Vaillant L, Chauchaix-Barthès S, Hüttenberger B, Arbeille B, Machet M, Jan V, Goga D, Lorette G
Consultation de Dermatologie Buccale, Hôpital Trousseau, France.
Ann Dermatol Venereol. 2000 Apr;127(4):381-7.
Desquamative gingivitis is a chronic diffuse inflammation of the gingiva. The aim of this study was to determine the causes and the clinical characteristics of desquamative gingivitis.
This was a retrospective descriptive study including 33 consecutive patients (25 women and 8 men) seen at a dermatology clinic for erosive gingivitis.
Thirteen patients (39 p. 100) had cicatricial pemphigoid, 12 (36 p. 100) had lichen planus, and 5 (15 p. 100) had pemphigus. Delay to diagnosis was a mean 19 months. The pinch sign was positive in 12 of the 13 cases of cicatricial pemphigoid. Dapsone improved the buccal lesions of cicatricial pemphigoid in all cases. Systemic corticosteroid therapy and acitretine were the most effective treatments for lichen planus and corticosteroid therapy improved pemphigus in all cases. At the time of assessment, only 3 cases of cicatricial pemphigoid, 2 cases of lichen planus and 1 case of pemphigus had reached complete remission without treatment.
Cicatricial pemphigoid and lichen planus are the most frequent causes of desquamative gingivitis, accounting for three-quarters of the cases. Positive diagnosis may be difficult and may require sophisticated techniques to avoid delay. Despite the effectiveness of symptomatic treatment, desquamative gingivitis may have a long course.
剥脱性龈炎是一种牙龈的慢性弥漫性炎症。本研究的目的是确定剥脱性龈炎的病因及临床特征。
这是一项回顾性描述性研究,纳入了33例连续在皮肤科诊所就诊的糜烂性龈炎患者(25名女性和8名男性)。
13例患者(39%)患有瘢痕性类天疱疮,12例(36%)患有扁平苔藓,5例(15%)患有天疱疮。诊断延迟的平均时间为19个月。13例瘢痕性类天疱疮患者中有12例捏起征呈阳性。氨苯砜在所有病例中均改善了瘢痕性类天疱疮的口腔损害。系统性糖皮质激素治疗和阿维A是治疗扁平苔藓最有效的方法,糖皮质激素治疗在所有病例中均改善了天疱疮病情。在评估时,只有3例瘢痕性类天疱疮、2例扁平苔藓和1例天疱疮未经治疗达到完全缓解。
瘢痕性类天疱疮和扁平苔藓是剥脱性龈炎最常见的病因,占病例的四分之三。阳性诊断可能困难,可能需要复杂的技术以避免延误。尽管对症治疗有效,但剥脱性龈炎病程可能较长。