Trichilemmal cysts, also known as pilar cysts, are slow-growing lesions commonly found on the scalp of elderly women. They arise from outer root sheath epithelium and have a distinctive pattern of keratinization called trichilemmal keratinization. Here, we describe a rare case of a trichilemmal cyst on the lower lip mucosa of a 29-year-old man. The infrequency of intraoral hairs unquestionably results in the shortage of reported cases of trichilemmal cysts into the oral cavity.

Keywords: intraoral hair, pilar cyst, trichilemmal cyst..

Canalicular adenoma is a rare benign tumor of the minor salivary glands that is the most prevalent in older adults (mean age, 60 years). The upper lip is the most commonly affected site, followed by the buccal mucosa and palate. It presents as a nodular lesion without a tendency for recurrence. Here, we describe a case of canalicular adenoma presenting as a nodular, painful mass in the upper lip of a 62-year-old man with a history of trauma. Fine needle aspiration biopsy yielded inconclusive results but excluded malignancy. The lesion was enucleated, and a definitive diagnosis of canalicular adenoma was established by histological and immunohistochemical analyses. No signs of recurrence were noted at the 8-month follow-up examination. The case emphasizes the importance of differential diagnosis of nodular lesions in the oral mucosa for appropriate treatment and histological analysis for definitive diagnosis.

Keywords: adenoma, lip, salivary gland neoplasm..

Gingival fibromatosis, a relatively rare condition, develops as a slowly progressing, benign, and localized or generalized enlargement of keratinized gingiva. The purpose of this study was to investigate the expression of epidermal growth factor and the epidermal growth factor receptor and perform histomorphometric analysis of epithelial tissue in gingival fibromatosis. Immunohistochemistry with antibodies against the aforementioned antigens was performed in gingival tissues from a family with hereditary gingival fibromatosis and a family with syndromic dental anomaly-associated gingival fibromatosis ; normal gingiva was used for comparison. The height of epithelial papillae and area and perimeter of epithelial layers were measured for histomorphometric analysis. Immunoreactivity to epidermal growth factor was found in the cytoplasm of epithelial cells, and immunopositivity for epidermal growth factor receptor was detected in the cytoplasm and membrane of epithelial cells. No differences in the expression of these proteins were observed among the groups. The gingival fibromatosis groups had higher epithelial papillae and larger epithelial areas that the normal gingiva group. Our findings suggest that enlargement of epithelial layers is associated with both forms of gingival fibromatosis.

Keywords: epidermal growth factor, epidermal growth factor receptor, gingival fibromatosis, normal gingiva..

Hepatitis C is associated with autoimmune diseases, hepatocellular carcinoma, and extrahepatic manifestations that, in conjunction, may seriously compromise the patient's quality of life. We herein describe a case of chronic hepatitis C with oral manifestations and discuss some implications for diagnosis and treatment. A 63-year-old woman complaining of spontaneous bleeding of the oral mucosa presented with bilateral asymmetric ulcers surrounded by white papules and striae on the buccal mucosa. Her medical history revealed leucopenia, thrombocytopenia, and skin lesions associated with chronic hepatitis C. Propranolol and ranitidine had recently been prescribed. Lichen planus, lichenoid reaction, and erythema multiforme were considered in the differential diagnosis. Histopathological analysis revealed lymphocytic infiltrate in a lichenoid pattern. The lesions partially healed after 1 week and completely regressed after 6 months, despite the maintenance of all medications; no recurrence was observed. The final diagnosis was oral lichen planus associated with hepatitis C. Chronic hepatitis C may present oral manifestations, which demand adjustments in dental treatment planning. Medication side effects may interfere with the clinical presentation and course of the disease and should be accounted for in the differential diagnosis. The possibility of spontaneous remission of oral lichen planus should always be considered, especially when putative etiological factors of a lichenoid lesion are withdrawn in an attempt to differentiate oral lichen planus from lichenoid lesions. This case emphasizes the importance of recognizing the extrahepatic manifestations of hepatitis C as a cause of increased morbidity.

Keywords: chronic hepatitis c, leucopenia, oral diagnosis, oral lichen planus, thrombocytopenia..

The nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder with complete penetrance and variable expressivity. It is caused by mutations in the patched gene, mapped to chromosome 9q22.3-q31. Its characteristics include multiple basal cell carcinomas, odontogenic keratocysts, vertebral and rib anomalies, and intracranial calcifications. Here, we describe the features of 4 familial and 2 sporadic cases of the NBCCS.

Keywords: congenital malformations, nevoid basal cell carcinoma syndrome, odontogenic keratocyst, ptch, skeletal anomalies..

The Levy-Hollister syndrome, also known as the lacrimo-auriculo-dento-digital (LADD) syndrome, shows different phenotypes, resulting in a variety of local and systemic signs and symptoms. It is a rare hereditary disorder that mainly causes lacrimal, auricular, and auditory apparatus disturbances and dental and digital anomalies. Here, we describe a case of the Levy-Hollister syndrome in a 24-year- -old woman and focus on its orofacial manifestations. The patient had chronic lacrimation, low-set ears, thumb agenesis, elbows with limited pronation and supination movements, pronounced hallux on the left foot, concave facial profile, and tooth roots with atypical morphology. The case emphasizes the importance of a multidisciplinary approach for early diagnosis of the Levy-Hollister syndrome.

Keywords: dental anomalies, diagnosis, digital anomalies, hereditary disorder..

Paracoccidioidomycosis (PCM) is a systemic fungal disease with oral manifestations that is the most prevalent in Latin America. The purpose of this cross-sectional epidemiological study was to examine the prevalence of PCM in the Public Laboratory (MT Laboratory) of the Brazilian Unified Health System in Mato Grosso. The following data from 3670 cytological and histopathological reports of oral lesions issued by the MT Laboratory over a 4-year (2004-2008) period were analyzed: diagnostic method (oral exfoliative cytology or biopsy), diagnosis by year, origin of cases (urban or rural), and patient gender and age. In the assessment period, 96 cases (2.6%) of PCM were diagnosed. Most cases originated from rural areas (94%), and PCM was the most prevalent in men (97.9%) and in the fifth decade of life (35.4%). These results show that Mato Grosso had a considerable number of PCM cases over a small period, suggesting that this state is an endemic region for PCM in Brazil.

Keywords: epidemiology, laboratories, oral diseases, paracoccidioidomycosis, public health..