title: The frequency of fungal infection in biopsies of oral mucosal lesions.
abstract: OBJECTIVE
  To determine the frequency of fungal infection in biopsies of oral mucosal lesions.
  
  
  METHODS
  Histopathology reports issued between 1991-1995 inclusive were reviewed. During this period, a single section of each mucosal biopsy had been stained using the periodic acid-Schiff (PAS) technique.
  
  
  RESULTS
  A total of 223 (4.7%) biopsies contained PAS-positive fungi: 191 individuals were affected, 124 (64.9%) of whom were male. There was a significant (P < 0.01) positive association of fungal infection with moderate and severe epithelial dysplasia, median rhomboid glossitis and squamous papillomas. Where a subsequent biopsy was available, 21.9% dysplasias which were infected with fungi worsened in histological severity, as compared with 7.6% of dysplasias which were not infected at any stage. There was a significant negative association of fungal infection with benign fibrous overgrowths (P < 0.01), benign hyperkeratoses, lichenoid reactions and pyogenic granulomas (P < 0.05). The difference in frequency of infection between the tongue and other sites was also significantly higher (P < 0.01).
  
  
  CONCLUSIONS
  There is a statistically significant association between histologically-determined fungal infection and epithelial dysplasia, and we recommend that a PAS stain be performed whenever oral epithelial dysplasia is diagnosed, especially in male patients. On histological confirmation of dysplasia, anti-fungal therapy should be considered in the management of these lesions.
authors.affiliation: Department of Oral Pathology, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK. A.Barrett@eastman.ucl.ac.uk
authors.forename: A W
authors.initials: AW
authors.lastname: Barrett
authors.forename: V J
authors.initials: VJ
authors.lastname: Kingsmill
authors.forename: P M
authors.initials: PM
authors.lastname: Speight
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002175:Candida / Q000302:isolation & purification; D002180:Candidiasis, Oral / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004848:Epithelium / Q000382:microbiology / Q000473:pathology; D005260:Female; D005928:Glossitis / Q000150:complications; D017789:Granuloma, Pyogenic / Q000150:complications; D006801:Humans; D007972:Leukoplakia, Oral / Q000150:complications; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000150:complications* / Q000175:diagnosis; D009061:Mouth Mucosa / Q000382:microbiology* / Q000473:pathology; D009181:Mycoses / Q000150:complications*; D010212:Papilloma / Q000150:complications*