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DermAtlas: GINGIVA - cyclosporine induced gingival hyperplasia
© 2001-2009, DermAtlas
Image Name: cyclosporine_induced_gingival_enlargment_1_090518   File Type: jpg
Diagnosis: CYCLOSPORINE INDUCED GINGIVAL HYPERPLASIA /
GINGIVAL HYPERPLASIA /
DRUG REACTION /
GINGIVAL HYPERPLASIA, CYCLOSPORINE INDUCED
  Category: dental/oral disorder /
drug reaction /
treatment complication
Body Site: gingiva   Age: 33 years
Contributor: Roshna Thattankandy, MD    
Description: thickening of the gingiva with some crusting and hemorrhage
Comments: This 33-year-old man complained of progressive thickening of his gums associated with bleeding and difficulty chewing food for 6 months. Two years earlier he was diagnosed with aplastic anemia and started on cyclosporine which has been associated with gingival hyperplasia.

DermAtlas: BUCCAL MUCOSA - morsicatio
© 2001-2009, DermAtlas
Image Name: morsicatio_1_090503   File Type: jpg
Diagnosis: MORSICATIO /
CHEEK BITING
  Category: dental/oral disorder
Body Site: buccal mucosa / mouth   Age: 30 years
Contributor: James Scuibba    
Description: thickened shredded areas of hyperkeratosis
Comments: This young adult was a chronic cheek chewer. These changes are found most commonly on the buccal mucosa, but the labial mucosa and lateral border of the tongue may also be involved. Zones of white thickening of the mocosa may be found with intervening erosions and ulceration.
Related Images: morsicatio_2_090503 

DermAtlas: BUCCAL MUCOSA - morsicatio
© 2001-2009, DermAtlas
Image Name: morsicatio_2_090503   File Type: jpg
Diagnosis: MORSICATIO /
CHEEK BITING
  Category: dental/oral disorder
Body Site: buccal mucosa / mouth   Age: 30 years
Contributor: James Scuibba    
Description: thickened shredded areas of hyperkeratosis
Comments: This young adult was a chronic cheek chewer. These changes are found most commonly on the buccal mucosa, but the labial mucosa and lateral border of the tongue may also be involved. Zones of white thickening of the mocosa may be found with intervening erosions and ulceration.
Related Images: morsicatio_1_090503 

DermAtlas: Histology - tattoo, amalgam
© 2001-2009, DermAtlas
Image Name: amalgam_tattoo_1_090401   File Type: jpg
Diagnosis: TATTOO, AMALGAM /
TATTOO
  Category: deposition disorders /
dental/oral disorder /
hyperpigmentation
Body Site: mouth, floor of   Age: 59 years
Contributor: Greg Hosler, MD, PhD    
Description: The mucosa appears normal. In the submucosa, there is an ill-defined hyperpigmented area.
Comments: This 59 year old woman had a pigmented lesion biopsied from the floor of her mouth to rule out melanoma. This is a common scenario for amalgam tattoos. These lesions develop when metals from dental work leach into the soft tissues. Common metals implicated are silver, mercury, aluminum, etc. On histology, the pigment may be black, brown, or golden. The main differential diagnosis is a melanocytic lesion, like a blue nevus, but the tattoo pigment is acellular and often accentuated on elastic fibers.
Related Images: amalgam_tattoo_2_090401 

DermAtlas: Histology - tattoo, amalgam
© 2001-2009, DermAtlas
Image Name: amalgam_tattoo_2_090401   File Type: jpg
Diagnosis: TATTOO, AMALGAM /
TATTOO
  Category: deposition disorders /
dental/oral disorder /
hyperpigmentation
Body Site: mouth, floor of   Age: 59 years
Contributor: Greg Hosler, MD, PhD    
Description: The pigment is golden brown, with variably-sized fibers. The pigment appears extracellular and is accentuated in an elastin pattern. Black granular pigment was found more superficially (not shown). There is no significant inflammatory response.
Comments: This 59 year old woman had a pigmented lesion biopsied from the floor of her mouth to rule out melanoma. This is a common scenario for amalgam tattoos. These lesions develop when metals from dental work leach into the soft tissues. Common metals implicated are silver, mercury, aluminum, etc. On histology, the pigment may be black, brown, or golden. The main differential diagnosis is a melanocytic lesion, like a blue nevus, but the tattoo pigment is acellular and often accentuated on elastic fibers.
Related Images: amalgam_tattoo_1_090401 

DermAtlas: Histology - Crohn disease
© 2001-2009, DermAtlas
Image Name: Inflammatory_bowel_disease_11_090421   File Type: jpg
Diagnosis: CROHN DISEASE /
PERLECHE /
GRANULOMATOUS REACTION /
CHEILITIS
  Category: granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder
Body Site: buccal mucosa / mouth   Age: 13 years
Contributor: James Scuibba    
Description: A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material.
Comments: These changes are consistent with but not specific of Crohn disease.
Related Images: All related Images  Inflammatory_bowel_disease_1_090421  Inflammatory_bowel_disease_2_090421  Inflammatory_bowel_disease_3_090421  Inflammatory_bowel_disease_4_090421  Inflammatory_bowel_disease_5_090421  Inflammatory_bowel_disease_6_090421  Inflammatory_bowel_disease_7_090421  Inflammatory_bowel_disease_8_090421  Inflammatory_bowel_disease_9_090421  Inflammatory_bowel_disease_10_090421 

DermAtlas: Histology - Crohn disease
© 2001-2009, DermAtlas
Image Name: Inflammatory_bowel_disease_10_090421   File Type: jpg
Diagnosis: CROHN DISEASE /
PERLECHE /
GRANULOMATOUS REACTION /
CHEILITIS
  Category: granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder
Body Site: buccal mucosa / mouth   Age: 13 years
Contributor: James Scuibba    
Description: A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material.
Comments: These changes are consistent with but not specific of Crohn disease.
Related Images: All related Images  Inflammatory_bowel_disease_1_090421  Inflammatory_bowel_disease_2_090421  Inflammatory_bowel_disease_3_090421  Inflammatory_bowel_disease_4_090421  Inflammatory_bowel_disease_5_090421  Inflammatory_bowel_disease_6_090421  Inflammatory_bowel_disease_7_090421  Inflammatory_bowel_disease_8_090421  Inflammatory_bowel_disease_9_090421  Inflammatory_bowel_disease_11_090421 

DermAtlas: Histology - Crohn disease
© 2001-2009, DermAtlas
Image Name: Inflammatory_bowel_disease_9_090421   File Type: jpg
Diagnosis: CROHN DISEASE /
PERLECHE /
GRANULOMATOUS REACTION /
CHEILITIS
  Category: granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder
Body Site: buccal mucosa / mouth   Age: 13 years
Contributor: James Scuibba    
Description: A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material.
Comments: These changes are consistent with but not specific of Crohn disease.
Related Images: All related Images  Inflammatory_bowel_disease_1_090421  Inflammatory_bowel_disease_2_090421  Inflammatory_bowel_disease_3_090421  Inflammatory_bowel_disease_4_090421  Inflammatory_bowel_disease_5_090421  Inflammatory_bowel_disease_6_090421  Inflammatory_bowel_disease_7_090421  Inflammatory_bowel_disease_8_090421  Inflammatory_bowel_disease_10_090421  Inflammatory_bowel_disease_11_090421 

DermAtlas: Histology - Crohn disease
© 2001-2009, DermAtlas
Image Name: Inflammatory_bowel_disease_8_090421   File Type: jpg
Diagnosis: CROHN DISEASE /
PERLECHE /
GRANULOMATOUS REACTION /
CHEILITIS
  Category: granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder
Body Site: buccal mucosa / mouth   Age: 13 years
Contributor: James Scuibba    
Description: A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material.
Comments: These changes are consistent with but not specific of Crohn disease.
Related Images: All related Images  Inflammatory_bowel_disease_1_090421  Inflammatory_bowel_disease_2_090421  Inflammatory_bowel_disease_3_090421  Inflammatory_bowel_disease_4_090421  Inflammatory_bowel_disease_5_090421  Inflammatory_bowel_disease_6_090421  Inflammatory_bowel_disease_7_090421  Inflammatory_bowel_disease_9_090421  Inflammatory_bowel_disease_10_090421  Inflammatory_bowel_disease_11_090421 

DermAtlas: Histology - Crohn disease
© 2001-2009, DermAtlas
Image Name: Inflammatory_bowel_disease_7_090421   File Type: jpg
Diagnosis: CROHN DISEASE /
PERLECHE /
GRANULOMATOUS REACTION /
CHEILITIS
  Category: granulomatous disorder /
cutaneous sign of systemic disease /
dental/oral disorder /
gastrointestinal disorder
Body Site: buccal mucosa / mouth   Age: 13 years
Contributor: James Scuibba    
Description: A biopsy of the buccal mucosa revealed focal and diffuse chronic inflammation with scattered non-caseating epitheloid granulomas. Special stains were negative for acid fast bacteria, fungus, and polarizing microscopy was negative for foreign material.
Comments: These changes are consistent with but not specific of Crohn disease.
Related Images: All related Images  Inflammatory_bowel_disease_1_090421  Inflammatory_bowel_disease_2_090421  Inflammatory_bowel_disease_3_090421  Inflammatory_bowel_disease_4_090421  Inflammatory_bowel_disease_5_090421  Inflammatory_bowel_disease_6_090421  Inflammatory_bowel_disease_8_090421  Inflammatory_bowel_disease_9_090421  Inflammatory_bowel_disease_10_090421  Inflammatory_bowel_disease_11_090421 

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© DermAtlas, Johns Hopkins University; 2000-2009
Bernard A. Cohen, MD, Christoph U. Lehmann, MD

DermAtlas was last updated: Oct-28-2009
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