Szpirglas Henri
Service de stomatologie et chirurgie-maxillo-faciale, Groupe hospitalier La Pitié-La Salpêtrière 75651 Paris.
Rev Prat. 2002 Feb 15;52(4):375-9.
Oral ulcerations have very varied characteristics, the analysis of which is often sufficient for the clinician to establish a diagnosis and propose a suitable treatment. Aphthous ulcers and traumatic lesions are the most frequent, however one also sees infectious ulcerations (tuberculous, syphilitic, common germs or viruses), inflammatory diseases of the gastrointestinal tract, bullous dermatosis of autoimmune, toxic or unknown origin such as erythema multiform, and erosive lichen planus. It is thus the general context or the evolution that orientates the diagnosis, which is made more precise in certain cases by complementary investigations, in particular by the biopsy. When the ulceration is isolated it is necessary to first exclude the much-feared squamous cell carcinoma, but also other malignant ulcerated tumours, lymphomas, and tumours of the salivary glands. Thus it is imperative that the histological examination confirms the diagnosis, to formulate a prognosis and to allow the commencement of treatment.
口腔溃疡具有非常多样的特征,对这些特征的分析通常足以让临床医生做出诊断并提出合适的治疗方案。阿弗他溃疡和创伤性病变最为常见,不过也可见到感染性溃疡(结核性、梅毒性、常见细菌或病毒引起的)、胃肠道炎性疾病、自身免疫性、毒性或病因不明的大疱性皮肤病,如多形红斑,以及糜烂性扁平苔藓。因此,总体情况或病情演变指导着诊断,在某些情况下通过补充检查,特别是活检,可使诊断更加精确。当溃疡孤立存在时,首先必须排除令人担忧的鳞状细胞癌,还有其他恶性溃疡肿瘤、淋巴瘤以及唾液腺肿瘤。因此,组织学检查必须证实诊断,以便制定预后并开始治疗。