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光生物调节疗法与曲安奈德联合治疗克罗恩病口腔重型阿弗他溃疡的疗效:病例报告

Effectiveness of combination the photobiomodulation therapy and triamcinolone acetonide on managing oral major aphthous ulcer in Crohn's disease: A case report.

作者信息

Kuraitby Shahed, ALhomsi Alaa, Aljoujou Abeer A

机构信息

Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus, Syria.

出版信息

Medicine (Baltimore). 2025 Jul 18;104(29):e43336. doi: 10.1097/MD.0000000000043336.


DOI:10.1097/MD.0000000000043336
PMID:40696693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12282737/
Abstract

RATIONALE: Inflammatory bowel diseases like Crohn's disease can manifest with oral ulcers that negatively impact quality of life. Managing these stubborn symptomatic lesions requires an integrated medical and dental approach. PATIENT CONCERNS: A 23-year-old male was diagnosed with Crohn's disease 3 years ago. He was referred to the oral medicine department due to a painful 3 cm ulcer on the dorsum of the tip of his tongue, which was interfering with his ability to eat and drink. DIAGNOSES: A gastrointestinal endoscopy revealed a rectal ulcer, a cecal ulcer, superficial erosion, and scattered millimetric warts in the rectal area. INTERVENTIONS: The patient was treated with a daily dose of azathioprine (50 mg) for 2 years. Once the clinical symptoms improved, the medication was discontinued. The major aphthous ulcer was managed with a combined treatment of 0.1% triamcinolone acetonide oral base and photobiomodulation laser therapy. OUTCOMES: This dual therapy approach aimed to reduce pain, accelerate healing, and prevent scarring. LESSONS: Collaborative care between gastroenterology and dentistry led to better symptom control and clinical outcomes for this patient with miserable mouth ulcers from Crohn's disease. The case highlights the benefits of a transdisciplinary treatment strategy targeting both oral and intestinal manifestations of inflammatory bowel disorders.

摘要

理论依据:像克罗恩病这样的炎症性肠病可能会出现口腔溃疡,对生活质量产生负面影响。处理这些顽固的症状性病变需要医学和牙科的综合方法。 患者关注:一名23岁男性3年前被诊断为克罗恩病。他因舌尖背部有一个3厘米的疼痛性溃疡而被转诊至口腔内科,该溃疡影响了他的进食和饮水能力。 诊断:胃肠内镜检查发现直肠溃疡、盲肠溃疡、浅表糜烂以及直肠区域散在的毫米级疣。 干预措施:患者接受了为期2年的每日剂量硫唑嘌呤(50毫克)治疗。临床症状改善后,停药。对重型阿弗他溃疡采用0.1%曲安奈德口腔糊剂和光生物调节激光治疗相结合的方法。 结果:这种双重治疗方法旨在减轻疼痛、加速愈合并防止瘢痕形成。 经验教训:胃肠病学和牙科之间的协作护理为这名患有克罗恩病导致痛苦口腔溃疡的患者带来了更好的症状控制和临床结果。该病例凸显了针对炎症性肠病口腔和肠道表现的跨学科治疗策略的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f87a/12282737/c35cf12b53d1/medi-104-e43336-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f87a/12282737/c35cf12b53d1/medi-104-e43336-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f87a/12282737/c35cf12b53d1/medi-104-e43336-g001.jpg

相似文献

[1]
Effectiveness of combination the photobiomodulation therapy and triamcinolone acetonide on managing oral major aphthous ulcer in Crohn's disease: A case report.

Medicine (Baltimore). 2025-7-18

[2]
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[3]
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[4]
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[5]
Methotrexate for induction of remission in refractory Crohn's disease.

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[6]
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[7]
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[8]
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[9]
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Cochrane Database Syst Rev. 2014-8-21

[10]
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Cochrane Database Syst Rev. 2014-2-21

本文引用的文献

[1]
Photobiomodulation in recurrent aphthous stomatitis management using three different laser wavelengths. A randomized clinical trial.

Lasers Med Sci. 2024-11-19

[2]
Combined treatment of dexamethasone mouthwash and low-level laser therapy in the management of aphthous-like ulcers caused by nonsteroidal anti-inflammatory drugs: A case report.

Clin Case Rep. 2024-3-27

[3]
The Oral-Gut Axis: Periodontal Diseases and Gastrointestinal Disorders.

Inflamm Bowel Dis. 2023-7-5

[4]
Low-Level Laser Therapy and Topical Medications for Treating Aphthous Ulcers: A Systematic Review.

J Multidiscip Healthc. 2020-11-18

[5]
The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines.

Int J Surg. 2020-12

[6]
Photobiomodulation Therapy and Dexamethasone in the Management of Oral Acute Graft-Versus-Host Disease: Case Report.

Photobiomodul Photomed Laser Surg. 2020-11

[7]
Comparison of therapeutic effect of mucoadhesive nano-triamcinolone gel and conventional triamcinolone gel on oral lichen planus.

Dent Res J (Isfahan). 2019-9-5

[8]
Prevalence of Oral Lesions and Correlation with Intestinal Symptoms of Inflammatory Bowel Disease: A Systematic Review.

Diagnostics (Basel). 2019-7-15

[9]
Effect of laser irradiation on aphthae pain management: A four different wavelengths comparison.

J Photochem Photobiol B. 2018-9-20

[10]
ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications.

J Crohns Colitis. 2019-2-1

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