on lip leishmaniasis.
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Affiliation(s)
- Iraj Mohammadpour
- Department of Medical Parasitology & Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Motazedian
- Basic Sciences in Infectious Diseases Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Handjani
- Department of Dermatology, Molecular Dermatology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholam Reza Hatam
- Department of Medical Parasitology & Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Palla B, Burian E, Klecker JR, Fliefel R, Otto S. Systematic review of oral ulceration with bone sequestration. J Craniomaxillofac Surg 2015; 44:257-64. [PMID: 26782844 DOI: 10.1016/j.jcms.2015.11.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/27/2015] [Accepted: 11/25/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This article represents the first systematic review entirely dedicated toward a disease called oral ulceration with bone sequestration (OUBS). We performed this review in order to further define and outline this disease. A secondary interest was to recognize the prevalence and importance of OUBS in relation to other oral disorders accompanied by ulceration and bone exposure. MATERIAL AND METHODS The systematic review was registered with PROSPERO (registration number CRD42015024294) and performed in cooperation with Harvard's Countway Library. Searches were built using MeSH terms and proximity operators previously mentioned in OUBS descriptions. Database searches were performed through EMBASE, Medline, and PubMed, followed by a handsearch of bibliographies for relevant articles. Articles were assessed against eligibility and inclusion criteria centering on bone exposure without known etiologic cause. We sought to gather information on patient age, sex, anatomical location, clinical presentation, and comorbidities. PRISMA guidelines were followed. RESULTS The searches identified 766 records total. Despite considerable inspection, we found only 8 articles qualifying for our review. In the 8 articles, there were a total of 24 patients fulfilling the criteria of OUBS. Although some abstracts mentioned idiopathic nature, most authors presented clinical cases with probable causes to ulceration and sequestration. The mean age of these patients was 43.21 ± 11.94 years. The male to female ratio was 3:1. The predominant area of occurrence was the mandible (n = 23, 95.8%). CONCLUSION The representation of OUBS in the literature remains scarce. More data must be generated and gathered on the concept of OUBS so as to determine the true incidence and importance of this disease. Despite rare occurrences of conditions characterizing OUBS, the recent discussion of this topic in the scientific community calls for more knowledge to be brought forth, with great benefit to patients suffering from ulcerative diseases and osteonecrosis.
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Affiliation(s)
| | - Egon Burian
- Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-Universität, Munich, Germany
| | | | - Riham Fliefel
- Department of Oral and Maxillofacial Surgery (Chair: Prof. Dr. Dr. Michael Ehrenfeld), Ludwig-Maximilians-Universität, Munich, Germany; Experimental Surgery and Regenerative Medicine, Ludwig-Maximilians-Universität, Munich, Germany; Department of Oral & Maxillofacial Surgery, Alexandria University, Alexandria, Egypt
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery (Chair: Prof. Dr. Dr. Michael Ehrenfeld), Ludwig-Maximilians-Universität, Munich, Germany.
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