State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Front Immunol. 2022 Sep 29;13:1013900. doi: 10.3389/fimmu.2022.1013900. eCollection 2022.
As an immune dysregulation-related disease, although ulcerative colitis (UC) primarily affects the intestinal tract, extraintestinal manifestations of the disease are evident, particularly in the oral cavity. Herein, we have reviewed the various oral presentations, potential pathogenesis, and treatment of oral lesions related to UC. The oral manifestations of UC include specific and nonspecific manifestations, with the former including pyostomatitis vegetans and the latter encompassing recurrent aphthous ulcers, atrophic glossitis, burning mouth syndrome, angular cheilitis, dry mouth, taste change, halitosis, and periodontitis. Although the aetiology of UC has not been fully determined, the factors leading to its development include immune system dysregulation, dysbiosis, and malnutrition. The principle of treating oral lesions in UC is to relieve pain, accelerate the healing of lesions, and prevent secondary infection, and the primary procedure is to control intestinal diseases. Systemic corticosteroids are the preferred treatment options, besides, topical and systemic administration combined with dietary guidance can also be applied. Oral manifestations of UC might accompany or precede the diagnosis of UC, albeit with the absence of intestinal symptoms; therefore, oral lesions, especially pyostomatitis vegetans, recurrent aphthous ulcer and periodontitis, could be used as good mucocutaneous signs to judge the occurrence and severity of UC, thus facilitating the early diagnosis and treatment of UC and avoiding severe consequences, such as colon cancer.
作为一种免疫失调相关的疾病,尽管溃疡性结肠炎(UC)主要影响肠道,但该病存在明显的肠道外表现,尤其在口腔。在此,我们对与 UC 相关的口腔病变的各种表现、潜在发病机制和治疗进行了综述。UC 的口腔表现包括特异性和非特异性表现,前者包括溃疡性口炎,后者包括复发性阿弗他溃疡、萎缩性舌炎、灼口综合征、口角炎、口干、味觉改变、口臭和牙周炎。尽管 UC 的病因尚未完全确定,但导致其发生的因素包括免疫系统失调、菌群失调和营养不良。治疗 UC 口腔病变的原则是缓解疼痛、加速病变愈合和预防继发感染,主要措施是控制肠道疾病。全身皮质类固醇是首选治疗方法,此外,还可以应用局部和全身给药联合饮食指导。UC 的口腔表现可能伴随或先于 UC 的诊断,尽管没有肠道症状;因此,口腔病变,尤其是溃疡性口炎、复发性阿弗他溃疡和牙周炎,可作为判断 UC 发生和严重程度的良好黏膜皮肤征象,从而有利于 UC 的早期诊断和治疗,避免结肠癌等严重后果。