Wollina Uwe, Verma Shyam B, Ali Fareedi Mukram, Patil Kishor
Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
Nirvana Skin Clinic, Vadodara, Gujarat, India.
Clin Cosmet Investig Dermatol. 2015 Apr 13;8:193-204. doi: 10.2147/CCID.S80576. eCollection 2015.
Oral submucous fibrosis (OSF) is a premalignant condition caused by betel chewing. It is very common in Southeast Asia but has started to spread to Europe and North America. OSF can lead to squamous cell carcinoma, a risk that is further increased by concomitant tobacco consumption. OSF is a diagnosis based on clinical symptoms and confirmation by histopathology. Hypovascularity leading to blanching of the oral mucosa, staining of teeth and gingiva, and trismus are major symptoms. Major constituents of betel quid are arecoline from betel nuts and copper, which are responsible for fibroblast dysfunction and fibrosis. A variety of extracellular and intracellular signaling pathways might be involved. Treatment of OSF is difficult, as not many large, randomized controlled trials have been conducted. The principal actions of drug therapy include antifibrotic, anti-inflammatory, and antioxygen radical mechanisms. Potential new drugs are on the horizon. Surgery may be necessary in advanced cases of trismus. Prevention is most important, as no healing can be achieved with available treatments.
口腔黏膜下纤维化（OSF）是一种由嚼槟榔引起的癌前病变。它在东南亚非常常见，但已开始蔓延至欧洲和北美。OSF可导致鳞状细胞癌，同时吸烟会进一步增加这种风险。OSF是一种基于临床症状并经组织病理学证实的诊断。导致口腔黏膜变白的血管减少、牙齿和牙龈染色以及牙关紧闭是主要症状。槟榔的主要成分是来自槟榔果的槟榔碱和铜，它们会导致成纤维细胞功能障碍和纤维化。可能涉及多种细胞外和细胞内信号通路。OSF的治疗很困难，因为尚未进行许多大型随机对照试验。药物治疗的主要作用机制包括抗纤维化、抗炎和抗氧自由基机制。潜在的新药即将出现。在牙关紧闭的晚期病例中可能需要手术。预防最为重要，因为现有治疗方法无法实现治愈。
