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[狼疮性唇炎:一例临床病例报告]

[Lupus Cheilitis: a clinical case report].

作者信息

Mendez-Flores Silvia, Palafox-Romo Rebeca, Esquivel-Pedraza Lilly

机构信息

Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Departamento de Dermatología. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Jul 1;62(4):1-4. doi: 10.5281/zenodo.11397310.

Abstract

BACKGROUND

Generalized lupus erythematosus (LEG) is an autoimmune disease with cutaneous and mucosal manifestations, with lupus cheilitis (LC) being a rare associated oral presentation. The difficulty in early diagnosis of QL lies in its various clinical forms. Although successful treatments have been described, information on specific management is limited, highlighting the importance of early recognition to improve the prognosis and quality of life of patients.

CLINICAL CASE

We describe the case of a 24-year-old woman with SLE of four years' duration, under treatment with prednisone. She presented a bilateral painful vermilion stomatosis, with extensive erosions and ulcerations covered by hematic crusts, showing no improvement despite previous topical treatments. Histopathological analysis revealed lymphoplasmacytic spongiotic stomatitis with eosinophils and lupus stomatitis associated with contact irritation. The dose of prednisone was adjusted, noting improvement after a month of treatment.

CONCLUSION

Even though the oral mucosa is commonly affected in SLE, LC is uncommon. The clinical presentation of QL starts with macules on the lips, and eventually presents with edema and painful ulcers. The diagnosis is essentially clinical but challenging cases may require a pathology report. Management includes adjustment of corticosteroid doses and general measures; early diagnosis is crucial for an adequate treatment response.

摘要

背景

全身性红斑狼疮(LEG)是一种具有皮肤和黏膜表现的自身免疫性疾病,狼疮性唇炎(LC)是一种罕见的相关口腔表现。唇部狼疮(QL)早期诊断的困难在于其多种临床形式。尽管已有成功治疗的报道,但关于具体治疗方法的信息有限,这凸显了早期识别对于改善患者预后和生活质量的重要性。

临床病例

我们描述了一名24岁、患系统性红斑狼疮4年且正在接受泼尼松治疗的女性病例。她出现双侧疼痛性唇红部口炎,有广泛糜烂和溃疡,表面覆盖血痂,尽管之前进行了局部治疗但无改善。组织病理学分析显示淋巴细胞浆细胞海绵状口炎伴嗜酸性粒细胞,以及与接触性刺激相关的狼疮性口炎。调整了泼尼松剂量,治疗一个月后病情有所改善。

结论

尽管口腔黏膜在系统性红斑狼疮中常受影响,但狼疮性唇炎并不常见。唇部狼疮的临床表现始于唇部斑疹,最终出现水肿和疼痛性溃疡。诊断主要依靠临床,但疑难病例可能需要病理报告。治疗包括调整皮质类固醇剂量和一般措施;早期诊断对于获得充分的治疗反应至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c1/12367276/1f73a1a562e2/04435117-62-4-e6056-c001.jpg

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