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Objective: Actinic cheilitis (AC) is a chronic lesion that usually precedes the onset of squamous cell carcinoma of the lip. Microscopically, AC may exhibit epithelial dysplasia (ED). Twist is a transcription factor that regulates the mesenchymal phenotype through negative E‐cadherin regulation. This study evaluated Twist and E‐cadherin immunoexpression in AC with different ED degrees. Materials and Methods: Twist and E‐cadherin immunoexpression was evaluated semiquantitatively in the epithelium of 86 cases of AC with different ED degrees. Data obtained were submitted to the Mann–Whitney test and Spearman's correlation test. Results: Immunohistochemical analysis revealed nuclear and cytoplasmic Twist immunoreactivity in all epithelial layers except the cornified layer. In contrast, the membrane and cytoplasmic E‐cadherin immunoreactivity was observed in all epithelial layers except the cornified layer. No significance was observed between the scores of these proteins and the ED degree. It was observed a correlation between total Twist and total (p = 0.030) and membrane (p = 0.014) E‐cadherin and between nuclear Twist and cytoplasmic E‐cadherin (p = 0.030). Conclusions: The results suggest that the high immunoexpression of Twist is an early lip carcinogenesis event. However, it appears not to influence the progression of ED in AC. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Aims Methods Results Conclusion There currently exists no consensus on objective features which are relevant in the assessment of overall lip health.This study seeks to identify features and factors that are associated with healthy lips. This survey will ultimately enable clinicians to objectively track lip health for clinical evaluations and clinical research.An anonymous survey was conducted among allied healthcare professionals in‐person and through email. The survey contained questions designed to assess the importance of features of lip health using a 5‐point Likert scale. Features included lack of lip dryness; even tone or lack of hyperpigmentation; lip smoothness; lip color; lip shine, radiance, or luster; definition of the vermillion border/defined lip contour; lip fullness or plumpness; lack of lip lines; and lip firmness. The final questions prompted respondents to select the top three most important features when assessing lip health and to provide any additional pertinent factors.A total of 334 responses were received, including board‐certified dermatologists (35.9%), dermatology residents (14.7%), and other healthcare specialties (49.4%). The features most cited were lack of lip dryness (65.8%), lip smoothness (38.4%), even tone or lack of hyperpigmentation (38.1%), definition of the vermillion border/defined lip contour (28.0%). Survey results reveal that lip dryness, lip smoothness, lack of hyperpigmentation, and definition of the vermillion border/defined lip contour were the features most associated with lip health.The results from this survey will provide a basis for future research in the field of lip health, research, and clinical treatment. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate the immunohistochemical expression of the ING3 in actinic cheilitis and squamous cell carcinoma of the lower lip. Methods: Forty-five specimens of actinic cheilitis and 48 specimens of squamous cell carcinoma of the lower lip were submitted to immunohistochemical detection of ING3. The protein expression in different cellular sublocations was compared between the two groups, and associations with the clinicopathological variables were analyzed. A significance level of 5% was adopted for all tests. Results: Deaths were significantly more frequent in tumors with a high histopathological risk score (p < 0.05). In actinic cheilitis, significant differences were found in the nucleus-cytoplasmic expression of ING3 and expression restricted to the cytoplasm with binary histopathological grading (p < 0.05). In squamous cell carcinoma of the lower lip, there was no statistically significant difference when comparing ING3 expressions with clinical and morphological parameters (p > 0.05). Nucleo-cytoplasmic ING3 expression was significantly lower in squamous cell carcinoma of the lower lip when compared to actinic cheilitis (p < 0.05) and the expression restricted to the cytoplasm was significantly higher in squamous cell carcinoma of the lower lip (p < 0.05). Conclusion: The results of this study suggest that there is a marked decrease in the nuclear expression of ING3 as malignant progression occurs, indicating an impaired tumor suppressor function of this protein in actinic cheilitis and squamous cell carcinoma of the lower lip. [ABSTRACT FROM AUTHOR]

Background: Multisystem Inflammatory Syndrome in Children (MIS-C) is a rare complication, which develops within 3–6 weeks after SARS-CoV2 infection. The coronavirus disease 2019 (COVID-19) vaccine was firstly introduced in adults and adolescents and later in patients aged 5–11 years old. Although a reduced incidence of MIS-C and with less severe symptoms has been reported in vaccinated adolescents, there is little knowledge in children younger than 12 years of age. In addition, it is not understood whether MIS-C in vaccinated patients can be triggered by Covid19 vaccination or be secondary to a recent asymptomatic Sars-Cov2 infection. Case presentation: We describe the case of a Caucasian 6-year-old girl, one month after double COVID-19 vaccination, who presented fever, acute abdominal pain, rash, pharyngotonsillitis, cheilitis, cervical lymphadenopathy without a prior detected Sars-Cov2 infection. She also had lymphopenia, increase in inflammatory markers, cardiac and pulmonary involvement. Therefore, we dosed both anti Sars-Cov2 Spike and Nucleocapsid antibodies, which were positive and allowed us to confirm the diagnosis of MIS-C. We promptly administered intravenous immunoglobulins and methylprednisone, resulting in the initial regression of fever. During the hospitalization, the child also developed pancreatitis and severe neurological involvement, including irritability, drowsiness, distal tremor, dyskinesia and buccal asymmetry with complete resolution after 2 months. After 3 months from the onset of the symptoms, she reported a transient loss of hair compatible with telogen effluvium. After 12 months of follow-up, she did not show any symptomatic sequelae. Conclusions: This case raises the question of whether COVID-19 vaccination may be involved in the pathogenesis of MIS-C in children between the ages of 5 and 11 years old. [ABSTRACT FROM AUTHOR]

A reed (Arundo donax) was acetylated to prevent serious cheilitis (reed allergy) in woodwind musicians in contact with the vibrating plate made of the reed. The reed was acetylated almost completely at 120 °C for 8 to 24 h. The maximum weight% gain (WPG) of the reed was lower than that of wood, reflecting a lower number of active reaction sites. The WPG of the inner part of the reed was slightly higher than that of the outer part, probably because the reactivity of the parenchyma cells is higher than that of the bundle sheaths. The acetylated reeds were tested by eleven skilled musicians suffering from the reed allergy. Eight musicians reported no allergic reactions. Three musicians reacted with the acetylated reed, but the reactions were much weaker than those induced by the unmodified reed. Thus, acetylation has been proven effective in preventing reed allergy. The patch test was not sufficient to detect allergies because although some musicians tested negative in the patch test, their mouths reacted seriously. [ABSTRACT FROM AUTHOR]

Background: Chronic nonspecific cheilitis is a complex condition characterized by persistent lip peeling and discomfort. This case report explores the clinical progression of a patient with history of tongue squamous cell carcinoma and subsequent Tislelizumab treatment, presenting with persistent lip peeling. Case presentation: A patient with a history of tongue squamous cell carcinoma (T2N0M0), treated with chemotherapy, surgery, and Tislelizumab, presented with six months of persistent lip peeling. Clinical examination revealed distinct features of chronic nonspecific cheilitis with infectious angular cheilitis (Oral Candidiasis). A tailored treatment plan, emphasizing oral hygiene practices and local treatments with Sodium Bicarbonate, Tacrolimus ointment, and Chlortetracycline ointment. Follow-up visits demonstrated sustained improvement, highlighting the significance of individualized approaches. Conclusions: This case underscores the importance of recognizing and managing oral manifestations in patients with a history of cancer and immunotherapy. The patient's response to treatment suggests that a multifaceted approach, combining local therapy with lifestyle modifications, can be effective in managing chronic nonspecific cheilitis associated with immunotherapy. Routine follow-up appointments, guided by personalized medicine principles, contribute to sustained patient well-being. [ABSTRACT FROM AUTHOR]

Background: Cheilitis is a chronic inflammatory condition of the lips, and frequent or prolonged use of topical corticosteroids may lead to various adverse events. Therefore, alternative therapies with fewer side effects are beneficial for the treatment of this condition. Aim: To evaluate the efficacy of a lip care formulation containing both panthenol and bisabolol as a monotherapy for mild‐to‐moderate cheilitis. Methods: This single‐centre prospective pilot open‐label study included 20 patients with mild‐to‐moderate cheilitis who were treated with the tested lip care for 8 weeks and evaluated by physician and patient assessments before the final efficacy was determined using the Visioscan score. Results: Of the 20 patients, 13 (65.0%) presented with moderate cheilitis with dry and chapped lips. All parameters, including physician and patient clinical scores and bioengineering measurements, showed significant improvements as early as week 2 and sustained until week 8 following the application of the tested lip care. The frequency of cheilitis flareups also decreased significantly. The tested product was well tolerated without any adverse effects. Conclusions: Lip care with panthenol and bisabolol was safe and effective. It can be used as monotherapy for the treatment of mild‐to‐moderate cheilitis. [ABSTRACT FROM AUTHOR]

Introduction: Chronic oral mucosal diseases (COMDs) can significantly impair the quality of life (QoL) of affected individuals. Monitoring the overall disease's impact and the efficacy of treatments requires the use of the Chronic Oral Mucosal Diseases Questionnaire-15 (COMDQ-15) as a standardized instrument for measuring QoL in these patients. Objective: This study aimed to assess QoL in patients with COMDs using an Indonesian version of the COMDQ-15. Methods: Seventy patients diagnosed with recurrent aphthous stomatitis (RAS), oral lichen planus, autoimmune blistering diseases (ABD), and cheilitis were included. Levels of QoL among different groups of disease were compared. Various potential factors influencing QoL were evaluated. Bivariate analysis was performed to identify factors associated with overall and specific aspects of QoL. Results: The mean total COMDQ-15 score was 20.83 ± 10.07. The highest scores were in the physical discomfort domain (8.76 ± 4.65), while the lowest was in the medication and treatment domain (2.13 ± 1.99). Physical discomfort was significantly associated with gender, major RAS, and cheilitis. Social and emotional aspects were significantly associated with age and ABD, while patient support was linked to employment status, RAS types, and cheilitis. Conclusions: The Indonesian version of the COMDQ-15 is a valid and reliable tool for assessing QoL in patients with COMDs. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Fanconi anemia (FA) is a genetic disorder that impairs the function of the bone marrow and predisposes individuals to aplastic anemia. The condition is caused by mutations in genes responsible for DNA repair. People with FA have an increased risk of developing tumors due to DNA damage. Flat-cell carcinomas of the head, neck, esophagus, and genital organs are often observed in individuals with FA. Case Report: A 31-year-old man with Fanconi anemia and a history of bone marrow transplantation was admitted to the General Surgery Department due to elevated levels of the CEA marker. Before the transplantation, chromosomal anomalies, bone marrow hypoplasia, kidney agenesis, and bone defects were noted. After the transplantation, he developed a skin rash. He was also diagnosed with squamous cell carcinoma of the lip and chronic conditions, including cholestatic liver damage, hypertension, and hypothyroidism. During the diagnostic process, computed tomography showed signs of Barrett's esophagus, numerous polyps in the stomach and intestines, and a nodular formation measuring 4.5x5x5.5 cm in the right iliac region. Laparoscopy revealed a neoplasm of the appendix with numerous metastases on the inner abdominal wall and omentum. Histological analysis confirmed mucinous appendiceal cancer. The patient was discharged for palliative treatment at the Oncology Center with a final diagnosis of appendiceal cancer, mucinous type, grade G3. This case underscores the importance of early and comprehensive cancer screening in individuals with FA, particularly those with a history of bone marrow transplantation. Conclusions: This clinical case underscores the critical importance of thorough and timely cancer diagnosis in individuals with this genetic pathology. [ABSTRACT FROM AUTHOR]

PLACK syndrome (OMIM 616295) is a rare genodermatosis associated with peeling skin, leukonychia, acral punctate keratosis, cheilitis, and knuckle pads and is caused by loss‐of‐function mutations in the CAST gene, which encodes calpastatin, a calcium‐dependent protease. This case report highlights a case of PLACK syndrome presenting with the unique findings of striate hyperkeratosis on the palms as well as life‐threatening cardiomyopathy. We review why CAST mutations might impact cardiac function and raise awareness of the potential association between PLACK syndrome and cardiac manifestations. [ABSTRACT FROM AUTHOR]

Background: Generalized lupus erythematosus (GLE) is an autoimmune disease with cutaneous and mucosal manifestations, with lupus cheilitis (LC) being a rare associated oral presentation. The difficulty in early diagnosis of QL lies in its various clinical forms. Although successful treatments have been described, information on specific management is limited, highlighting the importance of early recognition to improve the prognosis and quality of life of patients. Clinical case: We describe the case of a 24-year-old woman with GLE of four years' duration, under treatment with prednisone. She presented a bilateral painful vermilion stomatosis, with extensive erosions and ulcerations covered by hematic crusts, showing no improvement despite previous topical treatments. Histopathological analysis revealed lymphoplasmacytic spongiotic stomatitis with eosinophils and lupus stomatitis associated with contact irritation. The dose of prednisone was adjusted, noting improvement after a month of treatment. Conclusion: Even though the oral mucosa is commonly affected in GLE, LC is uncommon. The clinical presentation of QL starts with macules on the lips, and eventually presents with edema and painful ulcers. The diagnosis is essentially clinical but challenging cases may require a pathology report. Management includes adjustment of corticosteroid doses and general measures; early diagnosis is crucial for an adequate treatment response. [ABSTRACT FROM AUTHOR]

Background and Objectives: Lichen planus of the lip (LPL) is a chronic inflammatory condition that resembles actinic cheilitis, discoid lupus erythematosus, graft-versus-host disease, and lichenoid reaction to dental materials or drugs. The purpose of this study was to conduct a literature review on lichen planus lip involvement and to report a retrospective observational study that characterises and explores the clinical, histopathological, and evolution of the lesions in a group of patients with unique involvement of LPL. Materials and Methods: Clinical data of patients diagnosed with LPL was retrieved from the medical charts of the patients referred to the Oral Pathology Department of the "Carol Davila" University of Medicine and Pharmacy. A concurrent electronic literature research was carried out using PubMed and Web of Science from 2003 to 2023. Results: Eleven patients diagnosed with unique LPL were analysed (male/female ratio was 1.75, mean age 63.64 years ± 12.52). All patients presented lesions of the lower lip; the clinical forms were atrophic (six cases) and erosive (five cases), and the histopathological exam confirmed the diagnosis. After topical treatment with corticosteroids, most of the patients had complete remission. The literature review revealed 24 studies (sixteen case reports and eight case series) which comprised 84 patients. Isolated lip involvement was reported in 17 studies, and five articles with concomitant oral lichen planus, while two articles did not mention this criterion. Conclusions: Our study brings new data on isolated lichen planus of the lip that primarily affects the lower lip with predominance in male patients. It was reported worldwide in patients between 22 and 75 years old. Topical corticosteroids were the main treatment prescribed and they usually brought remission of the lesions. Lichen planus of the lip is a challenging diagnosis for oral health practitioner providers as well as for dermatologists. [ABSTRACT FROM AUTHOR]

Background: To evaluate the presence of myofibroblasts (MFs) in the development of lip carcinogenesis, through the correlation of clinical, histomorphometric and immunohistochemical parameters, in actinic cheilitis (ACs) and lower lip squamous cell carcinomas (LLSCCs). Methods: Samples of ACs, LLSCCs, and control group (CG) were prepared by tissue microarray (TMA) for immunohistochemical TGF‐β, α‐SMA, and Ki‐67 and histochemical hematoxylin and eosin, picrosirius red, and verhoeff van gieson reactions. Clinical and microscopic data were associated using the Mann–Whitney, Kruskal‐Wallis/Dunn, and Spearman correlation tests (SPSS, p < 0.05). Results: ACs showed higher number of α‐SMA+ MFs when compared to CG (p = 0.034), and these cells were associated with the vertical expansion of solar elastosis (SE) itself (p = 0.027). Areas of SE had lower deposits of collagen (p < 0.001), immunostaining for TGF‐β (p < 0.001), and higher density of elastic fibers (p < 0.05) when compared to areas without SE. A positive correlation was observed between high‐risk epithelial dysplasia (ED) and the proximity of SE to the dysplastic epithelium (p = 0.027). LLSCCs showed a higher number of α‐SMA+ MFs about CG (p = 0.034), as well as a reduction in the deposition of total collagen (p = 0.009) in relation to ACs and CG. There was also a negative correlation between the amount of α‐SMA+ cells and the accumulation of total collagen (p = 0.041). Collagen and elastic density loss was higher in larger tumors (p = 0.045) with nodal invasion (p = 0.047). Conclusions: Our findings show the possible role of MFs, collagen fibers, and elastosis areas in the lip carcinogenesis process. [ABSTRACT FROM AUTHOR]

The increasing popularity of tattoo art, including facial cosmetic tattoos, has led to a growing societal acceptance of tattoos. However, complications such as lip inflammation following cosmetic lip tattoos remain a concern. This article presents the case of a 47-year-old Asian woman who experienced recurrent lip swelling, purulent discharge, and scarring after receiving lip tattoos. Despite previous treatment with corticosteroid injections yielding unsatisfactory results, the patient showed significant improvement with topical application of 2% Crisaborole, a phosphodiesterase-4 inhibitor. Crisaborole modulates intracellular cyclic adenosine monophosphate levels, thereby reducing tissue inflammation and swelling associated with chronic cheilitis. Additionally, pulse laser therapy was effective in addressing residual tattoo pigment and scar tissue. This case highlights the therapeutic challenges of managing chronic inflammatory diseases of the lips secondary to cosmetic tattoos and introduces Crisaborole as a promising treatment option, offering insights for managing similar conditions in the future. [ABSTRACT FROM AUTHOR]

Introduction Mucocele is a commonly encountered lesion in the oral mucosa, resulting from alterations in minor salivary glands. There are two histological types - extravasation and retention, with distinct causative factors such as trauma leading to duct severance and mucin spillage into adjacent connective tissue, and obstruction, respectively. Clinically, mucoceles manifest as soft, bluish, and transparent cystic swellings, often resolving spontaneously. Painless yet troublesome, mucoceles can disrupt eating or speaking and, when untreated, may lead to a persistent bump on the inner lip. Treatment options include surgical removal, micro marsupialization, cryosurgery, steroid injections, and CO2 laser. Material and Methods In this case study, we present the case of a 10-year-old female patient with a painless, gradually progressing swelling in the anterior mandibular labial gingiva. Conclusion Treatment involved conservative surgical intervention, confirming the suspected clinical diagnosis of mucocele through radiographic assessments, substantiated by histological examination. [ABSTRACT FROM AUTHOR]

Human herpes virus is a family of DNA viruses that includes herpes simplex virus (HSV) and varicella zoster virus (VZV). HSV-1 and HSV-2 are fairly common and result in oral and genital lesions. Recurrent infections of herpes include lesions on the lips resulting in pain and possibly societal stigma. VZV is the cause of chicken pox and shingles. Acyclovir and other nucleoside analogues have been used to treat HSV and VZV, but newer, more effective treatments are being developed, which is beneficial regarding the issue of resistance to standard antivirals. Human papillomavirus (HPV) is also a DNA virus with different subtypes that result in four common oral benign lesions. The significance and treatments of HSV, VZV, and HPV are discussed, along with certain developing treatments of herpes labialis. [ABSTRACT FROM AUTHOR]

Oral Mucosal Lesions (OMLs) are conditions of the oral mucosa that cause alterations in their presentation and pain in the affected patient, highlighting their importance for study. The aim of this research is to determine the prevalence of oral lesions in the Ecuadorian Austro. Descriptive statistics were used to associate variables, yielding statistically significant findings based on oral lesions, sex, and geographical environment. This study was conducted under the appropriate bioethical permissions. The results obtained correspond to the prevalence of lesions by province. Morona Santiago displays a rate of 17% for abscesses, surpassing the provinces of Azuay (13.50%) and Cañar (10.67%). However, gingivitis for pathology, Azuay stands out with 13.17%, while Cañar and Morona Santiago present 10.50% and 8.33%, respectively. There is also a predominant occurrence of abscesses in rural areas (41.17%) compared to urban ones (26.33%). Regarding sex, girls show a higher percentage of abscesses (41.17%) compared to boys who have a clear tendency to present GUM lesions (22.33%). The data indicates that in the studied provinces, geographical environment and sex are key variables to understand the distribution of oral lesions. These findings encourage us to continue pursuing this type of research, which contributes to improving the quality of life for children. [ABSTRACT FROM AUTHOR]

Melkersson Rosenthal syndrome (MRS) is a disease of multifactorial origin typically presented with a triad of symptoms including peripheral facial nerve paralysis, plicated tongue and orofacial edema. Diagnosing MRS requires the exclusion of other granulomatous diseases and the correlation of clinical with histopathological finding. We present the case of a 56-year-old female with a four-month history of lower lip and right mandible angle swelling together with a plicated tongue that appeared during COVID-19 infection. The patient was successfully treated with intralesional Triamcinolone Acetonide at a dose of 40 mg. The presented case is specific by its late onset since the patient experienced their first symptoms in fifties, which differs from the majority of cases where the diagnosis is usually established in young adults. Infectious factors are established as possible etiologic factors of MRS, but few cases are described to be triggered or worsened by COVID-19 infection. [ABSTRACT FROM AUTHOR]

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Background: Patients with lymphedema and lipedema share physical exam findings that may lead to misdiagnosis. Poor mobility is common in patients with obesity and patients with lymphedema and lipedema. This may constitute a risk factor for venous thromboembolism (VTE). Our objective was to evaluate the association of VTE in obese patients with lymphedema and lipedema. Methods: The National Inpatient Sample (NIS) was searched from 2016 to 2020 to identify hospital admissions of obese female patients with lymphedema and lipedema. Patients were analyzed in the context of presence or absence of VTE while adjusting for complex cluster sampling techniques. Predictors of VTE were accessed by multivariable regression. Results: Lymphedema was identified in 189,985 patients and lipedema in 50,645 patients. VTE was observed in 3.12% (n = 374,210) of patients with obesity. In patients with obesity, VTE was more common in patients with lymphedema than without (2.6% vs 1.6%; p < 0.01). Similarly, VTE was more common in patients with lipedema than without (0.6% vs 0.4%; p < 0.01). After multivariable logistic regression, VTE events in obese patients with lymphedema were higher versus without (OR 1.6; CI 1.08–2.43; p = 0.02). Similarly, VTE events were more common in obese patients with lipedema versus obese patients without lipedema (OR 1.20; CI 1.03–1.41; p = 0.02). Conclusions: In this hypothesis-generating study, lymphedema and lipedema show a positive association with VTE after adjusting for baseline patient characteristics such as obesity, which is a known independent risk factor for VTE. Mechanisms whereby lymphedema and lipedema are associated with VTE should be investigated. [ABSTRACT FROM AUTHOR]

Background and Aim: The approach to vascular malformations in the face is a challenging step for professionals involved in the treatment of these anomalies. The objective is to describe a rare case of extensive vascular malformation in the face in an adult patient who had previously undergone several unsuccessful treatments during childhood and adolescence. Materials and Methods: A 46‐year‐old female patient reported an aesthetic discomfort in her face due to an increase in the volume of the upper lip and recurrent spontaneous bleeding in the oral cavity. On oral clinical evaluation, a blue‐purple colour, firm consistency on palpation, extension into the oral cavity, and moderate mobility of the incisors in the right hemimaxilla were observed. Angiography, magnetic resonance imaging and cone beam computed tomography were performed to verify the lesion's anatomical limits and hemodynamic properties. Four injections of sclerotherapy with an injection of 5% monoethanolamine oleate foam were performed. Results: A significant reduction in the extent of vascular malformation was noted. At the moment, the patient had 3 years of follow‐up. She is extremely satisfied with the aesthetic result, and has had no episode of spontaneous bleeding or other complications. Conclusions: The request for new imaging exams allowed the characterization and precise delimitation of the vascular malformation, guiding the use of a minimally invasive technique using the injection of monoethanolamine oleate foam, providing an effective and satisfactory result for the patient. [ABSTRACT FROM AUTHOR]

Ointment pseudo‐cheilitis is a recently recognized distinctive type of self‐induced cheilitis. Lesions consist of a variable amount of crusts adhered to the vermilion. These crusts consist of dried saliva and dead cells mixed with applied medications attached to the lip surface. Patients are typically severely anxious or depressed; the condition impacts quality of life. Ointment pseudo‐cheilitis is frequently misdiagnosed as exfoliative cheilitis or cheilitis glandularis. Biopsy reports are often non‐revealing because there are no established histopathological criteria for this disease, and clinicians usually do not formulate the correct diagnostic hypothesis. Here, we present the histopathological findings of four cases of ointment pseudo‐cheilitis. The most consistent finding was the presence of laminated parakeratotic material detached from the epithelium in biopsies that are devoid of other significant diagnostic changes. This material at the lip surface possibly represents physiologic labial desquamation mixed with dried saliva and applied medication. With this report, we intend to alert dermatopathologists to the diagnosis of ointment pseudo‐cheilitis if they receive biopsies from patients who present clinically exuberant labial lesions that show only minimal histopathological changes. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the occurrence of oral mucosal lesions (OML) in domestic waste collectors and their association with occupational exposure to domestic waste. This cross-sectional study included 295 adult men who worked in a waste management company: 129 men were exposed to domestic waste during their labor of waste collection, and 166 were not. The waste collectors used personal protective equipment. The lips, buccal mucosa and sulcus, gum, alveolar ridge, tongue, the floor of the mouth, and soft and hard palate were evaluated. The chisquare or Fisher's exact test assessed the variables associated with OML (P = 0.05). Twenty-five OMLs were observed in 22 volunteers, 8 in the exposed and 17 in the non-exposed group. Actinic cheilitis in the lips and candidiasis were the most common lesions in both groups. OML was not associated with waste exposure (OR= 0.72, 95% CI = 0.29-1.77, P = 0.47). There was no association between domestic waste exposure and actinic cheilitis (OR = 0.70, 95% CI= 0.23-2.15, P = 0.37), candidiasis (OR = 0.42, 95% CI= 0.08-2.12, P = 0.24) or leukoplakia (OR = 0.99, 95% CI= 0.97-1.01, P = 0.32). Actinic cheilitis in the lips and candidiasis were the most common lesions in both exposed and non-exposed groups. Occupational exposure to domestic waste was not related to OML. Proper use of personal protective equipment may have prevented the development of OML in domestic waste collectors. [ABSTRACT FROM AUTHOR]

Cheilitis is a relatively common lip disease with many etiologies and causes including concomitant mucocutaneous or systemic diseases, which needs multidisciplinary communication. The purpose of this study was to compare the scientometric characteristics of cheilitis publications by multidisciplinary specialists. All the papers on cheilitis were comprehensively retrieved from the Scopus database, and divided into three groups (dermatologists, stomatologists, and other scholars). There were 478 and 241 papers on cheilitis published by dermatologists and stomatologists, respectively. The total citation count was 5838 and the h index was 36 for cheilitis publications by dermatologists, and the total count was 2983 and the h index was 27 for cheilitis publications by stomatologists. Interestingly, we observed that dermatologists preferentially concerned contact cheilitis/dermatitis and plasma cell cheilitis, while stomatologists preferentially concerned cheilitis-related lip neoplasms including squamous cell carcinoma, dysplasia, and precancerous conditions. The most common disorder researched by both dermatologists and stomatologists was actinic cheilitis. The keywords such as patch test, cosmetic, edema, drug efficacy, toothpaste, lipstick, allergens, and granulomatous inflammation were common in dermatologists' publications; while the keywords such as protein expression, metabolism, risk factor, prevalence, malignant transformation, and carcinogenesis were common in stomatologists' publications. This study for the first time reported the scientometric characteristics of cheilitis as an interdisciplinary disease researched by specialists. It highlights that cheilitis-related specialists through reciprocal collaboration and communication will improve the patients' outcomes. [ABSTRACT FROM AUTHOR]

Background and Aim: The purpose of this review is to collect the oral-facial complications caused by the covid-19 vaccines and to know the reasons for their occurrence. Material and Methods: An electronic search without date restrictions was performed in the MEDLINE databases through PUBMED and google scholar. Among the 50 studies after removing duplicates, 11 articles that met the inclusion criteria were reviewed and included in the study. Result: Studies have shown that the injection of Covid-19 vaccines may cause oral side effects such as lichen planus, erythema multiforme, Steven Johnson syndrome, mucositis, and Bell's palsy. Bell's palsy (6023 cases), skin and mucosa itching (39 cases), erythema multiforme (6 cases), lichen planus (6 cases), Steven Johnson syndrome (3 cases), mucositis (1 case), angular cheilitis (1 case) ), pemphigus vulgaris (1 case) and one case with unknown cause. Pfizer vaccine is the most complicated vaccine reported in this study. Conclusion: Considering the high prevalence of covid-19 and the subsequent injection of covid-19 vaccines in order to prevent this disease, diagnosis and treatment of possible complications, especially oral and facial complications after vaccination, are of great importance. [ABSTRACT FROM AUTHOR]

Lip and oral cavity cancer is a severe and growing problem, ranked 16th for both incidence and mortality worldwide. These malignancies are mainly treated with surgery, which can cause a wide range of sequelae. Despite ultrasound-guided microwave ablation (MWA) being widely used, there is no report concerning its application in lip cancer. This study presents a case of ultrasound-guided MWA in a 97-year-old man with squamous cell carcinoma (SCC) and lymph node metastases under the lower lip. The patient was unsuitable for surgery due to his older age. At the most recent 1-year follow-up after treatment, the patient remained in good condition with no symptoms of dysphagia or slurred speech, and the cosmetic results were excellent. Based on clinical evaluation and radiographic imaging, there was no evidence of metastasis or recurrence. Ultrasound-guided MWA could be a promising option for the management of lip cancer. [ABSTRACT FROM AUTHOR]

Laffer-Ascher syndrome is characterized by double lips, blepharochalasis, and nongoiter thyroid enlargement. The syndrome was first described in 1923 and several case reports have been published thereafter. We illustrate the syndrome through a case of a 46-year-old woman who presented with both upper and lower double lips and blepharochalasis, and review the literature published. Thyroid involvement is the most inconsistent feature of the syndrome complex described in reported cases. [ABSTRACT FROM AUTHOR]

Introduction: Management of the neck in oral cavity squamous cell carcinoma (OCSCC) is essential to oncologic control and survival. The rates of lymph node metastasis (LNM) vary based on oral cavity tumor site and stage and influence treatment decisions. The aim of this paper was to describe clinical LNM for different tumor subsites and stages of surgically managed OCSCC. Methods: We conducted a retrospective analysis of 25,846 surgically managed OCSCC patients from the National Cancer Database (NCDB) stratified by tumor subsite and clinical T-stage. For cN + patients, rates of pathologic LNM and absence of pathologic LNM were determined. For cN0 patients, outcomes included the rates of elective neck dissection (END) and occult LNM and predictors of occult LNM determined by a multivariable logistic regression model. Results: A total of 25,846 patients (59.1% male, mean age 61.9 years) met inclusion criteria with primary tumor sites including oral tongue (50.8%), floor of mouth (21.2%), lower alveolus (7.6%), buccal mucosa (6.7%), retromolar area (4.9%), upper alveolus (3.6%), hard palate (2.7%), and mucosal lip (2.5%). Among all sites, clinical N+ rates increased with T-stage (8.9% T1, 28.0% T2, 51.6% T3, 52.5% T4); these trends were preserved across subsites. Among patients with cN + disease, the overall rate of concordant positive pathologic LNM was 80.1% and the rate of discordant negative pathologic LNM was 19.6%, which varied based on tumor site and stage. In the overall cohort of cN0 patients, 59.9% received END, and the percentage of patients receiving END increased with higher tumor stage. Occult LNM among those cN0 was found in 25.1% of END cases, with the highest rates in retromolar (28.8%) and oral tongue (27.5%) tumors. Multivariable regression demonstrated significantly increased rates of occult LNM for higher T stage (T2 OR: 2.1 [1.9–2.4]; T3 OR: 3.0 [2.5–3.7]; T4 OR: 2.7 [2.2–3.2]), positive margins (OR: 1.4 [1.2–1.7]), and positive lymphovascular invasion (OR: 5.1 [4.4–5.8]). Conclusions: Management of the neck in OCSCC should be tailored based on primary tumor factors and considered for early-stage tumors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cutaneous squamous cell carcinomas (cSCCs) of the lip have been reported to be at higher risk for poorer post-treatment outcomes. OBJECTIVE: To examine outcomes of patients with SCC of the lip treated with Mohs micrographic surgery (MMS) and identify factors for recurrence. MATERIALS AND METHODS: This retrospective review of a single tertiary referral center's Mohs case logs from 2010 to 2019 identified cases of lip SCC. Clinicopathologic characteristics and outcomes (local recurrence [LR], metastasis, and disease-specific death) were reviewed. RESULTS: One hundred ninety cases of SCC of the lip were identified and demonstrated that MMS offered a disease-free survival of 96.8% over an average follow-up period of 42 months. Younger age (61 vs 74 years p =.006), increased MMS stages (p =.009), and higher American Joint Committee on Cancer and Brigham and Women's Hospital T stages were risk factors for LR. Immunosuppression, large tumor size, mucosal lip involvement, aggressive histology, and perineural invasion were not associated with LR. CONCLUSION: The results of this study show that SCC of the lip behaved similarly to cSCC outside the lip area, and that both primary and recurrent lesions can be treated effectively with MMS. [ABSTRACT FROM AUTHOR]

There is no standardized technique for lip reconstruction because the structure and functions of the lip are diverse. We developed a new lip reconstructive approach using a bilateral oblique mucosal V-Y advancement flap. We present the case of a 76-year-old woman with severe dementia, referred to our institute for a tumor on her lower lip. She was diagnosed with lip squamous cell carcinoma (cT2N0M0). The tumor measured 25 × 20 mm. It was resected with a surgical safety margin of 6 mm. Bilateral triangular flaps were fashioned obliquely on the rear lateral side of the defect extending from the labial to the buccal mucosa and used to repair the defect. The operation time was 66 min. She was discharged on the fourth postoperative day without any complications. Speech and food intake functions have been preserved and she has been followed up for 26 months with no recurrence. The lip closing and color match has been adequate despite a slight thinning of the lip. This technique offered a major benefit of short operation and hospitalization time because it was a simple, less-invasive, one-step procedure. This is a practical procedure, suitable for vulnerable patients of advanced age or with comorbidities. [ABSTRACT FROM AUTHOR]

Necrolytic migratory erythema (NME) is pathognomonic of glucagonoma syndrome associated with pancreatic neoplasm. Pseudoglucagonoma syndrome, which is extremely rare, refers to NME without a glucagon-secreting tumor. We describe a rare case of NME in a 45-year-old female who presented with a skin rash associated with scaling, cheilitis, glossitis, hair loss, and weight loss. Serum glucagon and serum zinc levels were normal. Skin biopsy was suggestive of necrolytic erythema migrans. Ultrasonography (USG) and computed tomography (CT) of the abdomen showed chronic pancreatitis. Resolution of lesions was observed with topical steroids, emollients, intravenous (IV) protein infusions, and other supplements. [ABSTRACT FROM AUTHOR]

This article discusses a case of plasma cell cheilitis (PCC), a rare condition characterized by chronic lip swelling and erythema. The exact cause of PCC is unknown, but it is thought to be an immune-mediated reactive process triggered by various factors such as infections, trauma, and solar damage. The patient in this case study was a 40-year-old female who had been experiencing lip swelling and redness for 11 years. Despite trying various treatments, she did not experience much improvement until she was prescribed systemic steroids, which resulted in an excellent response. PCC typically affects elderly women and can also involve other areas of the oral cavity. Treatment options for PCC are limited and anecdotal, with topical steroids, intralesional steroids, and other medications being mentioned in reports. This case highlights the effectiveness of systemic steroids in treating PCC. [Extracted from the article]

Retinoids are used topically as well as orally, and the most commonly used oral retinoids are isotretinoin and acitretin. Mucocutaneous adverse effects are frequently seen with the use of systemic retinoids, the most common being cheilitis, which is dose-dependent and seen in almost all patients using it. To study the comparative effect of topical tacrolimus 0.1% ointment versus topical white soft petrolatum jelly in the treatment of cheilitis due to retinoids. A total of 26 patients with cheilitis post-treatment with isotretinoin were enrolled in this cross-sectional study conducted over a period of 6 months. They were randomized into two groups of 13 patients each to receive topical tacrolimus 0.1% ointment and soft petrolatum jelly twice daily, respectively. Patients were followed up weekly with clinical photographs. Resolution of cheilitis was assessed on the basis of photograph and ICGS score. About 84.6% of patients of group A and 53.8% of patients of group B showed resolution of symptoms within 1 week of treatment. A significant difference was seen in duration for complete cheilitis resolution and relapse rate in the two groups. Our study concludes that oral retinoid-induced cheilitis shows faster and more significant resolution with twice-daily topical tacrolimus 0.1% ointment application compared to twice-daily topical petrolatum jelly. [ABSTRACT FROM AUTHOR]

Purpose: Acquired defects of the central face pose significant challenges in achieving acceptable cosmetic and functional outcomes. The site, size, and depth of tissue loss often render local tissues inadequate for the repair of major nasal defects. In this article, we aim to demonstrate the efficacy of radial forearm-free flaps as an ideal choice for various central facial unit reconstructions. Methods: This study encompassed patients treated between 2020 and 2022 who underwent facial reconstruction using radial forearm flaps. These flaps were employed in eleven patients with defects involving the lower lid, nose, upper lip, and lower lip. Additionally, we used osteocutaneous flaps in one patient to reconstruct a right nasal bone defect. In three patients requiring medial and lateral canthal tendon reconstruction in one case and oral sphincter reconstruction in two cases, the palmaris longus tendon was included with the flap. Results: In the majority of cases, we achieved good to excellent aesthetic and functional results. Notably, there were no instances of flap failure or partial necrosis in this series. All patients experienced uneventful healing at the donor site. Conclusions: The radial forearm-free flap stands as an ideal and reliable method for reconstructing various facial defects. It offers efficient and thin-conforming skin coverage. [ABSTRACT FROM AUTHOR]

Tick-borne illnesses and methemoglobinemia have not been known to occur together in humans. Few cases have been documented in various animals of methemoglobinemia secondary to tick-borne infections. A 49-year-old man with no significant medical history presented to the emergency department from an urgent care with hypoxia saturating in the mid 80s. He also reported a pruritic rash on his back and right shoulder as well as both of his lower extremities. The rash had been present for 4 days. The patient was tachycardic and hypoxic at 90% but denied shortness of breath. He had cyanosis of the lips and fingertips and multiple erythematous, raised, ovoid lesions on the right shoulder and left lower extremity. Methemoglobin levels were elevated at 26%. He was treated with methylene blue, supplemental oxygen, and empiric doxycycline with improvement in his oxygenation. A tick-borne illness panel later tested positive for Babesia microti infection. His skin lesions resolved with the above described treatment. Both tick-borne illnesses and methemoglobinemia are typically easily treatable with proper antimicrobial coverage and methylene blue, respectively. The current literature is bare regarding concurrent tick-borne illnesses, specifically babesiosis, and methemoglobinemia. Without knowledge and documentation of a potential link between the two conditions, hypoxia, if found to be due to methemoglobinemia, may be treated adequately, but a potentially life-threatening tick-borne illness may continue to cause damage and disease to the patient if not tested for, identified, and treated. [ABSTRACT FROM AUTHOR]

Objective: Since the aetiologies of cheilitis are broad and overlapping, the purpose of this cross‐sectional clinical study was to examine the multiple factors involved in aetiology and the disease's clinical features. Subjects and Methods: We analysed cheilitis prevalence, demography, clinical features, patients' habits, psychological stress, systemic diseases, vitamin B9, B12 and iron serum levels and allergy test results in a total of 130 subjects with cheilitis, plus 22 healthy subjects. Results: The most common cheilitis types were: cheilitis simplex and eczematous cheilitis (28.5%); herpetic cheilitis (16.9%); and exfoliative and angular cheilitis (7.7%). Concerning bad habits, there was a significant association/connection between self‐reported saliva at the corners of the mouth and angular cheilitis, and between lip licking/biting and exfoliative cheilitis. Common associated conditions were skin diseases (56.5%) and atopy (84%). Vitamin B9 and B12 serum and iron values were mostly within the normal reference range. The patients suffering from herpetic cheilitis had significantly higher psychological/mental stress levels than the control group. Conclusion: To our knowledge, this is the first study of cheilitis patients that has simultaneously analysed aetiological factors, characteristics of the disease and diagnostic parameters. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate social smile asymmetry in patients with unilateral impacted maxillary canine on 3D stereophotogrammetric images. Material and methods: The 3D social smile images of participants with unilateral impacted maxillary canine (n:20) and without impaction as a control group (n:20) were included. The images were recorded with a hand-held 3D stereophotogrammetry device (Fuel3D® Scanify®) and Geomagic Essentials 2 reverse engineering software were used for analyses. After the orientation process of the 3D records, the tissues around the smile area were divided into five morphological regions: cheek, upper lip lateral and medial, and lower lip lateral and medial. The deviation margins in the negative and positive directions for the 95% mesh rate and the total percentages of meshes between − 0.5- and + 0.5-mm deviations were calculated. ICC, paired samples t test, independent samples t test, and the Mann–Whitney U test were used for statistical analyses. Results: In individuals with impacted canine, the amount of maximum positive deviation in the upper lip medial was 5.64 mm ± 1.46 and maximum negative deviation was − 4.6 mm ± 1.17. In the control group, mean of deviation limits for all parameters was less than 1.19 mm ± 2.62, while in individuals with unilateral impacted maxillary canine, the maximum value was 8.34 mm ± 2.23. The mesh percentage between − 0.5 and 0.5-mm deviations was over 95% in all morphological areas in the control group, while in the impacted canine group, the number of meshes within the specified deviation limits was less than 95%. Conclusion: Individuals with unilateral impacted maxillary canine exhibit greater asymmetry in social smile compared to the control group, with the asymmetry being most prominent near the corners of the mouth and cheeks. Clinical relevance: Amount of asymmetry was higher in impaction group compared to the control group in social smile. The quantification of a possible smile asymmetry due to the impacted canine is crucial for the diagnosis and treatment planning of orthodontic and/or orthognathic cases for ideal aesthetic results. Hence, smile asymmetry should not be overlooked and should be considered in diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

Background: Cheilitis is an inflammatory condition of the lips. Its causes can be exogenous (irritants, allergens), endogenous (atopic dermatitis, systemic disorders) or unknown. Objectives: To determine the prevalence of allergic contact cheilitis (ACC), its risk factors, and common allergens in patients with cheilitis at a Thai university‐based tertiary care hospital. Methods: A retrospective chart review was conducted on patients with cheilitis referred for patch testing between January 2007 and December 2021. Results: Among 5366 patients referred for patch testing, 410 (7.6%) had cheilitis. ACC was diagnosed in 32% of the cheilitis patients. Compared to non‐ACC cases, the patients with ACC were more likely to be young and female and have a disease duration of <3 months, no underlying disease and a white‐collar job (p‐value <0.05). The most common contact allergens were patient's products (73.3%), nickel sulfate (29.8%), potassium dichromate (14.5%), castor oil (14.3%) and benzalkonium chloride (13.0%). Lip cosmetics and toothpastes were major ACC sources. Conclusions: ACC should be considered in cheilitis patients, especially in patients with specific risk factors. Castor oil is an emerging allergen. Patch testing using commercial allergen series and patients' own products is crucial for identifying causative agents. The development of a specific cheilitis series is warranted. [ABSTRACT FROM AUTHOR]

Background: The role of contact sensitisation in the pathogenesis of oral lichen planus (OLP) has not been clearly defined. Objective: We aimed to evaluate relevant contact sensitisers in OLP. Methods: A retrospective study was conducted on OLP patients who underwent patch testing from 1 January 2006 to 31 December 2020 at an Australian tertiary dermatology institution, compared to cheilitis patients patch tested over the same time period. Results: Ninety‐six OLP patients and 152 cheilitis patients were patch tested during the 15‐year period. Seventy‐one (73.9%) OLP patients and 100 (65.8%) cheilitis patients recorded one or more relevant reactions. Forty‐three (44.8%), 22 (22.9%), 21 (21.9%) and 17 (17.7%) OLP patients had relevant reactions to mercury‐related chemicals, amalgam, spearmint and carvone, respectively, compared to 6 (3.9%), 3 (2.0%), 4 (2.6%) and 0 (0%) cheilitis patients, respectively (p‐value <0.001 each). Four (4.2%) OLP patients had relevant positive reactions to sodium metabisulfite, compared to none in the cheilitis group (p‐value 0.021). Conclusion: While dental amalgam is used less frequently these days, we report that mercury (found in amalgam) and additionally spearmint and carvone are relevant sensitisers in OLP in Australia. Sodium metabisulfite may also be a relevant sensitiser in OLP, which has not previously been reported. [ABSTRACT FROM AUTHOR]

Lip synechiae as a sequalae of erythema multiforme (EM) is rare. However, the condition results in significant dysfunctionality and disfigurement in affected individuals. The objective of this clinical case report is to highlight the importance of the preventative strategies in carbamazepine‐induced EM to alleviate complications such as lip synechiae. We reviewed a case report of lip synechiae as a sequelae of carbamazepine‐induced EM as well as the previously reported cases of lip synechiae. A 23‐year‐old female presented with the inability to open her mouth following carbamazepine exposure with concomitant eruption of mucocutaneous lesions on the torso, acral, conjunctiva and haemorrhagic crusting on both lips with fusion thereof. The lip synechiae resulted in dysfunction and disfigurement with reduced verbal articulation and mastication. Based on the history and the characteristic appearance of the mucocutaneous lesions, a diagnosis of EM was made. The suspected inciting drug was withdrawn followed by bilateral chalinoplasty. To prevent further adhesion of the lips, chlorhexidine‐impregnated paraffin gauze dressing was applied. The patient attained good functional and aesthetic outcomes. [ABSTRACT FROM AUTHOR]

Aim: Assessing the knowledge of clinical dental students regarding prevalent geriatric oral diseases is crucial in evaluating their clinical competency. This study focuses on analyzing dental students' knowledge of angular cheilitis (AC) and xerostomia in elderly patients. Materials and Methods: In this analytical cross-sectional investigation, clinical dental students from Universitas Airlangga were involved. We employed simple random sampling to select a minimum of 76 students and gathered data, including demographic information and knowledge about AC and xerostomia, through an online questionnaire. Respondents were then categorized into three groups based on their knowledge level: poor, moderate, and good. We utilized coefficient contingency and odds ratio analysis to explore relationships and effects between demographic factors and knowledge levels. Results: The study findings indicated that a significant majority of respondents demonstrated a high level of comprehension regarding AC (58.4%). Conversely, a notable proportion of respondents exhibited limited knowledge regarding xerostomia (66.3%). Furthermore, our correlation analysis, which aimed to identify potential associations between knowledge levels and intrinsic factors such as gender, clinical interest, and proximity to geriatric individuals, did not reveal any statistically significant relationships (P > 0.05). Conclusion: Within the population of clinical dental students, there is a commendable level of knowledge concerning AC in the geriatric demographic. However, a substantial segment of students lacks adequate understanding when it comes to xerostomia. [ABSTRACT FROM AUTHOR]