Epithelial dysplasia was examined clinico-pthologically in 199 patients (251 lesions) with oral leukoplakia according to WHO criteria (1978). Of all the lesions, 186 (74.1%) were found to have epithelial dysplasia. The average dysplasia score was 3.3±2.0 points. There was no correlation between the clinical site of lesions and the occurrence of epithelial dysplasia. However, the occurrence of epithelial dysplasia was associated with the clinical appearance of lesions; i. e. erosive-type lesions or verrucous-type lesions. Malignant transformation occurred in 6 patients (3.0%) with oral leukoplakia. In the 12 items of the WHO criteria for epithelial dysplasia, items 1, 3, 4, 6, and 8 were frequently seen, in that order, before malignant transformation. This study suggests that patients with erosive-type lesions or verrucous-type lesions with severe epithelial dysplasia are associated with a greater risk of malignant transformation.

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Nine cases of palatal mucosal burn were clinically examined. The lesions were most frequently observed in the median area of the palate, ranging widely from the hard to soft palate, over 10mm in diameter. The lesions appeared as ulcerative (erosive) or ruptured bullous areas, which were consequently considered to be second-degree burns. The causes were mostly hot food cooked in oil or hot soups, and others had unknown causes. Healing of the palatal mucosal burn was secondary healing, which was considered to be rapid, because proliferation of epithelium occurred from borders of the ulcer, and lots of epithelial islands occurred at the ulcer base.

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Diagnostic criteria for Sjögren's syndrome were revised in 1999. A comparison of clinical examinations between primary SS and secondary SS was carried out on the inspection which required for the diagnosis in this time variously. The clinical profiles of patients with Sjögren's syndrome were obtained from 91 patients who had visited the Department of Oral & Maxillofacial Surgery, Dokkyo University School of Medicine, during the period from December 1996 to September 2000. The diagnosis of Sjögren's syndrome was based on the revised Japanese criteria for Sjögren's syndrome (1999). The clinical profiles of 43 primary SS patients were compared with 48 secondary SS patients. The distribution of symptoms was examined in this study. All examinations did not show significant differences between primary SS and secondary SS. These results suggest that both primary SS and secondary SS can be diagnosed with the same criteria.

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We report a case of immunohistologically diagnosed bullous pemphigoid that first occurred in the oral cavity, and cicatricial pemphigoid was suspected. The patient was a 66-year-old male, who noticed intra-oral haphalgesia approximately 8 months earlier, and received treatment at a local dentist 4 months later; however, no improvement was observed. The paient had previously been infected with viral hepatitis type C, and he has received treatment for diabetes. Although no symptoms were observed in the skin or eyes, intra-oral ulceration was observed in the labio-buccal gingival margin, and in part of the attached gingiva in 6+6, and along the palatal gingival margin in the maxilla. Furthermore, in 7, ulceration ranging from the buccal gingiva to the alveolar crest and the palatal gingiva, as well as erosion in the buccal mucosa, were observed. Because cicatricial pemphigoid was suspected from the clinical symptoms, biopsy was performed, and the lesion was diagnosed as bullous pemphigoid that first occurred in the oral cavity. The intra-oral symptoms improved after treatment with intra-oral irrigation and washing the mouth in our department, and administration of tetracycline and nicotinic acid amide by the department of dermatology.

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Stevens-Johnson syndrome has various clinical manifestations involving the skin, eyes, and mucous membranes together with systemic symptoms such as fever and fatigue.
We herein report a patient with a long-standing ulcer of the tongue and a history of Stevens-Johnson syndrome, and we discuss the possible mechanism involved in the occurrence and prolongation of the ulcer.

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