Andrade Sérgio Araújo, Ribeiro Marisa Maria, Pratavieira Sebastião, Bagnato Vanderlei Salvador, Varotti Fernando de Pilla
Núcleo de Pesquisa em Química Biológica (NQBio), UFSJ - Universidade Federal de São João Del Rei, Divinópolis, MG, Brasil.
Service of Dental Specialties, Prefeitura Municipal de Divinópolis, Divinópolis, MG, Brasil.
Braz Dent J. 2019 Mar-Apr;30(2):191-196. doi: 10.1590/0103-6440201902270. Epub 2019 Apr 4.
Hairy tongue is a benign pathology, characterized clinically by hyperkeratinized plaques on the dorsal surface of the tongue, hairlike, whose coloration ranges from unpigment, whitish, yellowish, green, brown to black. Diagnosis is clinical, and, in cases of whitish plaques, it may be difficult to differentiate between oral hairy leukoplakia, potentially malignant leukoplakia or squamous cell carcinoma. Thus, widefield optical fluorescence complementary examination may allow a better visualization of the local hairlike pattern of hyperkeratinization, typical of the hairy tongue, facilitating the diagnosis. In this work, a 57-year-old man was referred to the Dental Specialties Department of the Divinópolis Health Department (MG, Brazil) by a general dental practitioner, aiming a differential diagnosis of possible malignant lesion on the dorsal tongue surface. The complementary examination by wide-field optical fluorescence was performed. For this, it was employed a device with high-power light-emitting diode emitting light centered at a wavelength of (400±10) nm and maximum irradiance of (0.040±0.008) W/cm2 was used for fluorescence visualization. Fluorescence images showed projections of hairlike appearance in tongue dorsal surface with no aspects of malignancy. Hairlike appearance is the principal feature of hairy tongue. In this way, the final diagnosis was established. In conclusion, in this case, the use of widefield optical fluorescence in oral diagnostic routine provided a differential diagnosis, with no need of an incisional biopsy.
毛舌是一种良性病变，临床上表现为舌背表面有角化过度的斑块，呈毛发状，其颜色从无色素、白色、淡黄色、绿色、棕色到黑色不等。诊断依靠临床判断，对于白色斑块的情况，可能难以区分口腔毛状白斑、潜在恶性白斑或鳞状细胞癌。因此，宽视野光学荧光互补检查可以更好地观察到毛舌典型的局部毛发状角化过度模式，有助于诊断。在这项研究中，一名57岁男性由一名普通牙科医生转诊至迪维诺波利斯市卫生部门（巴西米纳斯吉拉斯州）牙科专科，目的是对舌背表面可能的恶性病变进行鉴别诊断。进行了宽视野光学荧光互补检查。为此，使用了一种高功率发光二极管装置，其发射的光中心波长为(400±10)nm，最大辐照度为(0.040±0.008)W/cm²用于荧光观察。荧光图像显示舌背表面有毛发状外观的凸起，没有恶性特征。毛发状外观是毛舌的主要特征。由此，确立了最终诊断。总之，在这个病例中，宽视野光学荧光在口腔诊断常规中的应用提供了鉴别诊断，无需进行切开活检。
