Hornstein O P
Dermatologische Universitätsklinik Erlangen.
HNO. 1998 Feb;46(2):102-11. doi: 10.1007/s001060050208.
Recurrent aphthae (or aphthoses) are the most frequent inflammatory lesions of the oral mucosa. Aphthae can clearly be defined, but may also be barely discernible from aphthoid erosions and ulcers of heterogeneous origin. Although a subject of molecular research, the etiopathogenesis of oral aphthoses is still unknown. However, the clinical differentiation of a "benign" type of aphthosis from a "pernicious" one, such as Behçet's disease (BD), is a diagnostic matter of great significance. BD has been found clinically in increasing numbers in central Europe and represents an (auto-)hyperimmune multisystem life-threatening vasculitis. In this disorder possible damage can occur to many visceral organs and/or the cerebrospinal system. The prognosis of BD may depend on the changing involvement of very different organs, as well as the early recognition of the disease per se. The most prominent feature is a multilesional aphthous stomatitis that is almost never absent during acute episodes of BD. Hence, the occurrence of this peculiar type of aphthosis strongly indicates an active BD. The plethora of other aphthoid lesions can be challenging to the diagnostic competence of all physicians and may confuse the correct recognition of the severity of the disease present. This review particularly details the wide range of diagnostic, therapeutic and prognostic aspects of the various oral aphthoses.
复发性口疮(或口疮病)是口腔黏膜最常见的炎性病变。口疮可以明确界定,但也可能与来源各异的口疮样糜烂和溃疡难以区分。尽管口腔口疮病是分子研究的课题,但其病因发病机制仍不清楚。然而,将“良性”口疮病类型与“恶性”类型(如白塞病)进行临床鉴别,是一个具有重大意义的诊断问题。在中欧,临床上发现白塞病的病例越来越多,它是一种(自身)超免疫性多系统危及生命的血管炎。在这种疾病中,许多内脏器官和/或脑脊系统可能会受到损害。白塞病的预后可能取决于不同器官受累情况的变化以及对疾病本身的早期识别。最突出的特征是多灶性口疮性口炎,在白塞病急性发作期间几乎从不缺席。因此,这种特殊类型口疮病的出现强烈提示白塞病处于活动期。大量其他口疮样病变可能对所有医生的诊断能力构成挑战,并且可能混淆对当前疾病严重程度的正确认识。本综述特别详细介绍了各种口腔口疮病在诊断、治疗和预后方面的广泛内容。