Boulinguez S, Sommet A, Bédane C, Viraben R, Bonnetblanc J M
Department of Dermatology, University Hospital Dupuytren, Limoges, France.
J Oral Pathol Med. 2003 Sep;32(8):482-5. doi: 10.1034/j.1600-0714.2003.00166.x.
(i) To accurately define these lesions determining whether oral nicorandil-induced lesions are aphthous ulcers; (ii) To determine clinical characteristics of oral nicorandil-induced lesions.
Two slide conferences were held. A total of 60 dermatologists assigned diagnosis and clinical criteria to 11 photographs of oral nicorandil-induced lesions. Two slides were randomly selected and duplicated to be used as control. The panel of slides included independent lesions and photographs of different lesions of the same patient. Statistical analysis used chi2-test, estimation of the percentage interobserver agreement, and kappa-values.
The diagnosis of non-aphthous ulcer (71.8%) was significantly held in comparison with the diagnosis of oral aphthous ulcer (28.2%; P<0.001). To differentiate aphthous ulcer from non-aphthous ulcer, physicians significantly used three clinical criteria. The diagnosis of non-aphthous ulcer were significantly associated with the absence of yellow-based ulceration (P<0.001), with the linear shape (P=0.006) and the absence of inflammatory halo (P=0.003).
Oral nicorandil-induced lesions are not aphthous ulcers. We propose that at this stage of our knowledge, oral nicorandil-induced ulcer is the most suitable terminology.
（i）准确界定这些病变，确定口服尼可地尔引起的病变是否为阿弗他溃疡；（ii）确定口服尼可地尔引起的病变的临床特征。
举办了两次幻灯片研讨会。共有60名皮肤科医生对11张口服尼可地尔引起的病变的照片进行诊断并确定临床标准。随机选择两张幻灯片并复制用作对照。幻灯片组包括独立的病变以及同一患者不同病变的照片。采用卡方检验、观察者间一致性百分比估计和kappa值进行统计分析。
与口腔阿弗他溃疡的诊断（28.2%）相比，非阿弗他溃疡的诊断（71.8%）占比显著更高（P<0.001）。为区分阿弗他溃疡和非阿弗他溃疡，医生们显著采用了三项临床标准。非阿弗他溃疡的诊断与无黄色基底溃疡（P<0.001）、呈线性形状（P=0.006）以及无炎症晕（P=0.003）显著相关。
口服尼可地尔引起的病变不是阿弗他溃疡。我们建议，就目前我们的认知阶段而言，口服尼可地尔引起的溃疡是最合适的术语。
