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The association between tylosis (palmoplantar keratoderma) and esophageal carcinoma in a group of related patients has been previously established and has been shown to depend on dominant genetic transmission. Sixteen out of seventeen such affected patients have been found to exhibit lesions of the oral mucosa classified as pre-leukoplakia in the younger subjects and as leukoplakia in the older patients. The histology of the pre-leukoplakias examined resembles in some features that of several developmental oral epithelial disorders. The histological appearance of the leukoplakias examined was of benign keratosis with no special features. No similar lesions were found in small control groups of unaffected siblings of the subjects involved or in unrelated tylotic patients. It is suggested that the oral leukoplakia associated with tylosis should be considered as a possible indication of a tendency to develop esophageal carcinoma.

Forty-six patients were seen over a four-year period because of oral blistering. Of these 26 were thought to have pemphigoid affecting the oral mucosa. The clinical features in these patients are compared with the commonly accepted descriptions and some differences noted. The nomenclature is reviewed and the term 'intermittent mucosal pemphigoid' is suggested to describe a clinical variant in which lesions are few and widely separated in time and which heal without scar formation. The relationship between oral pemphigoid and oral 'blood blisters' is discussed.

Plaque-like lesions of the oral mucosa have been observed in seven immunosuppressed renal transplant patients. Whilst bearing a superficial resemblance to acute pseudomembranous candidiasis (thrush), these lesions have been shown to be associated with bacterial overgrowth and not with fungi. Treatment has depended on the use of appropriate antibiotics and antiseptics together with the adoption of measures to cause disintegration of the mucoid matrix of the lesions.

Ultrastructural studies have been carried out on epithelium taken from the oral lesions of tylosis-related leukoplakia and preleukoplakia in a group of patients known to be at high risk for esophageal carcinoma. Several structural abnormalities are described; in particular, the presence of intranuclear electron dense particles 90 nm in diameter. Similar particles have been found in the nuclei of epithelial cells from an esophageal carcinoma developing in one of the patients under study.