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Journal of the American Podiatric... 2023Kaposi sarcoma (KS) has multiple clinical variants, and most frequently presents on the lower extremities. Anti-human immunodeficiency virus (HIV) therapy has...
BACKGROUND
Kaposi sarcoma (KS) has multiple clinical variants, and most frequently presents on the lower extremities. Anti-human immunodeficiency virus (HIV) therapy has significantly reduced the incidence of KS. However, KS is still prevalent in both HIV-infected and HIV-uninfected patients. This case series analysis aims to reveal the clinical presentations, differential diagnosis, and treatment options of KS on the foot and ankle.
METHODS
Eleven cases of KS involving the foot and ankle were retrieved from our patient database, and their clinicopathologic features were analyzed.
RESULTS
All patients were men, aged 29 to 85 years. Two types of KS were found: classic and acquired immunodeficiency syndrome-associated epidemic. The average ages of classic and epidemic KS were 65.7 and 41.8 years, respectively. Clinically, three patients manifested multiple erythematous or deep violaceous, or blue-violaceous macules on either the dorsal or plantar surfaces of both feet. Eight patients showed exophytic, pyogenic granuloma-like nodules on the plantar surface, heels, and toes. Histologically, all KSs had uniform intervening fascicles of elongated spindle cells with slit-like vascular spaces filled with red blood cells and immunoreactivity with human herpesvirus-8. The patients were treated according to HIV infection status. Human immunodeficiency virus-infected patients were treated with anti-HIV therapy after primary surgical excision or biopsy. Human immunodeficiency virus-negative patients were treated with either surgical excision, Mohs surgery, or a combination of surgical excision and local radiotherapy according to individual patient clinical presentation.
CONCLUSIONS
Kaposi sarcoma is still prevalent in both HIV-infected and HIV-uninfected patients with a variety of clinical presentations. Biopsy, with histologic evaluation, in combination with immunohistochemistry is essential for the differential diagnosis. The patient should be treated according their clinical manifestation, staging, comorbidity, and immune function.
Topics: Male; Humans; Female; Sarcoma, Kaposi; HIV Infections; Ankle; Herpesvirus 8, Human; HIV
PubMed: 38170608
DOI: 10.7547/21-175 -
Cureus Nov 2023Pyogenic granuloma is a non-neoplastic inflammatory reactive hyperplasia commonly found on keratinized tissues caused by different factors such as hormonal imbalance....
Pyogenic granuloma is a non-neoplastic inflammatory reactive hyperplasia commonly found on keratinized tissues caused by different factors such as hormonal imbalance. Pyogenic granuloma has a wide age range and is frequently found in females in the second to third decade. Pyogenic granuloma developed in pregnancy is commonly known as pregnancy tumor. The standard treatment approach is surgical excision of the lesion. In the case report, a 42-year-old female presented with a persistent oral lesion in the left anterior mandible. The lesion first appeared during pregnancy and remained in the oral cavity for two years after delivery. Clinical, radiographic, and histopathological examination revealed a definitive diagnosis of pyogenic granuloma.
PubMed: 38143621
DOI: 10.7759/cureus.49326 -
International Journal of Molecular... Nov 2023Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic... (Review)
Review
Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic challenges due to its similarity and alarming proliferation. This narrative review synthesizes current knowledge on the epidemiology, etiopathogenesis, clinical manifestations, and management of oral PG, with emphasis on recent advances in diagnostic and therapeutic approaches. The epidemiology of the injury is meticulously analyzed, revealing a higher incidence in women and a wide range of ages of onset. It delves into the etiopathogenesis, highlighting the uncertainty surrounding the exact causal factors, although historical attributions suggest an infectious origin. It exhaustively analyzes the clinical and histopathological aspects of oral PG, offering information on its various presentations and the importance of an accurate diagnosis to guide effective treatment. It details treatment strategies, emphasizing the personalized approach based on individual patient characteristics. This comprehensive review consolidates current knowledge on oral PG, highlighting the need for further research to clarify its pathogenesis and optimize treatment protocols.
Topics: Humans; Female; Granuloma, Pyogenic; Mouth Mucosa; Mouth
PubMed: 38069207
DOI: 10.3390/ijms242316885 -
Cureus Nov 2023An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the...
An inflammatory hyperplasia known as a pyogenic granuloma (PG) appears as a nodular growth on the oral mucosa. The most frequent place is the gingiva, followed by the buccal mucosa, tongue, and lips. Histologically, the surface epithelium may be hyperkeratotic, have ulceration foci, or be intact. It lies on the dense connective tissue that contains a sizable amount of fully developed collagen. Most of the pregnancies result in PG of the gingiva; for this reason, the phrases "Pregnancy Tumor" and "Granuloma Gravidarum" are frequently used. It typically occurs during the second and third months of pregnancy and tends to bleed, making it challenging to masticate. Estrogen increases the vascular endothelial growth factor (VEGF) synthesis in macrophages, which is associated with PG development during pregnancy. This case describes a surgically treated case of PG in a middle-aged female with a conventional scalpel technique, giving functional and esthetic outcomes in a patient.
PubMed: 38058325
DOI: 10.7759/cureus.48305 -
Pyogenic Granuloma After Treatment of Port-Wine Stain With Hemoporfin-Mediated Photodynamic Therapy.Dermatologic Surgery : Official... Mar 2024
Topics: Humans; Port-Wine Stain; Granuloma, Pyogenic; Hematoporphyrins; Photochemotherapy; Hemangioma, Capillary
PubMed: 38048227
DOI: 10.1097/DSS.0000000000004049 -
Nigerian Journal of Clinical Practice Nov 2023A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature. (Observational Study)
Observational Study
BACKGROUND
A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature.
AIMS
To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu.
MATERIALS AND METHODS
This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance.
RESULT
There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies.
CONCLUSION
Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.
Topics: Adult; Humans; Male; Female; Infant; Child, Preschool; Child; Adolescent; Young Adult; Middle Aged; Aged; Granuloma, Pyogenic; Nigeria; Hemangioma; Gingiva; Retrospective Studies; Lymphangioma
PubMed: 38044779
DOI: 10.4103/njcp.njcp_332_23 -
Journal of Lasers in Medical Sciences 2023Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues.... (Review)
Review
Lasers in oral surgery have been extensively studied in recent years. Laser treatment is now a well-known technology that is frequently employed on oral soft tissues. The carbon dioxide (CO2) laser was one of the first soft tissue removal lasers. Because of the strong affinity of the CO2 laser to water, it is best used for removing, vaporizing, and coagulating these tissues. In minor oral surgery, CO2 laser therapy has shown advantages. Therefore, this study examined the CO2 laser use in minor oral soft tissue surgery. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were followed in this study. A question for research encompassing the inclusion criteria for the participants, intervention, comparison, outcome, and study design (PICOS) was formulated. The search queries were entered into the PubMed/Medline, Scopus, and Embase databases. Consideration was given to publications published between January 1, 2018 and March 15, 2023. The research included 37 studies after narrowing search results, eliminating duplicate titles, and conducting an eligibility review (three animal studies, seven case reports, three case series, and twenty-four clinical studies). CO2 lasers alone or in combination with other therapies successfully treated oral potentially malignant disorders (OPMDs), oral tumors, oral fibrous-epithelial lesions, gingival melanin hyperpigmentation, pyogenic granuloma, socket preservation, mucocele, high labial frenulum attachment, and so on. CO2 lasers reduced intra- and postoperative complications and adverse effects, improved postoperative functional results, ablated tissues with precision, and minimized disease recurrence and malignant transformation. Our study found that the CO2 laser in oral minor surgeries is successful, but further randomized clinical trials and multicenter studies are recommended to compare CO2 laser surgery to other treatments.
PubMed: 38028885
DOI: 10.34172/jlms.2023.44 -
Special Care in Dentistry : Official... 2024To discuss the diagnosis and treatment of an exuberant oral pyogenic granuloma (OPG) in the palatal region in a systemically compromised patient.
AIM
To discuss the diagnosis and treatment of an exuberant oral pyogenic granuloma (OPG) in the palatal region in a systemically compromised patient.
METHODS AND RESULTS
A 50-year-old woman presented with extensive and painless nodular mass that extended throughout the palatal region, with difficulty speaking, swallowing and spontaneous bleeding for 6 months. Her medical history showed poorly controlled type II diabetes mellitus and hypertension. The intraoral physical examination also revealed poor oral hygiene and periodontal disease. After clinical and radiographic evaluation, the presumptive diagnosis of OPG was made and complete excision of the lesion was performed. Local hemostatic measures were employed to control bleeding. Microscopic evaluation showed a lobulated lesion composed of many blood capillaries confirming the diagnostic hypothesis.
CONCLUSIONS
In summary, individuals with severe periodontal disease and systemic disorders may present exacerbated clinical presentations of OPG.
Topics: Humans; Granuloma, Pyogenic; Female; Middle Aged; Palate; Diabetes Mellitus, Type 2; Diagnosis, Differential; Hypertension
PubMed: 38010131
DOI: 10.1111/scd.12945 -
Graefe's Archive For Clinical and... Apr 2024To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion.
PURPOSE
To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion.
METHODS
Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138.
RESULTS
In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry.
CONCLUSION
The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions.
Topics: Male; Adult; Humans; Female; Young Adult; Middle Aged; Chalazion; Granuloma, Pyogenic; Immunophenotyping; CD4-Positive T-Lymphocytes; CD8-Positive T-Lymphocytes; Flow Cytometry
PubMed: 37934292
DOI: 10.1007/s00417-023-06304-w -
Cureus Oct 2023Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more...
Pyogenic granuloma is a common reactive oral lesion primarily found in the gingiva and rarely in extraction sockets. While it can develop at any age, it is more prevalent in the third and fourth decades of life with a higher occurrence in females. Various factors contribute to its development and surgical removal is the gold standard treatment; however, there are various other methods available. This case report documents a rare event in which a female patient in her early 40s presented with an exophytic lesion affecting the extraction socket of her maxillary right lateral incisor. The lesion was effectively removed through surgical excision. Additionally, it explores the clinical features and pathogenesis of this lesion. The purpose of this case report is to shed light on the uncommon incidence of pyogenic granuloma following tooth extraction. This non-neoplastic vascular growth often presents as an erythematous, ulcerated lesion with a tendency to bleed, with either a sessile or pedunculated base. Our case is one of only five instances documented in the literature, underscoring the importance of knowledge and timely response in such unusual circumstances. We emphasize the significance of early detection and management for improved patient outcomes and a better understanding of this rare condition.
PubMed: 37933368
DOI: 10.7759/cureus.46592