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无牙患者老年性紫癜口腔表现的管理:一例报告

Management of the oral manifestations of senile purpura in an edentulous patient: a case report.

作者信息

da Rosa Rosena Santos, Garcia Renata C M R, Cury Altair A D B, Faot Fernanda

机构信息

Departament of Dentistry, Pontifical Catholic University of Parana, Curitiba, Paraná, Brazil.

出版信息

Spec Care Dentist. 2011 May-Jun;31(3):111-3. doi: 10.1111/j.1754-4505.2011.00186.x.

Abstract

Senile purpura occurs because of a weakness of the vascular supporting tissues mainly caused by aging and is most often seen on the dorsal surface of the hands and the extensor surfaces of the forearms, and has also been observed in the oral mucosa of elderly patients. These red lesions present as sharply margined subcutaneous hemorrhagic spots and are due to trauma, such as damage to the endothelium of small blood vessels, or a coagulation defect. They can also be due to reduced perivascular support, or capillary fragility and permeability, or a combination of all of these factors. Oral manifestation of senile purpura can also be induced by long periods of medication use leading to fragile areas of the mucosa. The presence of senile purpura requires continuous follow-up since drug-induced purpura may cause plaque function alterations. An accurate diagnosis in elderly complete denture wearers can minimize bleeding and prevent possible development of ulcerations under the dentures, especially during the adaptation period to the prosthesis. This case report, presents the care and 3-year follow-up of a 66-year-old woman with complete dentures who presented with the oral manifestations of senile purpura caused by the continued use of several medications.

摘要

老年性紫癜的发生是由于主要由衰老引起的血管支持组织薄弱,最常见于手背和前臂伸侧,在老年患者的口腔黏膜中也有观察到。这些红色病变表现为边界清晰的皮下出血点,是由创伤引起的,如小血管内皮损伤或凝血缺陷。它们也可能是由于血管周围支持减少、毛细血管脆性和通透性增加,或所有这些因素的综合作用。长期用药导致黏膜脆弱区域也可诱发老年性紫癜的口腔表现。由于药物性紫癜可能导致血小板功能改变,因此对老年性紫癜的存在需要持续随访。在老年全口义齿佩戴者中进行准确诊断可以减少出血,并防止假牙下可能出现的溃疡,尤其是在适应假牙的时期。本病例报告介绍了一名66岁全口义齿女性患者的护理情况及3年随访,该患者因持续使用多种药物出现老年性紫癜的口腔表现。

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