Feller Liviu, Wood Neil Hamilton, Khammissa Razia Abdool Gafaar, Lemmer Johan
Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Department of Periodontology and Oral Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 May;123(5):559-565. doi: 10.1016/j.oooo.2017.02.007. Epub 2017 Feb 21.
Allergic contact stomatitis (ACS) is an oral mucosal immunoinflammatory disorder variably characterized clinically by erythematous plaques, vesiculation, ulceration, and/or hyperkeratosis and by pain, burning sensation, or itchiness. ACS is brought about by a T cell-mediated, delayed hypersensitivity immune reaction generated by a second or subsequent contact exposure of an allergen with the oral mucosa, in a genetically susceptible, sensitized subject. Lichenoid contact reaction is a variant of ACS brought about by direct contact with the oral mucosa of certain metals in dental restorations. The features of ACS are neither clinically nor histopathologically specific, so the diagnosis is usually presumptive and can only be confirmed by resolution of the inflammation after withdrawal or removal of the suspected causative allergen. When ACS is suspected but an allergen cannot be identified, patch testing is necessary. In persistent cases, topical corticosteroids are the treatment of choice, but for severe and extensive lesions, systemic corticosteroid and systemic antihistamines may be indicated. In this short review, we highlight the clinical, immunologic, and histopathological features of ACS, and provide some guidelines for diagnosis and management.
变应性接触性口炎（ACS）是一种口腔黏膜免疫炎症性疾病，临床上表现多样，包括红斑性斑块、水疱形成、溃疡和/或角化过度，并伴有疼痛、烧灼感或瘙痒感。ACS是由T细胞介导的迟发型超敏免疫反应引起的，在具有遗传易感性且已致敏的个体中，变应原第二次或后续接触口腔黏膜时引发该反应。苔藓样接触反应是ACS的一种变体，由牙科修复体中某些金属直接接触口腔黏膜所致。ACS的特征在临床和组织病理学上均无特异性，因此诊断通常是推测性的，只有在停用或去除可疑的致病变应原后炎症消退才能确诊。当怀疑ACS但无法确定变应原时，必须进行斑贴试验。对于持续性病例，局部用皮质类固醇是首选治疗方法，但对于严重和广泛的病变，可能需要全身用皮质类固醇和全身用抗组胺药。在这篇简短的综述中，我们重点介绍了ACS的临床、免疫和组织病理学特征，并提供了一些诊断和管理指南。
