On the Border: Actinic Keratosis/Cheilitis

From fungus to cancer?
? Candida albicans, a common opportunistic fungus found in the oral cavity, is typically associated with oral candidiasis, a fungal infection. Although there isn't a direct causative link established between Candida albicans and oral cancer, chronic infection or colonization by this fungus may have significant implications.

Suggested reading by panelists ( Dr. Jos Hille & Dr. Jeronimo Lazos) and Dr. Nasser Said - Al- Naif :

• Ho et al. Candida albicans and candidalysin in inflammatory disorders and cancer. Immunology 2021 Jan;162(1):11-16. Epub 2020 Sep 13. DOI
• Bertolini et al. Candida albicans induces mucosal bacterial dysbiosis that promotes invasive infection. PLoS Pathog 2019 Apr 22;15(4):e1007717. DOI
• Shukla et al. Role of Candida infection in the malignant transformation of oral leukoplakia: A systematic review of observational studies. Curr Opin Microbiol 2019 Dec:52:100-109. DOI
• Castillo et al. Study of virulence factor of Candida species in oral lesions and its association with potentially malignant and malignant lesions. Arch Oral Biol 2018 Jul:91:35-41. DOI.
• Warnakulasuriya et al. Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis 2021 Nov;27(8):1862-1880. DOI
• Di Cosola M, Cazzolla AP, Charitos IA, Ballini A, Inchingolo F, Santacroce L. Candida albicans and oral carcinogenesis. A brief review. Journal of Fungi. 2021 Jun 12;7(6):476. DOI
• Vadovics M, Ho J, Igaz N, Alföldi R, Rakk D, Veres É, Szücs B, Horváth M, Tóth R, Szücs A, Csibi A. Candida albicans enhances the progression of oral squamous cell carcinoma in vitro and in vivo. MBio. 2022 Feb 22;13(1):e03144-21. DOI
• Zhu GD, Xie LM, Su JW, Cao XJ, Yin X, Li YP, Gao YM, Guo XG. Identification of differentially expressed genes and signaling pathways with Candida infection by bioinformatics analysis. European Journal of Medical Research. 2022 Mar 21;27(1):43. DOI
• Yang L, Li A, Wang Y, Zhang Y. Intratumoral microbiota: roles in cancer initiation, development and therapeutic efficacy. Signal Transduct Target Ther. 2023 Jan 16;8(1):35. DOI



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Oral squamous cell carcinoma is often preluded by silent superficial changes related to dysplastic epithelial processes led by mutations. Ignoring these changes could delay the correct diagnosis of potentially malignant lesions, thus allowing a feared malignant transformation.
So, let’s take a look at this clinical case, highlighting the importance of:
• Cautiously studying the lesion before biopsy
• Using all possible clinical data when analyzing the sample under a microscope
• Performing a correct clinicopathological correlation
• Carefully observing possible early changes of oral epithelial dysplasia
• Making the patient understand the need to stay under control over time
Dr. Roberto Gerber
Specialist in Pathology and Oral Medicine, Professor at Latin University,
Costa Rica
#oralPathology360 #Oralcancer #OPMD

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In this video, Dr Ranganthan, a world-renowned expert on the topic, delves into the world of Oral Submucous Fibrosis (OSF), an oral potentially malignant disorder with a malignant transformation rate of 1.3 – 23%. The primary cause of OSF is the consumption of areca nut, the fourth most commonly consumed substance globally, after tobacco, alcohol, and caffeine. Shockingly, around 10%‐20% of the world's population consumes areca nut in various forms, with an estimated 600 million chewers worldwide. In India alone, 223.79 million people consume areca nut.

OSF is a debilitating condition characterized by fibrosis and atrophy of the epithelium, and its morbidity is unique, varying regionally depending on the type of areca nut consumed. In addition, the atrophic changes make diagnosing dysplasia challenging and prognosticating malignant transformation a hurdle.

In this presentation, we will explore OSF's clinical, histological, and molecular aspects. We hope to shed light on this unique condition and help raise awareness of its severity.

Dr K Ranganthan
Professor and HOD; Oral and Maxillofacial Pathology at Ragas Dental CollegeRanganathan
https://www.linkedin.com/in/ranganathan-k-7079a037/

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