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口腔黏膜硬化性苔藓:临床及组织病理学表现。文献综述及病例报告

Lichen sclerosus of the oral mucosa: clinical and histopathological findings. Review of the literature and a case report.

作者信息

Matela Anna-Maija, Hagström Jaana, Ruokonen Hellevi

机构信息

a Department of Oral and Maxillofacial Diseases, Head and Neck Center, Oral and Maxillofacial Diseases , Helsinki University, Helsinki University Hospital , Helsinki , Finland.

b Department of Pathology , Haartman Institute, University of Helsinki , Helsinki , Finland.

出版信息

Acta Odontol Scand. 2018 Jul;76(5):364-373. doi: 10.1080/00016357.2018.1463452. Epub 2018 Apr 16.

Abstract

OBJECTIVES

Lichen sclerosus (LS) is a rare, chronic mucocutaneous disease that most frequently affects the female genital area. Oral manifestations are seldom detected; only 36 well-documented and histopathologically verified oral LS cases have been published.

MATERIALS AND METHODS

Here we describe one patient affected by oral (LS) and review of the literature 1957-2017.

RESULTS

Findings in our review suggest a female to male ratio of 1.64:1. It is most commonly diagnosed at the age of 10-29 years (46%). Oral LS can appear as symptomless, irregular-shaped, porcelain-white and flat lesions situated asymmetrically. Lesion is commonly sole, well-demarcated area and its size varies from 2 mm (small macula) to 7 cm (large plaque). The most common sites in the oral cavity include the labial mucosa, lips and gingiva. The histopathological criteria include atrophy and sometimes hyperkeratosis of the epithelium, hydropic degeneration of basal cells, hyalinization of the lamina propria, lymphocyte infiltration beneath the zone of hyalinization and scantiness of elastin. Surgical excision is an effective treatment for small lesions; intralesional triamcinolone or corticosteroid injections are used for larger lesions.

CONCLUSIONS

Oral LS may be under-recognized due to its asymptomatic nature and rarity.

摘要

目的

硬化性苔藓(LS)是一种罕见的慢性黏膜皮肤疾病,最常累及女性生殖器区域。很少检测到口腔表现;仅发表了36例有充分文献记录且经组织病理学证实的口腔LS病例。

材料与方法

在此,我们描述了一名患有口腔LS的患者,并对1957年至2017年的文献进行了综述。

结果

我们综述中的发现表明,女性与男性的比例为1.64:1。最常见的诊断年龄为10至29岁(46%)。口腔LS可表现为无症状、形状不规则、瓷白色扁平病变,且不对称分布。病变通常为单发、边界清晰的区域,其大小从2毫米(小斑疹)到7厘米(大斑块)不等。口腔中最常见的部位包括唇黏膜、嘴唇和牙龈。组织病理学标准包括上皮萎缩,有时伴有角化过度、基底细胞水肿变性、固有层玻璃样变、玻璃样变区域下方的淋巴细胞浸润以及弹性蛋白稀少。手术切除是治疗小病变的有效方法;对于较大病变,可采用病灶内注射曲安奈德或皮质类固醇。

结论

由于口腔LS无症状且罕见,可能未得到充分认识。

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