Krawiecka Ewa, Szponar Elżbieta
Department of Oral Mucosa Diseases, Poznan University of Medical Sciences, Poznan, Poland. Head of the Department: Barbara Dorocka-Bobkowska MD, DDS, PhD.
Postepy Dermatol Alergol. 2015 Aug;32(4):302-6. doi: 10.5114/pdia.2014.43284. Epub 2015 Aug 12.
This paper aims at characterizing clinical features, occurrence, diagnostic process and treatment of oral tuberculosis (TB), basing on the available literature. Oral TB manifestations are uncommon and usually secondary to pulmonary changes. They predominantly appear as ulcers. Eruptions are usually single, painful and resistant to conventional treatment. Diagnosis always needs to be confirmed histopathologically. Anti-tubercular systemic therapy is required in every patient diagnosed with oral TB, while topical treatment is only adjuvant. A low incidence of oral TB together with a non-specific clinical picture might pose difficulties in its diagnosis. Oral changes in TB are likely to be overlooked what can result in further spread of Mycobacterium tuberculosis due to a delay in instituting proper treatment. Tuberculosis morbidity has risen recently and more multi-drug resistant strains of TB bacilli are found, what can result in a higher incidence of oral TB. Clinicians should be therefore aware of a possible occurrence of this entity and consider it while making a differential diagnosis of atypical oral changes.
本文旨在依据现有文献,对口腔结核的临床特征、发病率、诊断过程及治疗进行描述。口腔结核表现并不常见,通常继发于肺部病变。其主要表现为溃疡。病损通常为单个,疼痛且对常规治疗有抵抗性。诊断始终需要组织病理学证实。每一位诊断为口腔结核的患者都需要进行抗结核全身治疗,而局部治疗仅起辅助作用。口腔结核发病率低且临床表现不具特异性,这可能给其诊断带来困难。结核引起的口腔病变很可能被忽视,这可能因延误适当治疗而导致结核分枝杆菌进一步传播。近年来结核病发病率有所上升,且发现了更多耐多药的结核杆菌菌株,这可能导致口腔结核发病率升高。因此,临床医生应意识到这种疾病可能发生,并在对非典型口腔病变进行鉴别诊断时予以考虑。