OBJECTIVES: A retrospective review of a large series of oro‐facial cases of tuberculosis to analyse clinical, histo‐pathological, and radiological aspects, as well as those of chemotherapy. MATERIALS AND METHODS: A total of 42 cases of tuberculosis of the oro‐facial region were examined. Thirteen patients had a primary form and 29 a secondary form of the disease. Diagnosis was based on careful clinical examination, Mantoux reaction, histopathological examination, microbiological cultures and immunological investigation with the detection of antibodies against Mycobacteria in the patients' serum (ELISA). RESULTS: Cases examined consisted of 27 males and 15 females. The age range was 3 to 73 years (mean age 31 years). Clinical manifestations comprised oral ulcers in 69.1%, bone involvement in 21.4%, and salivary gland and/or lymph node involvement in 14.3%. A total of 79.4% patients with secondary disease had pulmonary lesions, 15 of whom showed clinical and radiological signs of activity; there was one case of bilateral renal lesions and two of skin lesions. CONCLUSIONS: Oro‐facial tuberculosis is often difficult to diagnose and it should be an important consideration in the differential diagnosis of lesions that appear in the oral cavity. The most important diagnostic tools remain a careful clinical evaluation, biopsy for histologic study, as well as acid‐fast stains, culture, and immunological assays, and skin testing.

Mucous membrane pemphigoid (MMP) is a sub-epithelial vesiculobullous disorder. It is now quite evident that a number of sub-epithelial vesiculobullous disorders may produce similar clinical pictures, and also that a range of variants of MMP exist, with antibodies directed against various hemidesmosomal components or components of the epithelial basement membrane. The term immune-mediated sub-epithelial blistering diseases (IMSEBD) has therefore been used. Immunological differences may account for the significant differences in their clinical presentation and responses to therapy, but unfortunately data on this are few. The diagnosis and management of IMSEBD on clinical grounds alone is impossible and a full history, general, and oral examination, and biopsy with immunostaining are now invariably required, sometimes supplemented with other investigations. No single treatment regimen reliably controls all these disorders, and it is not known if the specific subsets of MMP will respond to different drugs. Currently, apart from improving oral hygiene, immunomodulatory-especially immunosuppressive-therapy is typically used to control oral lesions. The present paper reviews pemphigoid, describing the present understanding of this fascinating clinical phenotype, summarising the increasing number of subsets with sometimes-different natural histories and immunological features, and outlining current clinical practice.

El fibrolipoma es una neoplasia de origen mesenquimal, rara en la cavidad oral, representando el 1% de todos los tumores benignos orales. Es una variante histológica del lipoma simple, que normalmente se manifiesta a nivel de la mucosa oral, suelo de la boca, lengua y labios. La etiología suele ser traumática cuando afecta localizaciones extraorales, mientras se considera idiopática al manifestarse a nivel bucal. En este artículo se presenta un raro caso de fibrolipoma de mejilla, y se discuten los aspectos diagnósticos, histo-patológicos y de tratamiento de acuerdo a la literatura.

Rendu-Osler-Weber syndrome, also known as __Hereditary Hemorrhagic Telangiectasia (HHT), is a vascular disorder with a prevalence estimated in one in 5-8.000 individuals. It is a dominant autosomic transmission determining multisystemic vascular dysplasia, which has been mapped to two genes, HHT1 and HHT2, determined by mutations of the endoglin (ENG) gene, localized to the chromosome 9, and by mutations of the activin receptorlike kinase 1 (ALK1) gene, localized on the chromosome 12. The 95% of affected present recurrent epistaxis, with a mean age of first event at about 12 years, generally the nosebleed frequency and severity increase with age and usually it is associated with pulmonary AVM and/or multiple telangiectases of gastrointestinal apparatus, of the hands, face, and oral cavity and others visceral involvement. The first diagnosis of HHT is still based on the presence of clinical signs and family history; for the molecular diagnosis of HHT is necessary sequencing the entire coding regions of the ALK1 and ENG genes. The genetic test is positive not in the 100% of all patients with clinical diagnosis of HHT, but it is also possible not find in the same family group the common mutation. We review the litterature and report 2 cases with oral manifestation, on the tongue and on the inferior lip, without others systemic HHT lesions, treated in our Department for general odontoiatric problems.

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