Altenburg Andreas, Krahl Dieter, Zouboulis Christos C
Department of Dermatology, Venerology and Allergology/Immunological Center, Dessau Medical Center, Germany.
J Dtsch Dermatol Ges. 2009 Mar;7(3):242-57. doi: 10.1111/j.1610-0387.2008.06962.x.
Non-infectious ulcerative oral mucous membrane diseases are difficult to separate at first glance: they can appear as aphthous, bullous, lichenoid, drug-induced or toxic-irritative reactions. The overall considerations of history, localization of lesions, clinical and histological features, as well as direct and indirect immunofluorescence examination are required for the correct diagnosis. Some disorders start preferably at the oral mucosa, like pemphigus vulgaris and Adamantiades-Behçet disease, while others, such as cicatricial pemphigoid and habitual aphthosis generally are confined to the mucous membranes. This overview summarizes clinical and diagnostic features, differential diagnoses and current therapeutic possibilities of non-infectious inflammatory stomatopathies, which possess a specific position among skin diseases in distinction to infectious or neoplastic oral ulcers. This group of diseases includes aphthous lesions, lichen planus mucosae, lupus erythematosus, disorders with intraepidermal or subepidermal formation of blisters including pemphigus, bullous pemphigoid, erythema multiforme and variants as well as allergic or toxic contact stomatitis.
它们可能表现为口疮性、大疱性、苔藓样、药物性或毒性刺激性反应。正确诊断需要综合考虑病史、病变部位、临床和组织学特征,以及直接和间接免疫荧光检查。有些疾病好发于口腔黏膜,如寻常型天疱疮和白塞病,而其他疾病,如瘢痕性类天疱疮和复发性口疮通常局限于黏膜。本综述总结了非感染性炎性口腔疾病的临床和诊断特征、鉴别诊断及当前的治疗方法,这类疾病在皮肤病中具有特殊地位,有别于感染性或肿瘤性口腔溃疡。这组疾病包括口疮性病变、黏膜扁平苔藓、红斑狼疮、表皮内或表皮下形成水疱的疾病,包括天疱疮、大疱性类天疱疮、多形红斑及其变型,以及过敏性或毒性接触性口炎。