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Concept: Stomatitis


BACKGROUND: Oral lichen planus (OLP) is seen frequently in patients with hepatitis C virus (HCV) infection. The aim of this study was to evaluate the occurrence of oral candidiasis, other mucosal lesions, and xerostomia during interferon (IFN) therapy for HCV infection. METHODS: Of 124 patients with HCV-infected liver diseases treated with IFN therapy in our hospital, 14 (mean age 56.00 +/- 12.94 years) who attended to receive administration of IFN once a week were identified and examined for Candida infection and other oral lesions and for the measurement of salivary flow. Serological assays also were carried out. RESULTS: Cultures of Candida from the tongue surfaces were positive in 7 (50.0%) of the 14 patients with HCV infection at least once during IFN therapy. C. albicans was the most common species isolated. The incidence of Candida during treatment with IFN did not increase above that before treatment. Additional oral mucosal lesions were observed in 50.0% (7/14) of patients: OLP in three (21.4%), angular cheilitis in three (21.4%) and recurrent aphthous stomatitis in one (7.1%). OLP occurred in one patient before treatment with IFN, in one during treatment and in one at the end of treatment. 85.7% of the oral lesions were treated with topical steroids. We compared the characteristics of the 7 patients in whom Candida was detected at least once during IFN therapy (group 1) and the 7 patients in whom Candida was not detected during IFN therapy (group 2). The prevalence of oral mucosal lesions (P=0.0075) and incidence of external use of steroids (P=0.0308) in group 1 were significantly higher than in group 2. The average body weight of group 1 decreased significantly compared to group 2 (P=0.0088). Salivary flow decreased in all subjects throughout the course of IFN treatment and returned at 6th months after the end of treatment. In group 1, the level of albumin at the beginning of the 6th month of IFN administration was lower than in group 2 (P=0.0550). According to multivariate analysis, one factor, the presence of oral mucosal lesions, was associated with the detection of Candida. The adjusted odds ratio for the factor was 36.00 (95% confidence interval 2.68-1485.94). CONCLUSION: We should pay more attention to oral candidiasis as well as other oral mucosal lesions, in patients with weight loss during IFN treatment.

Concepts: Interferon, Hepatitis C, Candida albicans, Candidiasis, Aphthous ulcer, Oral pathology, Lichen planus, Stomatitis


Microstomia is a term used to describe a small oral aperture. Most of the reported cases are caused by scar contracture after facial trauma, burn injury, and tumor excision. We experienced a rare case of microstomia in a patient with antilaminin 332 mucous membrane pemphigoid, which was an acquired autoimmune disease and showed blisters and erosive lesions mainly on the mucous membranes. The patient had recurrent aphthous stomatitis and presented microstomia caused by scar contracture of oral mucosa. We surgically corrected microstomia by 5-flap Z-plasty for commissuroplasty and 2 Z-plasty of both upper and lower lips for an enlargement of oral aperture. The patient could achieve an enough oral aperture and was satisfied with the result. There was no recurrence of microstomia for 2 years.

Concepts: Mucous membrane, Oral mucosa, Aphthous ulcer, Lip, Stomatitis


Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is considered the most common periodic fever syndrome of childhood. Although it was first described three decades ago, the pathogenesis has been poorly understood. Recent studies on the heritability and immunology of the disorder have begun to shed light into the mechanisms of this autoinflammatory disorder. This review will focus on the pathogenesis of PFAPA, especially as it pertains to the genetic susceptibility, tonsillar immunology, and the role of the microbiome.

Concepts: Immune system, Genetics, Immunology, Aphthous ulcer, Stomatitis, Periodic fever syndrome, Adenitis, Periodic fever, aphthous stomatitis, pharyngitis and adenitis


Recurrent aphthous stomatitis (RAS) is a common oral mucosal disorder of unclear etiopathogenesis. Although recent studies of the oral microbiota by high-throughput sequencing of 16S rRNA genes have suggested that imbalances in the oral microbiota may contribute to the etiopathogenesis of RAS, no specific bacterial species associated with RAS have been identified. The present study aimed to characterize the microbiota in the oral mucosa and saliva of RAS patients in comparison with control subjects at the species level.

Concepts: DNA, Archaea, Bacteria, Oral mucosa, Ribosomal RNA, 16S ribosomal RNA, Aphthous ulcer, Stomatitis


Minor Recurrent Aphthous Stomatitis (RAS) represents a disease which is very difficult to prevent. This case-control study focused on possible associations between minor Recurrent Aphthous Stomatitis in children, their oral health, and underlying behavioral indexes of children’s attitudes and habits pertaining to (home) oral hygiene, with the further goal of enabling the dentist to prevent these specific kind of lesions, both from a clinical and a broader psychosocial perspective.

Concepts: Epidemiology, The Association, Aphthous ulcer, Stomatitis


Recurrent aphthous stomatitis (RAS) is a common disease of the oral mucosa with an unknown etiology. This study aimed to determine if food additives play a role in the etiology of RAS as well as to determine if patch testing can be used to detect which allergens cause RAS.

Concepts: Oral mucosa, Aphthous ulcer, Stomatitis


Diagnosis of Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) is currently based on a set of criteria proposed in 1999 modified from Marshall’s criteria. Nevertheless no validated evidence based set of classification criteria for PFAPA has been established so far. The aim of this study was to identify candidate classification criteria PFAPA syndrome using international consensus formation through a Delphi questionnaire survey.

Concepts: The Canon of Medicine, Evidence-based medicine, Aphthous ulcer, Oral ulcer, Stomatitis, Periodic fever syndrome


Behcet’s disease (BD) patients should have recurrent aphthous stomatitis (RAS) but they may or may not have atrophic glossitis (AG). This study mainly assessed the frequencies of serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) positivities in 30 AG-positive RAS/BD (AG+RAS/BD) and 33 AG-negative RAS/BD (AG־RAS/BD) patients.

Concepts: Aphthous ulcer, Oral pathology, Parietal cell, Stomatitis


Behcet’s disease (BD) patients should have recurrent aphthous stomatitis (RAS) but they may or may not have atrophic glossitis (AG). This study mainly assessed whether 30 AG-positive RAS/BD (AG+RAS/BD) patients had significantly higher frequencies of hemoglobin, iron, vitamin B12, and folic acid deficiencies and of hyperhomocysteinemia than 33 AG-negative RAS/BD (AG־RAS/BD) patients or 126 age- and sex-matched healthy control subjects.

Concepts: Vitamin, Anemia, Heme, Folic acid, Vitamin B12, Aphthous ulcer, B vitamins, Stomatitis


The present study was aimed at identifying the association between interleukin family gene polymorphisms and recurrent aphthous stomatitis (RAS) risk using a meta-analysis. We searched the PubMed, web of science, Embase and ScienceDirect-Elsevier databases for research on the interleukin polymorphism and RAS risk. In total 12 studies were included to investigate the relationships between RAS risk and six polymorphisms by calculating pooled odds ratios (ORs) and 95% confidence intervals (CIs). A significant association was found between IL-1β+3954C/T polymorphism and RAS risk. A high risk of RAS was found in RAS patients with the G allele or GG genotype of IL-6-174 polymorphism. Low risk of RAS was found in the C allele of IL-10-592C/A polymorphism under an allele model, but a high risk of RAS was found in IL-10-1082G/A polymorphism. In the subgroup analysis, no correlation was found between the IL-10-1082 polymorphism and RAS risk in the caucasian population with the allele model. In conclusion, an IL-1β+3954C/T polymorphism was determined to be related to susceptibility to RAS, and individuals with the G allele and GG genotype of IL-6-174 or the A allele of IL-10-592 or the G allele of IL-10-1082 appeared to be more vulnerable to developing RAS.

Concepts: Gene, Genetics, Allele, Biology, Aphthous ulcer, Stomatitis