Human immunodeficiency virus (HIV) dan Acquired Immunodeficiency Syndrome (AIDS) telah menjadi masalah kesehatan dunia. Kasus HIV siap tahunnya terus meningkat sehingga membahayakan manusia selama lebih dari 20 tahun. Lesi oral terkait HIV dapat digunakan sebagai penanda status imun seseorang. Angular Cheilitis (AC) adalah salah satu dari tujuh lesi oral yang sangat terkait dengan infeksi HIV yang telah diidentifikasi dan dikalibrasi secara internasional. Tujuan penelitian ini adalah untuk mengidentifikasi AC dan hubungan dengan nilai hitung Cluster of Differentiation 4 (CD4 +) pada pasien HIV/AIDS di Unit Perawatan Penyakit Infeksi intermediet (UPIPI) RSUD Dr. Soetomo Surabaya 2014. Penelitian analitik observasional secara cross-sectional dan total sampling. Sampel terdiri dari 88 pasien HIV / AIDS yang dirawat di RSUD Dr Soetomo UPIPI Surabaya dari Juli hingga Agustus 2014. Diagnosis dari AC dilakukan secara klinis, rongga mulut subjek penelitian diperiksa oleh dokter gigi spesialis Penyakit Mulut (IPM). Nilai hitung CD4 + diperoleh dari rekam medis pasien. Delapan puluh delapan pasien HIV/AIDS telah diperiksa dan dijumpai 120 kasus manifestasi oral, diantaranya terdapat 31 kasus AC (25,83%). AC ditemukan secara signifikan berkorelasi dengan penurunan jumlah sel CD4 + di bawah 200 sel/mm 3 (p<-,245). Analisis Risiko relatif menunjukkan bahwa pasien HIV / AIDS dengan Oral Candidiasis 7.5 kali lebih sering menderita AC. Terdapat Korelasi yang erat antara AC dan OC (p< 0,357). AC dapat digunakan sebagai alternatif untuk memprediksi nilai CD4 + dan memprediksi status imun pasien yang terinfeksi HIV secara klinis.

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Background: Oral lichen planus (OLP) is a chronic inflammatory autoimmune oral mucosa disease. The ulcerative type of OLP presents as erythematous ulceration with mucosal erosions surrounding whitish striae. The aetiology of OLP is unknown, but can be predisposed by psychological factors. Purpose: Reporting ulcerative oral lichen planus predisposed by psychological stress. Case: A 36 years old woman complained very painful ulcer in the right buccal mucosa and a grey-purple lower lip lesion for a year. It had been treated with topical corticosteroids, antibiotics, tretinoin, and vitamins but did not heal. Extraoral examination on the lower vermillion showed bluish-purple macules, diffuse and irregular borders, rough and painful. Intraoral examination in the right buccal mucosa showed an irregular yellowish-white ulcer with an erythematous area and white striae. Case Management: Screening for psychological stress by DASS 42 showed moderate stress and severe anxiety. Autofluorescence examination showed no malignant transformation sign. A complete blood count test showed low neutrophil and lymphocyte count. ANA test was normal.  Systemic Methyl Prednisolone 8 mg was prescribed 2 tabs twice a day and tapered off after the lesion resolved within 1 week. Supportive treatments include Benzydamine HCl and multivitamins. Discussion: Stress, anxiety, and depression were possible factors of OLP mediated by the Hypothalamic-pituitary-adrenal (HPA) axis system and the Sympathetic-adrenal-medullary (SAM) system. Specific mechanisms are mediated by Antigen-specific CD8+ (CTLs) that are activated with the help of CD4+ T-cells. Non-specific mechanism mediated by MMP-9 activation. They led to the apoptosis of keratinocytes. Systemic corticosteroids are an important treatment for oral lichen planus that do not responded to topical steroids.  Conclusion: Oral Lichen Planus is a chronic inflammatory disease that affects the oral mucosa and can be predisposed by psychological stress. Corticosteroid is very effective to treat oral lichen planus, especially the erosive-ulcerative type.  Keywords: Oral Lichen Planus, Psychological Stress, Ulcerative

Background: Dysplasia is malignant transformation of stratified squamous epithelium characterized by cellular atypia and loss of stratification and maturation. It can caused by cigarette smoke. Measuring the activity of cell proliferation as the beginning of dysplasia is very useful to know the development of malignancy. One of proliferation marker is Ki67 that expressed in all cell cycle phase except G0.Methods: 30 male wistar rats divided into: control grup (n=10), exposed to cigarette smoke for 4 weeks (n=10), 8 weeks (n=10) as much as 20 cigarettes/group/day/exposure used smoking pump. Specimen were stained HE to see dysplasia and Ki67 expression seen immunohistochemically. Statistical analyzed by Spearman correlation.Result: There was an increase in mean of Ki67 expression and significant differences between groups (p=0,000) and also significant difference of degree of dysplasia between groups (p=0,000). There was a strong correlation between Ki67 score to degree of dysplasia (p=0.001).Conclusion: Increased of Ki67 expression proportional to the Increase in degrees of dysplasia