Langerhans cell histiocytosis (LCH) is a rare proliferative disorder in which the pathologic Langerhans cells infiltrate and destroy the tissues. Patients with LCH present varied clinical manifestations. Cutaneous lesions in LCH manifest as vesiculopapular eruptions that often mimic various infectious diseases particularly in infants. We present a case of a female infant with an ulcerative lesion intraorally. The baby was asymptomatic otherwise. A detailed history revealed the presence of cutaneous lesions that was overlooked by her parents. Conclusion: This report tries to briefly discuss the current concepts regarding the etiology of LCH. An attempt has been made to emphasis the need for a through systemic examination. The protocol of investigative procedures to be adopted in LCH is also discussed.

Oral cancer is a common site of cancer worldwide with oral squamous cell carcinoma (OSCC) comprising the major segment. The risk factors include tobacco and alcohol abuse, betel quid, and areca nut consumption. Warthin tumour (WT), also known as papillary cystadenoma lymphomatosum is a benign tumour of the salivary gland. It is one of the most common benign parotid neoplasms with cigarette smoking and radiation exposure as possible cited etiologic factors. Rarely, two or more histologically distinct neoplasms may occur synchronously. The synchronous occurrence of OSCC and WT is infrequent. The aim of this case series is to report the incidence rate of synchronous OSCC and WT in our centre between 2010 and 2019 and their socio-demographic, clinical, histopathological features, management, and prognosis and discuss the relevant literature. Out of 143 OSCC cases reported in our centre from the year 2010 to 2019, two had synchronous OSCC and WT with an incidence rate of 1.4%. These two cases occurred in a 63-year-old female and a 68-year-old male both with smoking habits. One OSCC was present in the left buccal mucosa and the other in the right ventral surface of the tongue, whereas the WT in both cases occurred in the tail of the parotid. One patient had a recurrence and died while the other is under follow-up without any recurrence. These unusual findings of synchronous occurrence of WT at a distant site from the primary tumour may mimic a malignant disease, more likely a metastasis from the primary OSCC, which could further complicate the management of these patients. Therefore, radiologists, head and neck surgeons, and pathologists should be aware of the occurrence of these unusual presentations to avoid overtreatment in such cases.

In this study we aimed to determine the adverse effects and pain outcome following carbamazepine pharmacotherapy to manage patients with classical trigeminal neuralgia. The study was carried out on patients diagnosed with classical trigeminal neuralgia at the Faculty of Dentistry, University of Malaya. Medical records of patients diagnosed with trigeminal neuralgia over a period of 11 years from April, 2003 to April, 2014 were reviewed. A total of 49 patients who fulfilled the inclusion criteria were included in the study. Demographic details, clinical features and blood test reports of the patients were recorded from the patient’s clinical files. Subjects included in the study were administered the Faces Pain Rating Scale (FPS) and Numeric Pain Rating scale (NRS) to measure the pain outcome retrospectively. Analysis and interpretation of results was carried out using SPSS. Hepatic adverse effects were more commonly seen in our patients (n=39) followed by haematological (n=27), renal (n=23) and non-specific adverse effects (n=22). However, there was no significant association between the observed side effects and carbamazepine pharmacotherapy. Analysis of our data using Pearson Chi Square test, showed no significant correlation between gender, ethnicity and age of the patients with adverse effects. 9 out of the 49 subjects included in the study were administered the FOS and the NRS. Pain perception after treatment was significantly decreased (p-0.007) in comparison to pain perception before commencement of therapy with carbamazepine in the selected group of patients. Even though pain perception decreased in the selected patients, the data is insufficient to state the efficacy of the treatment as none of the patients reported a complete relief from their pain. The results of our study showed that there were no significant haematological, hepatic, renal, and non-specific adverse effects associated with the use of carbamazepine. The efficacy of this drug in the treatment of trigeminal neuralgia was proven to be satisfactory. It may be concluded that carbamazepine could be considered as the drug of choice in the treatment of trigeminal neuralgia.