Objective The aim of this study is to analyze the tongue epithelial response to cigarette smoke exposure on a number of macrophages, lymphocytes, plasma cells, and matrix metalloproteinase 9 (MMP-9) expression to determine the risk factor of oral cancer development. Materials and Methods Thirty Rattus norvegicus will be exposed to two kinds of cigarette smoke by a smoking pump for 4 and 8 weeks. The tongues were collected to analyze the number of macrophages, lymphocytes, and plasma cells with hematoxylin-eosin. The MMP-9 expression was similarly analyzed with immunohistochemical staining and then compared with the control group. Results The number of macrophages, lymphocytes, and MMP-9 expression was higher in the 8-week cigarette smoke exposure compared to the 4-week cigarette smoke exposure and the control group (p < 0.000). The number of plasma cell did not differ in the 8-week cigarette smoke exposure from that of the control group (p > 0.05). The number of plasma cells in the tongue tissue during the 4-week cigarette smoke exposure was not determined. Conclusion Cigarette smoke exposure induces the risk of oral cancer development as a result of an increase in the number of macrophages, lymphocytes, and MMP-9 expression in the tongue epithelial.

Latar belakang: Kandidiasis oral merupakan infeksi oportunistik yang sering ditemukan pada penderita yang terinfeksi human immunodeficiency virus (HIV) atau acquired immune deficiency syndrome (AIDS) ditandai dengan adanya penurunan jumlah CD4 + . Tujuan: Melaporkan kandidiasis oral pada pasien yang terinfeksi HIV/ AIDS. Kasus: Pasien wanita 40 tahun mengeluh langit-langit dan lidahnya terasa panas dan sakit sejak 3 bulan lalu. Gambaran klinis menunjukkan pseudomembran putih dapat dikerok, daerah sekitar kemerahan pada palatum kanan dan lidah, nodul multipel warna kemerahan pada palatum kanan dan kiri. Pemeriksaan jamur menunjukkan bentukan yeast dan pseudohifa. Pemeriksaan darah lengkap menunjukkan penurunan jumlah limfosit. Kandidiasis oral yang meluas ke orofaring disertai penurunan jumlah limfosit menimbulkan kecurigaan adanya infeksi HIV/AIDS sehingga dilakukan pemeriksaan CD4 + dan anti HIV. Hasil uji laboratorium menunjukkan jumlah CD4 + = 95 sel/mL, dan anti HIV reaktif. Pasien kemudian dirujuk ke Unit Perawatan Intermediate Penyakit Infeksi (UPIPI) RSUD Dr Soetomo untuk mendapatkan perawatan dengan anti retroviral (ARV). Kandidiasis oral dirawat menggunakan obat antijamur sistemik golongan azole. Simpulan: Kandidiasis oral yang telah diderita pada pasien dewasa muda dalam jangka waktu lama, sulit disembuhkan dan melibatkan daerah orofaring dapat menjadi penanda adanya infeksi HIV/AIDS.

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease which damages tissues and causes chronic inflammation with an idiopathic etiology. It has been suggested that oral lesions in patients with SLE can be grouped clinically as erythema, discoid lesions and oral ulcerations. The latter have been said to indicate the onset of a severe systemic disease flare and that oral ulcers represent cases of mucosal vasculitis. Palatal lesions generally present in the form of ulcers or, in more severe forms, as perforation. Acquired palatal perforations can be caused by several etiologies including: developmental disorders, malignancy and infections. Purpose: To report the management of palatal perforation in an SLE patient. Case: A 14-year-old female patient attended the Dr. Ramelan Naval Hospital, with both a perforated palate that often caused her to choke when eating or drinking and maxillary anterior tooth mobility. Case Management: The treatment for the patient in this case consisted of debridement and DHE, pharmacological therapy including aloclair gel and minosep mouthwash to maintain oral hygiene and prevent re-infection. At the end of the first consultation, the patient was prescribed an obturator in order to avoid oro-anthral infection. During the second consultation, the patient’s orthodontic bracket was removed to facilitate scaling and splinting of the anterior maxillary teeth carried out to prevent their movement. During the third consultation, a swab was taken by an oral surgeon who also administered antifungal therapy. During the fourth and final consultation, the patient was examined a prosthodontic specialist due to an obturator which was causing discomfort. Conclusion: The management of palatal perforation lesions in an SLE patient requires a multidisiplinary approach.

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