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Fulltext Oral Lichen Planus in a Patient With a Thymoma: A Rare Finding

Gubod ER, Ramanathan A, Mohamad Zaini Z, Warnakulasuriya S

Cureus, 2021 Aug;13(8):e17376.
PMID: 34584786 DOI: 10.7759/cureus.17376

We present a rare case of ulcerative oral lichen planus that was associated with a thymoma discovered during the management phase, seven months after the initial diagnosis of oral lichen planus. Thymectomy was performed and investigations revealed pure red cell aplasia. Although rare, the association of a thymoma should be considered in recording the medical history of patients presenting with oral lichen planus.
Fulltext Periodontal disease as the initial oral manifestation of langerhans cell histiocytosis - a case report

Ahmad AR, Ismail SM, Zain RB, Mohamad Zaini Z

Ann Dent, 2009;16(1):31-36.
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Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.
Accelerated implementation of teleconsultation services for the monitoring of oral potentially malignant disorders as a result of the COVID-19 pandemic

Rajendran S, Mohamad Zaini Z, Lim YZ, Kallarakkal TG, Ramanathan A, Chan SW, et al.

Oral Oncol, 2022 Feb 14;126:105730.
PMID: 35176655 DOI: 10.1016/j.oraloncology.2022.105730
High referral accuracy for oral cancers and oral potentially malignant disorders using telemedicine

Haron N, Rajendran S, Kallarakkal TG, Zain RB, Ramanathan A, Abraham MT, et al.

Oral Dis, 2023 Mar;29(2):380-389.
PMID: 33914993 DOI: 10.1111/odi.13892

OBJECTIVE: To evaluate the accuracy of MeMoSA®, a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral.
SUBJECTS AND METHODS: A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA®. The identification of the presence of lesion/variant and referral decision made using MeMoSA® were compared to clinical oral examination, using kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions.
RESULTS: Kappa values comparing MeMoSA® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892, respectively. Sensitivity and specificity for referral decision were 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3%, respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA®.
CONCLUSION: Referral decisions made through MeMoSA® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.