There was a few study concerning the oral adverse events during cancer therapy with molecular targeted drugs. Among the patients referred to our oral care unit from April 2007 to March 2014, 23 patients who were treated with molecular targeted drugs showed 27 oral adverse events. We examined the details of the oral adverse events and the causal drugs on these 23 patients. Ten patients were treated with small molecule drugs, while 17 patients were treated with monoclonal antibody drugs. The small molecule drugs were used singly, whereas the monoclonal antibody drugs were always used with conventional cytotoxic chemotherapeutic agents. Oral mucositis was observed in all 23 patients (27 events), and taste disorder was seen in 4 patients (4 events). All patients received the professional oral management, then they completed their cancer chemotherapy in the designated period. Because the single use of sunitinib (multi-kinase inhibitor) could lead oral mucositis, an intensive oral management before sunitinib treatment should be necessary.

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A clinical diagnosis of oral lichen planus (OLP) can be made according to several classifications. Specifically, 2-type, 3-type, and 6-type classifications have been established, each offering greater diagnostic precision. Typical cases can usually be diagnosed without difficulty; however, clinical diagnoses for mixed lesions can differ among doctors. Thus, standard guidelines for clinical classification of OLP are needed.
In the present study, 5 specialists in Japanese Society of Oral and Maxillofacial Surgeons classified cases that had been diagnosed as OLP in the Department of Dentistry, Oral and Maxillofacial Surgery at Jichi Medical University. The results showed that the rate of agreement for each diagnosis was high when using Axéll’s 2-type classification, but the rate of agreement decreased as the number of types increased. In addition, the rate of agreement was higher in cases with the typical reticular type and lower in cases with the mixed type. Although the 2-type classification was found to be most suitable, it is necessary to establish definitions for the classification of compound cases and multiple onset cases.

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Acute generalized exanthematous pustulosis (AGEP), one of the severe drug eruptions, is characterized by acute onset of generalized erythematous pustular eruptions without hemorrhage and high fever. A 29-year-old woman, who presented generalized pustulosis lesions including intraoral region and high fever after the use of oral anti-influenza drug for influenza B, was admitted to our hospital. The diagnosis was confirmed by the medical history, clinical findings, and clinical examination such as blood test for infectious disease. The symptoms were improved after withdrawal of anti-influenza drug and topical steroid treatment for pustulosis lesions. There has been no evidence of recurrence after being discharged from hospital.

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A lymphoepithelial cyst often was identified with branchial cyst and lateral cervical cyst. A lymphoepithelial cyst usually occurs in the lateral cervical areas. It is characterized histopathologically as the lymphoid tissue below the lining of the stratified squamousepithelium of the cyst, but the same cyst sometimes occurs in the oral cavity, especially the sublingual area or floor of the mouth. This report includes two cases of the cyst in the oral cavity. We excised the swelling with surround tissue in the local anesthesia. Histopathological diagnosis was a lymphoepithelial cyst.

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Methotrexate （MTX）-associated lymphoproliferative disorder is one of the side effects of MTX, and their reports in the oral cavity are rare. We report a case in which an ulcer in the mandibular gingiva gradually caused a bone exposure. The diagnosis was suggested by biopsy. The lesion disappeared after the withdrawal of MTX. In the treatment of the ulcerative lesions without bone exposure in a patient receiving MTX, this side effect should be taken into consideration, and the general diagnosis should involve a histopathological examination at an early stage.

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Verruciform xanthoma is an uncommon lesion that is characterized by the proliferation of foamy or xanthoma cells in the submucosal stroma, and is generally considered to be a reactive change, not to a true neoplasm. We report two cases of Verruciform xanthoma in the Oral Cavity and a review of the literature. We describe an 83-year-old woman （Case 1） with an exophytic mass on the right margin of the mandible and a 69-year-old woman （Case 2） with an exophytic pedunculated mass on the tongue. Both lesions were surgically resected and histopathologically diagnosed as Verruciform xanthoma.

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A 16-years-old girl has suffered from a recurrent blistering around both the nostril parts and lips. Later, she also noticed a similar lesion on the palate. She visited our OPD in considering a possible herpes simplex. These mucocutaneous lesions occurred the day after she used analgesics during a menstrual period. We diagnosed this patient as fixed drug eruption cause by analgesics based on the blistering and pigmentation on the transition zone of lips and the medication history. There are some similarities between clinical pictures of fixed drug eruption and those of herpes simplex. Therefore, it is important to differentiate fixed drug eruption from labial herpes simplex.

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A case of bilateral nasolabial cysts in a 44-year-old female patient is reported. The patient was referred to our hospital with a chief complaint of swelling in the right alar base. Physical examination showed swelling with fluctuation in the oral vestibule of the bilateral maxillary canine areas. Yellow-colored fluid was aspired by fine needle aspiration cytology. CT scan showed two cystic lesions separately existing in the alar bases of the both sides. Under a clinical diagnosis of bilateral nasolabial cysts, the lesions were enucleated under general anesthesia. Histopathologically, the cystic cavities were lined by pseudostratified ciliated columnar epithelium with goblet cells.

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Methotrexate（MTX） is an antifolic agent with a well-established history of use in the treatment of various neoplastic diseases. Low-dose MTX has been widely used for rheumatoid arthritis（RA） as a disease-modifying antirheumatic drug （DMARD）. We report three cases of oral ulceration caused by an antirtheumatic drug（MTX） and a review of the literature in these cases is MTX was discontinued and the oral ulceration disappeared.

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