Oral Submucous Fibrosis

introduction
definition
case report onosf
its etiology and prevelance
pathogenesis and histo pathological findings
diagnosis and differential diagnosis
classification
investigations and treatment
counselling and prevention

1. ORAL SUB-MUCOUS FIBROSIS..... TAKEN FROM ARTICLE PUBLISHED On 13 April 2015 Journal : CLINICAL COSMETIC & INVESTIGATIONAL DERMATOLOGY.. MADE BY: AMMARA IFTHIKAR MARIYAM TAUQEER...

2. Introduction.... Oral Submucous Fibrosis is a Pre-malignant disorder associated with chewing of Areca nut ( Betel nut ). It is very common in Southeast Asia but has started to spread to Europe and North America. Can lead to squamous cell carcinoma, a risk that is further increased by concomitant tobacco consumption .

3. DEFINATION... Oral Submucous Fibrosis (OSMF) is a chronic disease of insidious onset and a prevailing potentially malignant disorder characterized by epithelial inflammatory reaction along with mucosal fibrosis. First described by Schwartz as“ Atrophica Idiopathic Mucosae Oris” In 1952.

4. CASE REPORT.... A 35-year-old Indian women presented with difficulty in mouth opening and burning sensation while eating. On examination, blanching of the oral mucosa with diffuse white pigmented lesion of size 3.5 to 2 cm along with melanotic pigmentation was seen on the left buccal mucosa posteriorly. The patient was diagnosed with oral submucous fibrosis.

5. ETIOLOGY... Multi-Factorial. Local Factors. Chillies. Areca Nut ( major factor). Systemic Factors. Nutritional deficiency. Genetic Factors. Auto immunity.

6. PREVELANCE... The disease is predominantly seen in India , Bangladesh , Sri-lanka , Pakistan , Taiwan , Southern China , Polynesia and Micronesia. More prevalent in younger Individual (15 -35 yrs age). 2.3: 1 Male: Female.

7. Pathogenesis...

8. HISTO PATHOLOGICAL FEATURES... Collagen Hyalinization as Smooth Sheet. Extensive Fibrosis Obliterating the mucosal Blood Vessels and eliminating the melanocytes. Fibroblast markedly absent in hyalinized zone. Total loss of epithelial rete-pegs. Mild to moderate Atypia present. Extensive degeneration of Muscle fibres evident.

9. Diagnosis...

10. Investigation

11. CLASSIFICATION OF OSF.....

12. Very early (stage I) Early (stage II) Moderately advanced (stage III) Advanced (stage IV) A finely fibrillar collagen, dispersed with marked edema The juxta-epithelial area shows early hyalinization The collagen is moderately hyalinized The collagen is completely hyalinized The fibroblastic response is strong Plump young fibroblasts are present in moderate numbers The fibroblastic response is less marked, the cells present being mostly adult fibrocytes The hyalinized areas are devoid of fibroblasts Histopathological classifications of oral submucous fibrosis The blood vessels are sometimes normal, but more often they are dilated and congested The blood vessels are dilated and congested Blood vessels are normal or constricted Blood vessels are completely obliterated or narrowed Inflammatory cells, mainly PMNs leukocytes with an occasional eosinophil, are present Inflammatory cells are mostly mononuclear lymphocytes, eosinophils, and an occasional plasma cell Inflammatory exudates consist of lymphocytes and plasma cells, although an occasional eosinophil is seen Inflammatory cells are lymphocytes and plasma cells

13. C0UNSELING AND PREVENTION Encourage through education for discontinuation of habit. Patient should be explained about the disease and its possible malignant potential. Counseling for deaddiction. Vitamin, iron and mineral rich diet should be advised. Intake of fresh fruits and leafy vegetables should be included in regular diet.

14. THANK YOU....