Gonçalves Priscilla Santana Pinto, Mendez Daniela Alejandra Cusicanqui, Santos Paulo Sérgio da Silva, Damante José Humberto, Rios Daniela, Cruvinel Thiago
Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
Case Rep Dent. 2017;2017:1986834. doi: 10.1155/2017/1986834. Epub 2017 Feb 15.
Factitious ulcers are characterized by self-inflicted lesions with multifactorial origin. These lesions are frequently found in head, neck, and hands. This report shows a 6-year-old boy diagnosed with factitious oral ulcers that occurred after the self-biting of buccal vestibule and nail-scratching of gingival tissue. Clinically, a significant swelling was observed, hard on palpation, located at the right lower third of the face, next to the posterior area of the mandible. In the intraoral examination, ulcers at different healing stages were noted on the swelling area. During the anamnesis, the father reported a change in his familial structure that triggers psychological stress, providing the clues to the presumptive diagnosis of factitious oral ulcers. We prescribed the topical use of Gingilone® three times a day to control the local pain and inflammation. At 7-day follow-up, we noticed the reduction of extraoral swelling and the initial healing of the ulcers. The presumptive diagnosis was confirmed at 30-day follow-up, with the lasting remission of oral lesions. The treatments of factitious oral ulcers should be individually tailored for each patient, focused on a multidisciplinary approach, including psychotherapy and periodic clinical control. To the best of our knowledge, gaps of evidence lead to the lack of standardized clinical protocols on this issue.
人为性溃疡的特征是由多因素引起的自我造成的损伤。这些损伤常见于头部、颈部和手部。本报告展示了一名6岁男孩，被诊断为因自咬颊前庭和搔抓牙龈组织而出现的人为性口腔溃疡。临床上，在右脸下部、下颌骨后部区域旁观察到明显肿胀，触诊坚硬。口腔检查时，在肿胀区域发现处于不同愈合阶段的溃疡。在问诊过程中，父亲报告了家庭结构的变化引发了心理压力，这为推测性诊断人为性口腔溃疡提供了线索。我们开了Gingilone®局部用药，每天3次，以控制局部疼痛和炎症。在7天的随访中，我们注意到口外肿胀减轻，溃疡开始愈合。在30天的随访中，推测性诊断得到证实，口腔病变持续缓解。人为性口腔溃疡的治疗应针对每位患者进行个体化定制，侧重于多学科方法，包括心理治疗和定期临床检查。据我们所知，证据空白导致在这个问题上缺乏标准化的临床方案。
