Frequency of fissured tongue (lingua plicata) as a function of age

Fissured tongue (lingua plicata; LP) is a mostly asymptomatic condition characterized by grooves and fissures of varying depth on the dorsal surface of the tongue. Most reports in the literature indicate a prevalence of 10–20%, although there is marked variation. On the basis of 1,000 patients (n=465 males, n=535 females), this study examined the association between LP and age as well as further influencing factors. Participants completed a questionnaire comprising information regarding gender, age, alcohol and tobacco consumption, possibly existing removable dentures, and potential mouth burning. Subsequently, photographs of the protruded tongue were taken and examined by two investigators regarding the presence of LP. Four degrees of severity of the condition were distinguished. Degrees of severity of LP as well as numbers of affected individuals increased as a function of age (p<0.001). LP occurred more frequently in males than females (p=0.0029). In addition, smoking exerted a positive influence on the prevalence (p<0.05), and a positive correlation appeared between mouth burning and LP (p<0.01).

Clinicopathological significance of Melkersson-Rosenthal syndrome

Melkersson-Rosenthal syndrome (MRS) classically shows a triad of orofacial swelling, fissured tongue and facial palsy, more commonly the oligosymptomatic form. The orofacial swelling is characterised by swollen reddish-brown non-pruritic lips and facial oedema. In one-third to one half of patients, fissured tongue is seen, which also aids in diagnosis. The histological finding of MRS includes non-caseating, sarcoidal granulomas, but their absence does not exclude the diagnosis. All these findings together form a basis for a cautious search for confrontational reasons for the symptom complex of MRS.

Phenotypic and dermatological manifestations in Down Syndrome

Down syndrome (DS) is associated with various uncommon dermatological disorders and increased frequency of some common dermatoses. This study was conducted over a 2-year period to evaluate the frequency of phenotypic and dermatologic manifestations in patients with Down syndrome in south India. The most common phenotypic manifestations that characterize DS include the epicanthic fold (93.7%), brachicephaly (90.6%), flat nasal bridge (84.2%), upward angle of eyes (83.2%), wide gap between first and second toe (81.1%), clinodactyly (77.9%), small nose (74.7%), short broad neck (72.6%), single palmar crease (61.1%), increased nuchal skin fold (61.1%), and fissured tongue (52.6%). The most common dermatological manifestation seen in patients with DS were lichenification, xerosis, dental anomaly, fine, sparse hair, and delayed dentition. Alopecia areata was seen in 9.4 percent of patients and tended to be severe. Infections were relatively less common in our study. Our study has highlighted many phenotypic features and dermatoses, which may help provide better care for patients and counseling to the families.

Oral mucosal findings related to tobacco use and alcohol consumption: a study on Swiss army recruits involving self-reported and clinical data

PURPOSE

The aim of the present study was to assess the oral mucosal health status of young male adults (aged 18 to 24 years) in Switzerland and to correlate their clinical findings with self-reported risk factors such as tobacco use and alcohol consumption.

MATERIALS AND METHODS

Data on the oral health status of 615 Swiss Army recruits were collected using a standardised self-reported questionnaire, followed by an intraoral examination. Positive clinical findings were classified as (1) common conditions and anatomical variants, (2) reactive lesions, (3) benign tumour lesions and (4) premalignant lesions. The main locations of the oral mucosal findings were recorded on a topographical classification chart. Using correlational statistics, the findings were further associated with the known risk factors such as tobacco use and alcohol consumption.

RESULTS

A total of 468 findings were diagnosed in 327 (53.17%) of the 615 subjects. In total, 445 findings (95.09%) were classified as common conditions, anatomical variants and reactive soft-tissue lesions. In the group of reactive soft-tissue lesions, there was a significantly higher percentage of smokers (P < 0.001) and subjects with a combination of smoking and alcohol consumption (P < 0.001). Eight lesions were clinically diagnosed as oral leukoplakias associated with smokeless tobacco. The prevalence of precursor lesions in the population examined was over 1%.

CONCLUSIONS

Among young male adults in Switzerland, a significant number of oral mucosal lesions can be identified, which strongly correlate with tobacco use. To improve primary and secondary prevention, young adults should therefore be informed more extensively about the negative effects of tobacco use on oral health.

Patients with local adverse effects from dental alloys: frequency, complaints, symptoms, allergy

Data on the prevalence of adverse effects from dental cast alloys and on the characteristics of the related patient groups are scarce. Therefore, the aim of the present study was to investigate patients in a defined part of Germany attributing oral complaints or symptoms to dental cast alloys. All dentists in the area of Eastern Bavaria (with 1 million inhabitants) were asked to send corresponding patients to our department during a 3-year period. Out of this collection, patients with complaints or symptoms in the oral cavity were recruited and characterized with regard to number, age and sex distribution, type of subjective complaints and objective intraoral symptoms, and allergy status based on an alloy analysis. Patients reporting to our department with suspected local adverse effects from dental cast alloys represented 0.01% of the population. Thirty-four percent of the patients were 50-59 years old, with females prevailing (76%). A great variety of subjective complaints was reported, which mainly resembles those reported by patients with adverse effects attributed to other dental materials like amalgam or denture base materials. The main objective intraoral symptoms were gingivitis, anomalies of the tongue (lingua plicata, lingua geographica), discoloration of the gingiva, redness of the palate or tongue and lichenoid reactions of the oral mucosa. In not more than 10% of the patients, allergy was diagnosed as contributing to the complaints or symptoms.

Insulin-dependent diabetes mellitus and oral soft tissue pathologies. I. Prevalence and characteristics of non-candidal lesions

OBJECTIVE

A large epidemiologic study on oral health has found that several oral soft tissue lesions were more prevalent in subjects with insulin-dependent diabetes mellitus than in control subjects without diabetes. Our objective in part I of this article is to characterize those lesions not associated with Candida.

STUDY DESIGN

This cross-sectional study determined the prevalence and characteristics of oral soft tissue diseases identified during a comprehensive oral evaluation of 405 adult subjects with diabetes and 268 control subjects without diabetes.

RESULTS

Twenty specific oral soft tissue lesions were identified. Nearly twice as many subjects with diabetes as subjects without diabetes were found to have one or more oral soft tissue lesions (44.7% vs 25.0%; P <.0001). Subjects with diabetes also had significantly higher prevalence rates for 7 lesions, 3 of which were non-candidal: fissured tongue, irritation fibroma, and traumatic ulcers. (Four lesions generally associated with Candida infection-median rhomboid glossitis, denture stomatitis, generalized atrophy of the tongue papillae, and angular cheilitis-will be described in part II of this article.) There were no differences found between the subjects with diabetes and the control subjects for lichen planus, gingival hyperplasia, or salivary gland disease.

CONCLUSIONS

Oral soft tissue lesions were seen more frequently in subjects with insulin-dependent diabetes than in the control subjects. Characterization of 3 non-candidal lesions suggests that they are associated with trauma, delayed healing, or both.

[Epidemiologic survey of tongue lesions and analysis of the etiologic factors involved]

The prevalence of tongue lesions, and relationships with different systemic diseases, according to the international literature of epidemiologic studies were reviewed. The data were compared with a Hungarian investigation of 5034 individuals, between 1992 and 1995 in Budapest. Tongue lesions were found in 22.76% of the examined individuals. The ratio was similar in women (51%) and men (49%). Fissured tongue was found in 21.49%, geographic tongue in 2.21%, atrophic tongue in 0.12% and central papillar atrophy in 0.70%. These data agree in general with the epidemiological data found in the international literature. Some rare tongue alterations were also investigated. Lingua indentata was found in 1.49% and hypertrophy of papillae foliatae was found in 0.20%. The relationship with different systemic diseases was the following: In diabetes mellitus tongue lesions were found in 29.03%, in hypertension in 28.63%, connected to heart- and vascular diseases in 25.15%, to haematologic diseases in 17.54%. Tongue lesions were found in 23.86% in the case of liver disease, in 22.38% in gastrointestinal diseases and in 20.69% associated to tumors. In the case of Candida's infection tongue alterations were found in 41.6%, in smokers in 23.72%. Tongue lesions caused complaints rarely, only in 2.27%. The recognition of tongue lesions may be helpful in the early diagnosis of systemic diseases.

Oral psoriasis: report of six new cases

This article presents six cases of oral psoriasis originally diagnosed by means of the histological changes found on biopsies of the oral lesions. Three of the patients presented with oral and skin psoriasis. Of the remaining three, two presented with oral manifestations alone, although their follow-up was short, whilst the third showed delayed dermatological changes. Two of the cases were also complicated by psoriatic arthritis, one of them to the temporomandibular joint.

Pemphigus vegetans presenting as scrotal tongue

A case of scrotal tongue is described. Histological and immunofluorescent findings revealed that this case was pemphigus vegetans, which should therefore be added to the differential diagnosis of scrotal tongue.

Glossodynia and other disorders of the tongue

This article discusses the approach to diagnosis and management of disorders of the tongue. These disorders include glossodynia, geographic tongue and smooth tongue, fissured tongue, and black hairy tongue and furred tongue. A brief review of the examination of the tongue is also included.

Acquired hypertrichosis lanuginosa

A 32-year-old Thai woman developed acquired hypertrichosis lanuginosa with generalized lanugo hair, deeply furrowed tongue, and keratosis pilaris. She had metastatic adenocarcinoma of the liver. A review of world literature reveals 24 cases of which 22 were associated with proven malignancies. Acquired hypertrichosis lanuginosa is almost always a cutaneous sign of internal cancer.

Chondroectodermal dysplasia (Ellis-van Creveld syndrome): report of two cases

Our two patients with chondroectodermal dysplasia had most of the classic manifestations of the syndrome. The simultaneous occurrence of partial anodontia and embedded supernumerary and second premolars in the mandible in one patient was interesting. The inverted impaction of the left maxillary lateral incisor is also a unique finding. The median fissure on the tongue may be an associated developmental anomaly of the syndrome.

Oral manifestations of Morquio's syndrome

The clinical and laboratory findings in two siblings affected with Morquio's syndrome are described. The oral findings, consisting of disturbances in the structure of the enamel in both deciduous and permanent teeth, resemble those of amelogenesis imperfecta, Type 1. Preformed crowns are recommended as the initial treatment, in order to avoid loss of vertical height. The dentist's familiarity with the oral manifestations of Morquio's disease may contribute to the early detection of this condition.