bromochloroacetic-acid and Mouth-Diseases

Epidermoid cysts of the body of the tongue are rare. Only 12 cases of such lesions have been reported in the English literature.. A 14-year-old boy had a 7×5-mm-sized cystic lesion with a yellowish-white surface on the ventral aspect of his tongue. The cystic wall was composed of squamous epithelium containing keratinous material. No skin appendages were attached to the wall. These findings were consistent with a diagnosis of an epidermoid cyst.. For the thirteen cases, including ours, the average age was 18.0 years. The highest incidence was found in the first decade of life. Eight of the patients were male and five were female. The size varied from several millimeters to several centimeters. There may be a left side predilection of the occurrence. There is no evidence for malignant transformation of epidermoid cysts of the tongue, though two cases were reported as carcinoma arising from an epidermoid or dermoid cyst of another oral area.. Epidermoid cysts of the body of the tongue are congenital or acquired. The congenital type can arise due to a failure of surface ectoderm separation or invagination of the surface ectoderm along the embryologic fusion sites. The acquired type is caused by trauma, with implanting of an epithelial element into the deeper tissue. In the present case, it was difficult to determine whether the pathogenesis was congenital or acquired because there are no clinical or histopathological differences between the two types.

Topics: Adolescent; Epidermal Cyst; Epithelium; Humans; Keratins; Male; Mouth Diseases; Tongue

The dynamics of oral mucosa is known by its inherent defensive nature. Certain areas demand tough shield when subjected to mechanical insults. This is met by structural scaffolding material referred as cytoskeleton comprised of intracellular protein filaments called cytokeratins in the surface squames of oral epithelia. They also equally contribute towards the architecture of odontogenic apparatus and salivary gland. Differentiation of epithelial cells within stratified epithelia regulates the expression of specific keratin gene. Any mutation in, or autoantibodies to keratins, desmosomal and cornified envelope proteins is translated into genetic and acquired human disorders. Sound knowledge of structural proteins, their expression, distribution and function plays a vital role in acquainting with these disorders and their application as differentiation markers. Thus, they form an integral aid in diagnostic pathology and may be instrumental in the future interventions by gene therapy. This review focuses on basics to current updates on oral cytokeratins with an emphasis on the genetic and acquired disorders of cytokeratins with oral implications.

Topics: Cell Differentiation; Cytoskeleton; Epithelial Cells; Humans; Keratins; Mouth Diseases; Mouth Mucosa

Topics: Animals; Genetic Therapy; Herpesviridae Infections; Herpesvirus 1, Human; Humans; Keratins; Mouth Diseases; Mouth Neoplasms; Mutation; Periodontitis; Reactive Oxygen Species; Recurrence

A sensitive in situ hybridization test under low stringency conditions (LCS) with a set of digoxigenin-labeled human papillomavirus mixed probes (D-L HPV MP) revealed a positive reaction in 8 of 10 cases of oral verruca vulgaris (OVV). Ages ranged from 5 to 37 years with a mean of 14.5 years. 50% of all cases were located intraorally on the hard palate, followed in frequency by the commissures. These preliminary findings provide evidence of the role of HPV in OVV from a sample of the Venezuelan population. We show that in situ hybridization conducted under LSC is useful in HPV detection (regardless of the type) and the digoxigenin-labeling system is a rapid, relatively easy and specific method. In addition, this technique permits the retrospective evaluation of routinely processed material, thus widening the investigative spectrum for HPV.

Topics: Adolescent; Adult; Cell Nucleus; Child; Child, Preschool; Condylomata Acuminata; DNA Probes, HPV; Epithelium; Female; Humans; Keratins; Male; Mouth Diseases; Mouth Neoplasms; Nucleic Acid Hybridization; Papilloma; Papillomaviridae; Venezuela; Warts

This article proposes a classification of oral epithelial and summarizes recent literature of cytokeratin expression in the oral cavity. The oral epithelial are subdivided into two major groups: superficial and deep epithelia. Epithelial lining the oral cavity, i.e., superficial, are essentially stratified squamous epithelia, with the exception of taste buds. The epithelium covering the dorsal tongue is a combination of keratinized and non-keratinized epithelia. Deep epithelia are of two kinds, odontogenic and glandular epithelia. This study provides a classification of the cytokeratins expressed in the oral cavity in healthy and pathological situations based on published data and our own studies. The profiles of these polypeptides in different oral epithelia should provide information that may be used in various disciplines of oral medicine.

Topics: Classification; Epithelium; Humans; Keratins; Mouth Diseases; Mouth Mucosa

Recent progress in understanding the biology of keratins together with the development of monoclonal antibodies to individual keratin proteins provide the foundation for studying keratin expression in normal and pathological oral epithelia. Areas of oral pathology in which the examination of epithelial keratin profiles may yield information of potential diagnostic value are discussed. Examples of altered keratin expression in epithelial dysplasia, oral cancer and odontogenic cysts and tumours are presented. Immunocytochemical demonstration of individual keratins can clarify the composition of complex epithelia and may help to establish epithelial lineage or indicate progression changes in tumours. Some problems in the application and interpretation of keratin immunocytochemistry are also considered.

Topics: Antibodies, Monoclonal; Antigens, Surface; Gene Expression Regulation; Humans; Keratins; Mouth Diseases

Topics: Animals; Epithelial Attachment; Epithelium; Gingiva; Humans; Keratins; Mouth Diseases; Mouth Mucosa; Permeability; Pharmaceutical Preparations

Topics: Biological Transport, Active; Chemical Phenomena; Chemistry; Connective Tissue; Diffusion; Endocytosis; Epithelial Attachment; Epithelial Cells; Epithelium; Gingiva; Gingival Crevicular Fluid; Humans; Keratins; Methods; Mouth Diseases; Mouth Mucosa; Permeability

Verruciform xanthoma (VX) is an uncommon, benign epithelial lesion of the oral mucosa. While this entity can also present extraorally, including on the skin and in anogenital areas, the variation in its histologic features in extraoral sites is not yet well defined. Differences in the demographics and morphologic features of oral versus extraoral VX were assessed to help facilitate the accurate diagnosis and management of this lesion.. After obtaining IRB approval, 110 cases of diagnosed VX were retrospectively collected from our institutional archives spanning from 2000 to 2022. Patient age, gender, available medical history, lesion appearance, and duration were obtained for each case.. The median age was 55 years (range 13-86) with a male-to-female ratio of 1.2:1. The most common oral sites, in descending order, were the palate (n = 24, 22%), buccal mucosa (n = 18, 16%), gingiva (n = 16, 15%), and tongue (n = 13, 12%). Extraoral sites comprised 9% of all lesions, including the scrotum (9), vulva (2), cheek (1), wrist (1), gluteal region (1), and abdominal wall (1). The median size for all lesions was 6.0 mm, and extraoral lesions were associated with a 6.7 mm larger size compared to oral lesions (B ± SE: 6.7 ± 2.5 cm, p = 0.01). The lesions were most frequently pink or white in color and often described as papillary, pedunculated, verrucous, and/or exophytic. Microscopically, the presence of wedge-shaped parakeratosis, keratin projections above the epithelium/epidermis, and associated inflammation significantly differed between oral and extraoral lesions. Prominent wedge-shaped parakeratosis (p = 0.04) and keratin projections above the epithelium/epidermis (p < 0.001) were more prevalent in extraoral lesions. There was no significant link between keratin projections and epithelial atypia (p = 0.44).. Familiarity with the broad morphological spectrum of VX, including the presence and degree of wedge-shaped parakeratosis, keratin projections above the epithelium/epidermis, and associated underlying inflammation, will be helpful in diagnosing it in unusual locations.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Genitalia; Humans; Keratins; Male; Middle Aged; Mouth Diseases; Parakeratosis; Retrospective Studies; Xanthomatosis; Young Adult

Verruciform xanthoma of the oral cavity is an uncommon benign lesion that usually affects the palate and gingiva mainly as a well-circumscribed solitary yellowish to whitish plaque or nodule, which is promptly recognized microscopically by identification of sub-epithelial foamy macrophages. The aim of this study was to evaluate the clinicopathologic and immunohistochemical features of 20 cases of oral verruciform xanthoma. All cases were evaluated by conventional hematoxylin/eosin staining and six of those were submitted to immunohistochemical reactions for CD68, CD63, CD163, syndecan-1 (CD138), S-100 protein and cytokeratins (CK) 8, 14 and 19. Oral verruciform xanthoma presented as yellowish papillary nodules affecting mainly the palate (30%), buccal mucosa (30%) and gingiva (25%) of middle-aged male patients. Most cases presented papillary epithelial hyperplasia and sub-epithelial foamy cells, which were immunopositive for CD68, CD63 and CD163 in all cases. The orange parakeratin superficial layer was negative for CK14 and presented a distinct granular membrane pattern of positivity for CD138. S-100 protein, CK8, and CK19 were negative.

Topics: Adult; Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Mouth Diseases; Receptors, Cell Surface; S100 Proteins; Syndecan-1; Tetraspanin 30; Xanthomatosis

Topics: Adult; Diagnosis, Differential; Female; Humans; Keratins; Mouth Diseases; Mouth Mucosa; Tooth Bleaching Agents; Toothpastes

Paracoccidioidomycosis (Pmycosis) is one the most prevalent deep systemic mycoses in Latin America. It is characterized by granulomatous inflammation and pseudoepitheliomatous hyperplasia. Cytokeratins (CKs) are a group of intermediate filaments of epithelial cells and their expression varies according to the epithelium type, differentiation and pathological processes. This study describes cytokeratin expression as examined by immunohistochemistry, in 28 cases of oral Pmycosis involving the buccal mucosa, lip, gingiva and hard palate. Expression of CKs in the basal layer of the epithelium in pseudoepitheliomatous hyperplasia of Pmycosis was similar to that in normal oral mucosa (NOM), but in Pmycosis CK1 and CK10 were not expressed in the spinous and superficial layers of the lip, gingiva or hard palate, and, in the spinous and superficial layers of the lip and buccal mucosa, CK14 was positive in contrast to NOM where it was negative. In Pmycosis, CK6 was more frequently expressed in the spinous layer of the lip, gingiva and hard palate, but nevertheless CK16 expression was decreased in the spinous and superficial layers of the gingiva and hard palate. We conclude that pseudoepitheliomatous hyperplasia in oral Pmycosis shows a different pattern of CK expression, particularly CKs 1, 10 and 14, compared with NOM.

Topics: Gingiva; Humans; Hyperplasia; Immunohistochemistry; Keratins; Lip; Mouth Diseases; Mouth Mucosa; Palate, Hard; Paracoccidioidomycosis

Topics: Adult; Amino Acid Sequence; Ectodermal Dysplasia; Female; Humans; Keratins; Keratoderma, Palmoplantar; Keratosis; Mouth Diseases; Mutation, Missense; Nails, Malformed; Proline; Syndrome

Cannon's disease or white sponge naevus is a relatively rare genetically determined skin disorder. It is inherited as an autosomal dominant trait that displays a high degree of penetrance and expressivity. This article describes cases of Cannon's disease in a mother and her son.

Topics: Adult; Burns, Chemical; Candidiasis, Oral; Child, Preschool; Diagnosis, Differential; Female; Genetic Diseases, Inborn; Humans; Keratins; Keratosis; Leukoplakia, Oral; Male; Mouth Diseases; Mouth Mucosa; Mutation; Pedigree

We sought to investigate a novel mutation in the keratin genes assumed to be responsible for a familial case of oral white sponge nevus.. The affected family consisted of a 36-year-old woman, her 17-year-old daughter, and her 14-year-old son. Keratin 4 and 13 genes extracted from venous blood lymphocytes were amplified by using the polymerase chain reaction and directly sequenced.. Sequencing analysis of the 3 patients revealed the presence of a novel heterozygous T-to-C transition mutation in exon 1 of the keratin 13 gene, with no abnormalities detected in the keratin 4 gene.. We identified a novel heterozygous missense mutation at 332T>C in the keratin 13 gene believed to be related to the development of white sponge nevus.

Topics: Adolescent; Adult; Codon; Cytosine; Exons; Female; Hamartoma; Heterozygote; Humans; Keratins; Male; Mouth Diseases; Mutation, Missense; Thymine

Regular use of snuff is known to cause whitish oral mucosal lesions of variable severity at the usual quid placement site. The main aim of this study was to elucidate cellular mechanisms involved in snuff-induced epithelial changes.. Expression patterns for markers of cell proliferation (PCNA, Ki-67), cell cycle regulation (p53, p21), keratin changes (pankeratin, CK18, CK19), cell stress (HSP 70) and collagen type IV in 14 snuff-induced oral mucosal lesions and 12 control samples were analyzed by immunohistochemistry (IHC).. On light microscopy, all snuff-induced lesions were characterized by a hyperkeratinized and thickened epithelium. Some vacuolized cells, markers of cell degeneration, were frequently seen (in 9/14 of the samples) in the superficial layers in epithelia. Expression of PCNA and Ki-67 was found in a statistically significantly fewer cells in snuff-induced lesions (P < 0.001) than in the controls. This indicates that epithelia in snuff-induced lesions are not thickened as a result of increased cellular proliferation, but by protracted turnover of differentiating cells. Of cell cycle markers, p21 was found be up-regulated in 4/14 snuff-induced lesions, probably by p53-independent pathways. Only two snuff-induced lesions showed p53 positivity. However, the number of stained cells with p53 and p21 was not statistically different from that in controls. Expression of CK18, but not any alterations in CK19 expression, was seen in 5 of 14 snuff-induced lesions. Snuff also seems to stimulate the expression of collagen type IV, possibly by basal cells, as indicated by the thickened staining of the basal lamina.. The findings of this study showing suppressed cellular proliferation and infrequent p53 dysfunction in snuff lesions may partly explain why dysplastic changes are seldom seen in mucosal lesions induced by the Scandinavian type of snuff.

Topics: Adolescent; Adult; Aged; Basement Membrane; Biomarkers; Cell Differentiation; Cell Division; Collagen Type IV; Coloring Agents; Cyclin-Dependent Kinase Inhibitor p21; Cyclins; Enzyme Inhibitors; Epithelium; Female; HSP70 Heat-Shock Proteins; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Lip; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Proliferating Cell Nuclear Antigen; Statistics as Topic; Tobacco, Smokeless; Tumor Suppressor Protein p53; Up-Regulation; Vacuoles

Topics: Diagnosis, Differential; Epithelium; Hamartoma; Humans; Keratinocytes; Keratins; Mouth Diseases; Mouth Mucosa

White sponge nevus (WSN) is an autosomal-dominantly inherited form of mucosal leukokeratosis. Defects in keratins, proteins that form the stress-bearing cytoskeleton in epithelia, have been shown to cause several epithelial fragility disorders. Recently, mutations in the genes encoding mucosal-specific keratins K4 and K13 were shown to be the underlying cause of WSN. We have studied a large Scottish family with 19 persons affected by WSN in four generations. The K4 locus was excluded by genetic linkage analysis; however, genetic linkage consistent with a K13 defect was obtained. Subsequently, a heterozygous missense mutation 335A>G was detected in exon 1 of the KRT13 gene, predicting the amino acid change N112S in the 1A domain of the K13 polypeptide. The mutation was confirmed in affected family members and was excluded from 50 unaffected people by restriction enzyme analysis. These results confirm that mucosal keratin defects are the cause of WSN.

Topics: Adenine; Adolescent; Asparagine; Chromosome Mapping; Chromosomes, Human, Pair 12; Chromosomes, Human, Pair 17; Codon; Epithelium; Exons; Genetic Linkage; Guanine; Hamartoma; Humans; Keratins; Leukoplakia, Oral; Male; Mouth Diseases; Mutation, Missense; Protein Structure, Tertiary; Scotland; Serine

The murine genome is known to have two keratin 6 (K6) genes, mouse K6 (MK6)a and MK6b. These genes display a complex expression pattern with constitutive expression in the epithelia of oral mucosa, hair follicles, and nail beds. We generated mice deficient for both genes through embryonic stem cell technology. The majority of MK6a/b-/- mice die of starvation within the first two weeks of life. This is due to a localized disintegration of the dorsal tongue epithelium, which results in the build up of a plaque of cell debris that severely impairs feeding. However, approximately 25% of MK6a/b-/- mice survive to adulthood. Remarkably, the surviving MK6a/b-/- mice have normal hair and nails. To our surprise, we discovered MK6 staining both in the hair follicle and the nail bed of MK6a/b-/- mice, indicating the presence of a third MK6 gene. We cloned this previously unknown murine keratin gene and found it to be highly homologous to human K6hf, which is expressed in hair follicles. We therefore termed this gene MK6 hair follicle (MK6hf). The presence of MK6hf in the MK6a/b-/- follicles and nails offers an explanation for the absence of hair and nail defects in MK6a/b-/- animals.

Topics: Animals; Epithelial Cells; Gene Deletion; Hair Diseases; Hyperplasia; Isomerism; Keratins; Mice; Mice, Knockout; Microscopy, Electron; Molecular Sequence Data; Mouth Diseases; Nail Diseases; Phenotype; Sequence Homology, Amino Acid; Skin; Starvation; Tongue; Wound Healing

Infection by Staphylococcus epidermidis, an opportunistic pathogen, has become a major problem due to the increased use of implanted medical devices and the growing number of patients who are therapeutically or infectiously immunosuppressed. These infections appear to proceed via modulation of the coagulation and complement systems. In this communication we describe the purification and characterization of a novel extracellular proteinase from an oral strain of S. epidermidis that can degrade fibrinogen, complement protein C5, and several other proteins. This proteinase has a strong preference for cleavage after glutamic acid residues, but not after aspartic acid. The S. epidermidis enzyme may be a multifunctional protein which not only provides this organism with both the ability to evade the complement defense system and to dysregulate the coagulation cascade, but also supplies nutrients for its growth through the degradation of Glu-rich proteins.

Topics: Amino Acid Sequence; Animals; Cattle; Complement C5; Electrophoresis, Polyacrylamide Gel; Fibrinogen; Humans; Keratins; Molecular Sequence Data; Molecular Weight; Mouth Diseases; Protease Inhibitors; Sequence Homology, Amino Acid; Serine Endopeptidases; Staphylococcal Infections; Staphylococcus epidermidis

The light microscopic features and keratin filament distribution of human vaginal epithelium resemble those of buccal mucosa. We used vaginal epithelium to establish a human cyst model in immunodeficient mice. To strengthen the view that this experimental cyst is a suitable model to study mucosal diseases, we compared specific light microscopic and ultra-structural features of vaginal epithelium and the epithelial lining of the cyst. Nineteen cyst walls and 6 specimens of vaginal mucosa, which had been used to establish the cysts, were examined. We counted the number of cell layers of 17 cyst linings and the 6 vaginal specimens. Surface keratinisation was evaluated on sections stained with the Picro-Mallory method. To demonstrate intercellular lamellae and membrane coating granules 2 cyst linings were examined ultra-structurally. The epithelium lining of the cyst wall was thinner than that of vaginal mucosa but the surface keratinisation and ultra-structural features of the intercellular lamellae and membrane coating granules were similar. We concluded that vaginal mucosa is a useful substitute for oral mucosa in the cyst model.

Topics: Actin Cytoskeleton; Animals; Cell Count; Coloring Agents; Cysts; Cytoplasmic Granules; Disease Models, Animal; Epithelial Cells; Epithelium; Extracellular Space; Female; Humans; Intracellular Membranes; Keratins; Mice; Microscopy, Electron; Middle Aged; Mouth Diseases; Mouth Mucosa; Mucous Membrane; Statistics as Topic; Vagina

White Sponge Nevus (WSN) is a rare, autosomal dominant disorder that predominantly affects noncornified stratified squamous epithelia. Clinically, it is characterized by the presence of soft, white, and "spongy" plaques in the oral mucosa. The characteristic histopathologic features are epithelial thickening, parakeratosis, and vacuolization of the suprabasal layer of oral epithelial keratinocytes. Mutations in keratin 4 (K4) and keratin 13 (K13) genes have already been demonstrated to be responsible for WSN; the identification of new keratin mutations in a stratified squamous epithelia closely related to epidermis is of relevance for the understanding of the biochemistry of intermediate filaments, and for genotype phenotype correlations. In this study we investigated a 27-y-old, female Italian patient, affected by white asymptomatic oral plaques. Sequence analysis revealed a 3 bp (ACA) heterozygous insertion localized in the helix initiation motif of the 1A alpha helical domain of K4. We report this new K4 gene mutation and describe an amino acid insertion, in the 1A domain, responsible for a keratin disease.

Topics: Adult; DNA Mutational Analysis; DNA Transposable Elements; Family Health; Female; Glutamine; Hamartoma; Humans; Keratins; Mouth Diseases; Mouth Mucosa; Pedigree; Protein Structure, Tertiary

Gene expression for the differentiation-specific keratins (K4, K13, K1 and K10) was analyzed in oral non-dysplastic keratoses, oral lichen planus (OLP) and lichenoid reactions (LR) by comparative in situ hybridization (ISH) and immunohistochemistry (IHC) to investigate molecular changes in the altered differentiation pattern from non- to para- or orthokeratinization. At the protein level, K4 and K13 were detected homogeneously in the suprabasal compartment of parakeratotic epithelium but showed reduced expression in orthokeratoses, particularly in the presence of lymphocytes. Corresponding transcripts were restricted to basal and lower prickle cells. Synthesis of K1 and K10 was upregulated and more pronounced in orthokeratotic epithelia. The study showed an alteration in the pattern of differentiation-specific keratins, although involvement of the lymphocytic infiltrate in OLP and LR resulted in further gene modulation. In both diseases, K1 and K10 showed transcriptional control, proteins having the same distribution as their transcripts. This represented a change from post-transcriptional regulation in normal buccal epithelium, in which mRNAs for K1 and K10 are more widely expressed than their proteins. Thus, the pattern of keratin gene expression may be altered in response to frictional/smoking stimuli or immune-mediated mechanisms.

Topics: Cell Differentiation; Epithelium; Gene Expression Regulation; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; In Situ Hybridization; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Lichenoid Eruptions; Lymphocytes; Mouth Diseases; Mouth Mucosa; Parakeratosis; RNA Processing, Post-Transcriptional; RNA, Messenger; Transcription, Genetic; Up-Regulation

Epidermoid cysts are rare lesions in the head and neck. Most often the are located in the submental region, although they sometimes can impose certain diagnostic problems. We report the case of a 19-year-old girl who presented with a fluctuant, painless, midline swelling of the floor of her mouth that had persisted for three months. Ultrasonographic examination showed a 5 x 5 x 4 cm cystic tumor with the unusual aspect of multiple smaller spherical formations. The differential diagnosis of the lesion included dermoid cysts, epidermoid cysts, ranula and parasitic lesions. Computed tomography and magnetic resonance tomography were not diagnostic. The patient underwent excision of the lesion, during which the cyst was completely removed. Histopathological diagnosis was consistent with an epidermoid cyst. The striking sonographic aspect of multiple spherical formations in the lesion was caused by multiple spherical keratin formations.

Topics: Adult; Diagnosis, Differential; Epidermal Cyst; Female; Humans; Keratins; Mouth Diseases; Mouth Floor; Ultrasonography

Immunohistochemistry with monospecific antibodies was used to study the expression patterns of cytokeratins (Cks) and vimentin in non-dysplastic lesions of the oral cavity, including lichen planus and fibromas. In hyperplastic lesions, Ck expression did not deviate significantly from the normal non-keratinizing squamous epithelium of the oral cavity. Hyperkeratotic lesions showed pronounced aberrations in their Ck profile. These lesions were characterized by extended expression of the keratinization marker Ck 10, the basal cell Ck 14 and the hyperproliferation-associated Ck 16 in the suprabasal compartment. The stratification markers Cks 4 and 13 showed a decreased expression. Coexpression of Cks and vimentin was found in lesions having accumulations of inflammatory cells in the subepithelial cell layer. These changes are felt to characterize benign mucosal lesions without dysplasia and might be helpful for distinguishing these lesions from potentially malignant ones.

Topics: Antibodies, Monoclonal; Cell Division; Epithelial Cells; Epithelium; Fibroma; Gene Expression Regulation; Humans; Hyperplasia; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Vimentin

The purpose of this study was to investigate the histological changes following short-term smokeless tobacco application in humans. Sixteen smokeless tobacco-using subjects participated in this trial. Each subject had used at least 3 cans of snuff per week for the previous 2 yr and had an existing lesion at the site of habitual snuff placement. The experimental design included subject placement of moist snuff (University of Kentucky reference tobacco brand 1S3) at a new site in the mandibular arch. At either 2 or 7 d, biopsies were taken from the new lesions and from a non-placement site in the opposing arch. The volume density of inflammatory cells was determined by point counting. Keratin and epithelial thickness were evaluated by digitizing morphometry. Data were analyzed by repeated measures analysis of variance. In 7-d lesions, increased keratin thickness was observed at the new sites compared to the non-placement sites (p = 0.05). Increased volume density of fibroblasts (p = 0.027) and decreased volume densities of macrophages (p = 0.0083) and mast cells (p = 0.05) were observed at 2 d in new versus non-placement sites. Clinically, the new sites showed erythema, erythema plus ulceration, or white striations. This study demonstrated histological and clinical changes at new snuff placement sites in as few as 2-7 d, underscoring the rapidity of tissue alterations following snuff use.

Topics: Adult; Analysis of Variance; Cell Count; Epithelium; Erythema; Fibroblasts; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Keratins; Macrophages; Male; Mandible; Mast Cells; Mouth Diseases; Mouth Mucosa; Neutrophils; Oral Ulcer; Plants, Toxic; Tobacco, Smokeless

This study evaluated use of a combination assay of tumor markers in the diagnosis of oral squamous cell carcinoma.. Serum levels of four tumor markers (carcinoembryonic antigen [CEA], squamous cell carcinoma antigen [SCCA], immunosuppressive acidic protein [IAP], and cytokeratin 19 fragment [Cyfra]) were simultaneously measured in 42 patients with oral squamous cell carcinoma (O-SCC) and in 12 patients with oral benign diseases.. The positive rates were 31.0% for CEA, 38.1% for SCCA, 52.4% for IAP, and 38.1% for Cyfra in patients with O-SCC. These rates were significantly different (P < .01) from those of control patients with oral benign diseases. The sensitivity (81.0%) and accuracy (77.8%) of the combination assay uses higher than that obtained with individual markers.. A combination assay with CEA, SCCA, IAP, and Cyfra may be useful for the screening of patients with suspected oral squamous cell carcinoma.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma, Squamous Cell; Chi-Square Distribution; Female; Humans; Keratins; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Neoplasm Proteins; Sensitivity and Specificity; Serpins

Because of the scarcity of sizeable specimens of normal oral mucosa and the availability of human vaginal mucosa, which resembles the lining mucosa of the mouth, we used the latter to establish a human cyst model. Fragments of vaginal mucosa, removed during corrective procedures, were sutured around 2 mm glass balls and implanted into the flanks of nude mice. Thirty-seven specimens were implanted and 31 harvested after 3, 6, 9 and 12 weeks. At 6 weeks the wall of the implanted cyst consisted of recognizable unkeratinized vaginal mucosa but had not healed completely at the sutured edges. From 9 weeks the cyst cavities were healed and the lumens lined by unkeratinized stratified squamous vaginal epithelium. The enclosing connective tissue had retained the characteristics of the lamina propria of the vaginal mucosa and could be distinguished from mouse tissue.

Topics: Animals; Connective Tissue; Cysts; Disease Models, Animal; Epithelium; Female; Granulation Tissue; Humans; Keratins; Mice; Mice, Nude; Mouth Diseases; Mouth Mucosa; Mucous Membrane; Muscle, Skeletal; Time Factors; Vagina; Wound Healing

This study was undertaken to analyze keratin gene expression at both the mRNA and protein level in oral hairy leukoplakia (OHL). Comparisons were made with normal lingual epithelium from a similar site, tongue biting, normal buccal mucosa and another condition which disturbs oral epithelial differentiation, white sponge nevus. Combined immunocytochemical and in situ hybridization studies for keratins 14 and 19 were carried out on 2 specimens of OHL from HIV-positive males and one sample each of the other cases. Keratin 14 protein expression was uniform throughout all the epithelia. In normal epithelia and in lesions other than OHL, keratin 14 mRNA was most strongly expressed in basal cells with weaker but still significant amounts in the spinous cell layer. In both cases of OHL there was weaker basal cell expression of keratin 14 mRNA and frequent absence in koilocytoid cells. Keratin 19 protein expression was heterogeneous in the basal layer of all specimens with suprabasal staining of occasional groups of cells. Its mRNA was uniformly distributed in all cases. The findings indicate the keratin mRNA expression does not always parallel that of protein and that, in the case of keratin 14, expression may be influenced by the presence of EBV.

Topics: Adult; AIDS-Related Opportunistic Infections; Autoradiography; Basement Membrane; Epithelium; Female; Gene Expression Regulation; Herpesvirus 4, Human; Humans; Immunohistochemistry; In Situ Hybridization; Keratins; Leukoplakia, Oral; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Nevus; RNA, Messenger; Tongue Diseases; Tongue Habits; Tumor Virus Infections

We examined 142 biopsy specimens of smokeless tobacco-associated oral mucosal lesions from 133 professional baseball players. Four types of epithelial change were observed in the specimens: hyperparakeratosis, hyperorthokeratosis, pale surface staining, and basal cell hyperplasia. These types of epithelial change were associated with the type of smokeless tobacco used (snuff or chewing tobacco) but not with the duration (years) or amount (hours per day) of use. The thickness of hyperkeratosis in a specimen correlated directly with the amount of smokeless tobacco use. The use of snuff was more frequently associated with development of oral mucosal lesions than was the use of chewing tobacco, and snuff appeared to cause a greater variety and severity of epithelial change than did chewing tobacco.

Topics: Adult; Baseball; Cell Nucleus; Epithelium; Humans; Hyperplasia; Keratins; Leukoplakia, Oral; Male; Mouth Diseases; Mouth Mucosa; Plants, Toxic; Time Factors; Tobacco, Smokeless; United States

The various cytokeratin polypeptides in oral epithelia are expressed in dependence on site and formation of a stratum corneum. Certain cytokeratins occur permanently and others occasionally. In fibrous hyperplasia and Lichen ruber planus, patterns of cytokeratins did not deviate significantly from normal. In some but not all cases of squamous cell carcinoma and leukoplakia studied, marked aberrations of pattern were characterized by (i) appearance of cytokeratin No. 19, (ii) somewhat more frequent occurrence of cytokeratins Nos. 8 and 18, (iii) proteolytic modifications of cytokeratins, and (iv) partial loss of a few site-specific cytokeratins. The aberrations may be taken as additional diagnostic criteria for differentiation between non-aggressive and potentially aggressive leukoplakic lesion, even if they are not correlated with the conventional histological grading of dysplasia.

Topics: Adolescent; Adult; Aged; Carcinoma, Squamous Cell; Female; Gingiva; Humans; Hyperplasia; Keratins; Keratosis; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Molecular Weight; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms

Cellular expression of keratins (intermediate filaments) can be demonstrated by immunocytochemistry using unfixed tissue. However, for practical reasons, provision of fresh tissue to the laboratory is often difficult. Recently a fresh tissue transport medium (Patent applied for) has been developed which allows keratin immunocytochemistry to be performed up to 4 days after biopsy. In this study oral mucosal biopsies from 10 patients were hemisected, half placed in the new transport medium at 4 degrees C and the other half immediately frozen in liquid nitrogen. After 4 days frozen sections of both halves of the biopsies were stained by immunocytochemistry using various antikeratin antibodies. The morphology and staining characteristics of the two halves of the biopsies were then assessed. No significant difference could be found in either morphology or preservation of keratin expression in specimens stored in transport medium, as compared to those in liquid nitrogen. This new transport medium may offer considerable advantage for the provision of a histologic and immunocytochemical diagnostic service.

Topics: Cacodylic Acid; Carcinoma, Squamous Cell; Culture Media; Freezing; Gelatin; Humans; Immunoenzyme Techniques; Intermediate Filament Proteins; Keratins; Leukoplakia, Oral; Lichen Planus; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Nitrogen; Specimen Handling; Staining and Labeling

From a total material of 184 Swedish users of loose packed moist snuff and 68 users of portion-bag packed moist snuff, cases were selected from subgroups based on a four-point clinical grading scale. The selected material for the study comprised 70 cases (ten from each clinical grade group, no Degree 4 lesion was found among portion-bag users). Features recognized in biopsies from these cases together with findings in previous studies correlated well with the use of a four-point scale for the grading of clinical changes, especially in the context of discriminating lesions for which special efforts should be undertaken to make the patient stop or change the snuff dipping habit and for selecting patients in whom regular clinical follow-up including a biopsy should be carried out. In this article is also discussed the labeling of the clinical oral mucosal changes seen at the site where a quid of snuff is regularly placed. The conceptual use of "snuff dippers' lesions" is recommended instead of e.g. snuff-induced leukoplakia.

Topics: Adult; Atrophy; Epithelium; Humans; Hyperplasia; Keratins; Male; Mitosis; Mouth Diseases; Mouth Mucosa; Necrosis; Plants, Toxic; Sweden; Time Factors; Tobacco, Smokeless

Weanling rats fed a zinc-deficient diet (less than 1 part/10(6)) for 4 weeks develop parakeratotic and hyperplastic buccal epithelium with increased mitotic activity. Normal buccal epithelium contains major keratin polypeptides of 56, 46 and 43 kDa. Four-week zinc-deficient rats lacked the 43 kDa keratin. It appears that the 46 and 43 kDa keratins are related, differing as a result of some post-translation modification. A proteolytic cleavage of the 46 kDa keratin to the 43 kDa species is the most likely mechanism. The findings point to a decrease of keratinolytic enzyme activity in the zinc-deficient rats.

Topics: Animals; Deficiency Diseases; Electrophoresis, Agar Gel; Evaluation Studies as Topic; Keratins; Mouth Diseases; Mouth Mucosa; Peptide Hydrolases; Peptides; Phosphorylation; Rats; Rats, Inbred Strains; Zinc

Epithelial dendritic cells (EDC) were examined in human oral tissues with non-specific keratosis, lichen planus and squamous cell carcinoma. Acetone-fixed frozen sections were stained using an indirect immunoperoxidase technique and monoclonal antibodies to the human CD1 thymocyte (OKT6) and HLA-DR antigens. Significantly more T6+ and DR+ EDC were present in lichen planus tissues than normal controls, tissues with non-specific keratosis and the epithelial overlying/adjacent to squamous cell carcinomas, the latter tissues having comparable numbers of both T6+ and DR+ EDC. By contrast, significantly fewer T6+ EDC and significantly more DR+ cells were present in the invasive epithelium of squamous cell carcinomas than the overlying/adjacent epithelium of carcinomas, the non-specific keratosis group and the normal tissues. 23-60% of pathological tissues had either focal or general DR+ reactivity in keratinocytes, but there was no correlation between the density of T6+ or DR+ EDC and the keratinocyte DR status of the tissues. The results suggest that immunological enhancement occurs in lichen planus and possibly immunological impairment may characterize invasive squamous cell carcinoma.

Topics: Carcinoma, Squamous Cell; Dendritic Cells; Epidermis; Epithelium; HLA-DR Antigens; Humans; Immunoenzyme Techniques; Keratins; Langerhans Cells; Leukoplakia, Oral; Lichen Planus; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms

The incidence and distribution of keratinocytes expressing the major histocompatability complex antigens HLA DR, DP and DQ and their relationship to the density of the inflammatory infiltrate was determined in lesions of oral lichen planus and normal mucosa using an immunoalkaline phosphatase technique. Seven of eight biopsies of lichen planus showed evidence of keratinocyte HLA DR expression but the pattern was variable both within and between biopsies. A significant increase in density of lymphocytes was found beneath those areas showing HLA DR expression throughout the prickle cell layer compared with those areas showing patchy or no expression. No evidence for keratinocyte expression of HLA DP or DQ was found. These results suggest that expression of HLA DR by keratinocytes in lichen planus may be induced by the lymphocytic infiltrate perhaps as a result of interferon gamma production. The functional significance of such MHC Class II expression remains unknown.

Topics: Antibodies, Monoclonal; Epidermal Cells; Epidermis; HLA-DP Antigens; HLA-DQ Antigens; HLA-DR Antigens; Humans; Immunohistochemistry; Keratins; Langerhans Cells; Lichen Planus; Mouth Diseases; Mouth Mucosa

The purpose of this study is to examine the ultrastructure of leukoplakia and lichen planus. The light and examine electron-microscopical observations were made in the specimens of leukoplakia and lichen planus as dyskeratosis in oral mucosa which were diagnosed as benign lesions clinically and histopathologically. The results were as follows: 1. Light microscopical findings: Leukoplakia exhibited orthokeratinization and the thickening of prickle and corneal cell layers was seen. The clear and unclear granular layers were seen. Lichen planus was classified as the type of parakeratinizing region or the mixed type of orthokeratinizing and parakeratinizing region, but the former was more abundant. The thickened prickle and corneal cell layers were seen and the granular layer was unclear in the parakeratinized cell regions. Various cells were observed in expanded intercellular spaces of basal cell and prickle cell layers. The infiltration of inflammatory cells in the lamina propria was more marked in lichen planus than in leukoplakia. 2. Electron microscopical findings: 1) The melanocyte and histiocyte-like cell were seen in the expanded intercellular spaces of basal and prickle cell layers in lichen planus, while they were not observed in leukoplakia. 2) The aggregation and scattering of the discharged desmosomes into the expanded intercellular spaces of prickle cell layers were observed in leukoplakia. The number of desmosome was decreased in the orthokeratinization process from granular layer to corneal layer. An increase in the width of intercellular contact layer and the disappearance of attachment plaque were observed. In lichen planus, the desmosome of parakeratinized regions were decreased in number toward the superficial layer, but the structure was clear even in the superficial part. 3) Small number of Odland bodies in the cytoplasm of superficial layer of prickle cell layer were seen. They increased in the granular layer and were discharged into the intercellular spaces in the most superficial layer of granular layer. The lamellar pattern of Odland bodies was not clear in the more superficial layer.(ABSTRACT TRUNCATED AT 400 WORDS)

Topics: Humans; Keratins; Keratosis; Leukoplakia, Oral; Lichen Planus; Mouth Diseases; Mouth Mucosa

In SDS-electrophoresis the hyperortho- and hyperparakeratoses showed cytokeratin patterns fairly similar to those in the normal masticatory mucosa in cases of reactive hyperkeratosis due to mechanical stimulatory action; however, in Lichen ruber planus they agreed only incompletely. The site-specific, normally stably expressed cytokeratins of the mucosa-type concerned were likewise regularly demonstrable in the pathologically changed tissue specimens under study, except cytokeratin no. 1 which is known to be a reliable indicator of keratinocyte cornification merely in orthological but not in pathological conditions. Deviating from the normal cytokeratin pattern in the oral mucosa, a more frequent and more expressed occurrence of cytokeratins no. 17 and 18 was observed in Lichen ruber planus. In 4 extraordinarily reactive hyperkeratoses, among these 2 papillomas the cytokeratins no. 7/13 were present.

Topics: Biopsy; Electrophoresis, Polyacrylamide Gel; Humans; Keratins; Lichen Planus; Molecular Weight; Mouth Diseases; Mouth Mucosa

Specimens from 22 cases of oral lichen planus were prepared for studies of the basement membrane zone by immunohistochemical and histochemical methods. Langerhans' cells, monocytes, and lymphocytes constitute the predominant cells of the inflammatory infiltrate, thus indicating a cell-mediated response. Lymphocyte-related necrosis of epithelium and nonspecific vasculitis are associated with an altered basement membrane zone. Immunoproteins, including IgG, IgA, IgM, and C'3 as well as fibrinogen, are present and distributed in a nonspecific pattern.

Topics: Actins; Basement Membrane; Complement C3; Fibronectins; Humans; Immunoglobulins; Keratins; Laminin; Langerhans Cells; Lectins; Lichen Planus; Lymphocytes; Mouth Diseases

HLA-DR is a Class II histocompatibility antigen which has recently been reported to occur in increased amounts in dermal and oral lichen planus. Its expression in epithelium was previously thought to be limited to Langerhans cells. In this study, formalin-fixed sections of oral lichen planus and a variety of other oral mucosal lesions were stained with a monoclonal antibody to HLA-DR using an indirect immunofluorescence test. The expression of HLA-DR by keratinocytes did not appear to be a specific marker for lichen planus as demonstrated by the reactivity of the epithelium in a variety of lesions of the oral mucosa. If HLA-DR expression is considered to be an inducible function, perhaps in response to gamma interferon secreted by activated lymphocytes, then keratinocyte reactivity would not be expected to occur only in lichen planus.

Topics: Fluorescent Antibody Technique; HLA-D Antigens; HLA-DR Antigens; Humans; Immunity, Cellular; Keratins; Lichen Planus; Mouth Diseases; Mouth Mucosa; Staining and Labeling

Involucrin has been recognized recently as a marker of terminal differentiation of squamous epithelial cells and also as a useful marker for keratinization; its expression in epithelial tumors of oral and pharyngeal mucosa and skin was examined. Involucrin in normal oral mucosa and skin was restricted to the granular and upper spinous layers and was absent in the basal layer. Hyperkeratosis was characterized by strong positive staining for involucrum in spinous and granular cell layers. A similar pattern was noted in seborrheic keratosis and verruca vulgaris. Condyloma acuminatum specimens revealed slight staining, whereas Paget cells were negative. Calcifying epitheliomas of Malherbe were usually unreactive. Papillomas exhibited the regular distribution of involucrin, as found in normal squamous epithelium. Basal cell carcinomas were generally negative, whereas squamous cell carcinomas showed an irregular distribution of involucrin. Immunohistochemical staining for involucrin may be useful for identification of keratinizing cells in epithelial tumor foci, just as is the use of monoclonal antibody to keratin KL1.

Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Epithelium; Humans; Immunoenzyme Techniques; Keratins; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Papilloma; Pharyngeal Neoplasms; Protein Precursors; Skin Diseases; Skin Neoplasms; Staining and Labeling

By electron microscopy colloid bodies have been shown to be derived from epithelial cells. It has been suggested, however, that connective tissue cells or components from the basement membrane zone contributed to the formation of colloid bodies. In order to examine these possibilities we stained oral lesions of discoid lupus erythematosus (DLE) with antibodies against intermediate filaments (keratin, vimentin), basement membrane components (laminin, collagen type IV) and fibronectin. IgM was used as a marker for colloid bodies. Colloid bodies were stained positive for keratin, whereas vimentin was never found in colloid bodies. Laminin and collagen type IV were occasionally seen in their periphery probably owing to adherence of basement membrane fragments during apoptosis. Fibronectin was frequently seen at the entire periphery of colloid bodies which may facilitate their elimination by macrophages. In conclusion, connective tissue cells or basement membrane components do not seem to contribute to the formation of colloid bodies in oral DLE.

Topics: Antibodies, Monoclonal; Basement Membrane; Collagen; Colloids; Cytoplasmic Granules; Humans; Intermediate Filaments; Keratins; Laminin; Lupus Erythematosus, Discoid; Mouth Diseases; Mouth Mucosa; Staining and Labeling

Topics: Carcinoma; Humans; Keratins; Leukoplakia, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms

Topics: Adolescent; Adult; Female; Gingiva; Humans; Keratins; Male; Melanocytes; Melanosis; Microscopy, Electron; Middle Aged; Mouth Diseases; Smoking

Electron microscopic, histochemical and light-microscopic studies were carried out on biopsy specimens of 12 cases of leukoedema and on the desquamated epithelial cells of a further 50 examples. For comparison, similar observations were made of 4 examples of healthy cheek mucosa and 29 cases of a variety of pathological conditions of the oral mucosa. Only in leukoedema were a series of structures encountered which consisted of an aggregation of ribosomes and electron dense masses, or a network of electron-dense material, or an electron-dense network with a central dense core or a solid body with a few central cavities. Histochemical stains and RNA extraction studies showed that they are probably abnormal forms of keratohyalin granules and that ribosomes is an important component of their composition.

Topics: Cytoplasmic Granules; Humans; Hyalin; Keratins; Leukoedema, Oral; Microscopy, Electron, Scanning; Mouth Diseases; Mouth Mucosa; Ribosomes; RNA, Ribosomal

Topics: Adult; Carcinoma; Female; Humans; Keratins; Keratosis; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Nicotiana; Plants, Toxic; Precancerous Conditions

Strata cornea of normal human gingival and palatal epithelia and of metaplastic lesions (leukoplakia simplex) in the mucosa of the cheek and floor of the mouth were examined by light- and electronmicroscopy. The overall thickness of the stratum corneum, individual corneocyte thickness, number of corneocyte layers, and the type of keratin pattern expressed by individual corneocytes were determined. The data demonstrated that (1) the oral gingival and hard palate epithelia produce similar strata cornea with corneocytes ranging from 0.9 to 1.3 micron in thickness and displaying a high degree of conformity with respect to the keratin pattern, (2) the normal keratin pattern expressed in oral corneocytes differs from that reported for epidermal corneocytes, (3) under conditions of metaplastic keratosis, the strata cornea of lesions developing in the mucosa of the cheek and floor of the mouth are of variable thickness with 15 to 30 layers of corneocytes displaying either the oral or, more often, the epidermal keratin pattern. It is suggested that (1) the expression of a particular keratin pattern is independent of the presence or absence of nuclei and (2) the mechanism generating and alteration in cell differentiation from normal, non-keratinizing cheek epithelium to an epidermal one possibly operates through an intermediary step usually encountered as an expression of the oral keratin pattern of normal gingiva and hard palate.

Topics: Adolescent; Adult; Aged; Child; Epithelial Cells; Female; Gingiva; Humans; Keratins; Leukoplakia, Oral; Male; Metaplasia; Middle Aged; Mouth Diseases; Mouth Mucosa; Palate

Topics: Aged; Candida albicans; Carcinoma, Squamous Cell; Diagnosis, Differential; Epithelium; Glycogen; Humans; Keratins; Leukoplakia, Oral; Lichen Planus; Middle Aged; Mitosis; Mouth Diseases; Mouth Neoplasms

Topics: Epithelium; Humans; Keratins; Mouth Diseases; Mouth Mucosa

Topics: Humans; Hyalin; Keratins; Mouth Diseases; Mouth Mucosa

Twenty-one cases of verruciform xanthoma are reported, bringing to fifty the total cases in the literature. The lesion was found most often in middle-aged persons, and the most common location was the gingiva or alveolar ridge. The cause of the verruciform xanthoma is still uncertain.

Topics: Adolescent; Adult; Aged; Connective Tissue; Epithelium; Female; Humans; Keratins; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Xanthomatosis

Superficial, transitional and polygonal buccal epithelial cells from patients with the erosive type of lichen planus were compared with similar cells from non-keratinizing human buccal mucosa. Transitional cells from non-keratinizing buccal mucosa had glycogen lakes and membrane-coating granules with electron dense cores. Surface cells were not keratinized and pathological cells were less granular. In lichen planus membrane-coating granules were numerous, markedly electron dense, and some showed an internal lamellar structure. Surface cells were keratotic or parakeratotic. Processes of macrophages were associated with the pathological membrane-coating granules.

Topics: Cytoplasmic Granules; Epithelium; Gingiva; Glycogen; Intracellular Membranes; Keratins; Lichen Planus; Microscopy, Electron; Mouth Diseases; Mouth Mucosa; Organoids

Topics: Adult; Child; Connective Tissue; Gingiva; Gingival Diseases; Humans; Keratins; Mouth Diseases; Mouth Mucosa; Transplantation, Autologous

Topics: Erythema Multiforme; Fluorescent Antibody Technique; Gingiva; Humans; Keratins; Lichen Planus; Mouth Diseases; Mouth Mucosa; Pemphigus; Skin

Hereditary mucoepithelial dysplasia is an autosomal, dominantly inherited disorder affecting all of the orificial mucosa with cataracts, follicular keratosis of skin, nonscarring alopecia, bouts of pneumonia, spontaneous pneumothorax, and terminal cor pulmonale. The oral lesion is a fiery red, flat or micropapillary-appearing mucosa most frequently involving the gingiva and hard palate. All oral and pharyngeal mucosa may be involved, however. Red scrotal mucosa of the tongue is common. Histologically, the oral mucosa shows a lack of cornified and keratinized cells, a decrease in the thickness of the epithelial cell layer, dyshesion, and dyskeratosis. Papanicolaou smears show lack of epithelial cell maturation, poikilocytosis, anisocytosis, large paranuclear cytoplasmic vacuoles, and cytoplasmic strand-shaped inclusions. Ultrastructural features include a paucity of desmosomes, intercellular accumulations of amorphous material, cytoplasmic vacuoles, and paranuclear lesions with strands of material resembling gap junctions and desmosomes. The condition most likely represents a basic defect in gap junction and desmosome formation.

Topics: Adult; Cell Adhesion; Cytoplasm; Desmosomes; Epithelium; Female; Gingiva; Gingival Diseases; Humans; Inclusion Bodies; Infant; Intercellular Junctions; Keratins; Mouth Diseases; Mouth Mucosa; Mucous Membrane; Syndrome; Vacuoles

Reported is a rare case of multiple fibroepithelial hyperplasias of the oral cavity, and the suggestion is made that several previous authors may have confused this lesion with focal epithelial hyperplasia (Heck's disease). The differential diagnosis of multiple fibroepithelial hyperplasias is discussed in order to elucidate some of the confusions in the diagnosis of cases of multiple papules and nodules of the oral mucosa.

Topics: Connective Tissue; Diagnosis, Differential; Epithelium; Humans; Hyperplasia; Keratins; Male; Middle Aged; Mouth Diseases; Mouth Mucosa

Topics: Candidiasis, Oral; Carcinoma in Situ; Diagnosis, Differential; Epithelium; Erythroplasia; Humans; Keratins; Keratosis; Leukoedema, Oral; Leukoplakia, Oral; Lichen Planus; Lupus Erythematosus, Discoid; Melanins; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Nevus; Precancerous Conditions; Risk; Sebaceous Glands; Smoking; Stomatitis

"Keratin pools," previously characterized clinically and histochemically in the superficial epithelium of chronic hyperplastic oral mucosa, were studied by light and electron microscopy. These occured as small beaded and larger coalescent masses which varied in metachromasia. Ultrastructurally, the "keratin pools" consisted of electron-dense, amorphous or finely-granular material developing and coalescing, chiefly as extracellular deposits. The "pools" frequently possessed a layered arrangement alternating with cells having distinct tonofilaments, desmosomes, and definite cell membranes. Occasional bands of filamentous-like material, possibly representing tonofilament bundles, were observed in some "pools."

Topics: Aged; Cell Nucleus; Chronic Disease; Desmosomes; Epithelium; Female; Humans; Hyperplasia; Inclusion Bodies; Keratins; Microscopy, Electron; Mouth Diseases; Mouth Mucosa

The technique for registration of fluid pressure in jaw cysts by means of pressure transducer and cannulation of the cyst cavity or cementation of a two-way valve into a tooth communicating with the cyst is described. Twenty-six closed cysts were subjected to registration of intracystic pressure. Subsequent histologic examination showed that all cysts were non-keratinized. Initial pressure values in apical periodontal cysts averaged +47 mmHg, in follicular cysts +44 mmHg, and in residual cysts +38 mmHg. A median palatine cyst exhibited a pressure of +81 mmHg. Most cysts showed intracystic pulsation corresponding to the number of heart beats on electrocardiograms obtained simultaneously. The intracystic pulsation disappeared when the intracystic pressure was experimentally increased and reappeared when it was lowered. In three cases in which registration of pressure was performed 7-14 days after the aspiration of the cyst fluid, an intracystic pressure in the same range as the initial one was found. The findings indicate deficient lymphatic drainage of non-keratinizing jaw cysts.

Topics: Bone Cysts; Humans; Jaw Diseases; Keratins; Lymphatic System; Mouth Diseases; Odontogenic Cysts; Periodontal Cyst; Pressure

It is proposed that oral keratoses appear white because of the ability of abnormal oral keratin to evenly reflect the visible light spectrum because of the hydration of the keratin layer in a manner similar to the reaction of the stratum corneum of the epidermis to water. Thickening of the keratin layer per se or the over-all thickness of the epithelium does not appear to be the primary factor in causing an intraoral lesion to appear white. The white appearance is related to thickness only insofar as it takes a certain amount of abnormal keratin to be clinically evident. It appears that an accumulation of only 10 to 20 microns of abnormal keratin is sufficient to cause a lesion to appear very white. This is about the amount seen on the normal human palate. It seems likely that, when a normally nonkeratinized area, such as the buccal mucosa or floor of the mouth, is stimulated to produce keratin, the keratin thus produced would be different from normally occurring oral keratin. This difference apparently manifests itself clinically as hydration of the keratin layer. A more complete understanding of why white lesions are white awaits further elucidation in regard to the role of lipids, keratohyaline granules, membrane-coating granules, and intercellular cement. Characterization of the oral keratins as to their amino acid residues and types of bondings, as well as insight into the events transpiring when the prickle cell becomes keratinized, may not only shed light on the etiology of these lesions but also have prognostic implications.

Topics: Animals; Color; Cytoplasm; Cytoplasmic Granules; Dogs; Epithelium; Haplorhini; Humans; Hyalin; Keratins; Keratosis; Mouth Diseases; Mouth Mucosa; Swine

Cytochemical studies of glycogen of oral mucosa cells have been made on the smears by freeze-drying and PAS staining. The specimens were obtained from different areas of oral cavity of 77 human subjects and an attempt was made to find some interrelation amoung glycogen deposition, keratinization and inflammation. The largest glycogen deposition was found in the mucosa cells from mouth floor and cheek, a little in those from gingiva and quite a small or no glycogen in those from mucosa of hard palate and tongue. In gingiva the cells showing much more keratinization were less in glycogen contents, and vice versa. In inflammation some increase in glycogen contents were found in the gingivitis and the highest glycogen content in the cases of denture irritation of the palate as far as the present observation is concerned.

Topics: Adolescent; Adult; Aged; Cheek; Denture, Complete; Female; Gingiva; Gingivitis; Glycogen; Humans; Inflammation; Keratins; Male; Middle Aged; Mouth Diseases; Mouth Floor; Mouth Mucosa; Palate; Stomatitis, Aphthous; Tongue

Topics: Bone Cysts; Cysts; Dentigerous Cyst; Humans; Keratins; Mouth Diseases; Nonodontogenic Cysts; Odontogenic Cysts; Radicular Cyst; Radiography

Topics: Diagnosis, Computer-Assisted; Giant Cell Tumors; Humans; Infant; Jaw Neoplasms; Keratins; Leukoplakia, Oral; Lichen Planus; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Odontogenic Cysts; Odontogenic Tumors; Precancerous Conditions; Tooth; Tooth, Deciduous

Topics: Acid Phosphatase; Animals; Esterases; Histocytochemistry; Keratins; Keratosis; Male; Mouth Diseases; Mouth Mucosa; Muramidase; Rats; Sulfhydryl Compounds; Sulfides; Vitamin A Deficiency

Topics: Alveolar Process; Animals; Autoradiography; Gingiva; Gingivitis; Haplorhini; Keratins; Keratosis; Mitosis; Mouth Diseases; Mouth Mucosa; Thymidine; Tritium

In biopsies from the oral mucosa of 235 cases in which the diagnosis was lichen planus, keratosis or leukoplakia, mitotic values were calculated for the stratum basale (M.V. basal) and the stratum spinosum (M.V. spinous). The mean M.V. basal was significantly different from the mean M.V. spinous in the keratosis and leukoplakia groups, but not in the lichen planus group. Within the keratosis and leukoplakia groups, M.V. basal and M.V. spinous were significantly correlated. When each of the mean M.V.s was compared with the M.V.s for the other diagnostic groups, various significant differences were found. The M.V.s were examined in relation to the type of keratinization, the presence of acanthosis or atrophy, and the patient's age, but the M.V.s were not significantly related to these features.

Topics: Acantholysis; Age Factors; Atrophy; Epithelium; Humans; Keratins; Keratosis; Leukoplakia, Oral; Lichen Planus; Mitosis; Mouth Diseases; Mouth Mucosa

Topics: Adult; Aged; Biopsy; Cytoplasmic Granules; Epithelium; Female; Gingiva; Glycogen; Histocytochemistry; Humans; Keratins; Leukoplakia; Leukoplakia, Oral; Lichen Planus; Male; Microscopy, Electron; Middle Aged; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Palate; Tongue

Topics: Adolescent; Adult; Aged; Female; Humans; Keratins; Leukoplakia; Male; Mouth Diseases; Nails; Skin Diseases

Topics: Humans; Keratins; Mouth Diseases; Mouth Mucosa; Polysaccharides; Staining and Labeling

Topics: Epithelial Cells; Humans; Keratins; Leukoplakia; Microscopy, Electron; Mouth Diseases; Mouth Mucosa

Topics: Cell Differentiation; Humans; Keratins; Mouth; Mouth Diseases; Organogenesis; Skin; Skin Physiological Phenomena