口腔黏膜病

二期梅毒40例口腔表现及病理分析;TFAR19在口腔白斑和口腔鳞癌中表达的研究;人体口腔黏膜上皮细胞体外培养和鉴定;复发性口腔念珠菌病患者感染源初探;口腔黏膜下纤维化的易感性研究（综述）     

梅毒在口腔黏膜表现的临床分析——附8例报告

目的:分析梅毒在口腔黏膜的临床表现。方法:总结8例以口腔梅黏膜病损为首发症状的梅毒患者的临床特征,并结合相关文献进行临床分析。结果:8例梅毒患者中7例表现为梅毒黏膜斑,好发部位为下唇;3例表现为梅毒性黏膜炎。1例在一期梅毒时期被误诊为复发性口疮。1例儿童因父母双方均为梅毒患者而间接感染结论:梅毒在口腔的首发症状以梅毒黏膜斑最为常见。口腔医生应掌握梅毒的口腔病损,并及时对患者家属进行梅毒筛查,以免误诊,漏诊。     

二期梅毒口腔黏膜损害4例报告

梅毒(syphilis)是梅毒苍白螺旋体引起的一种全身性传染性疾病。近年来，随着性传播疾病发病率的增加，以口腔黏膜损害为首发症状的性病患者明显增多。但常易被患者和医务工作者所疏忽。现将2001年期间以口腔黏膜损害而首诊我院口腔科的患者，经实验室检查确诊为梅毒的4例病例报告如下。1病例与方法1．1一般情况4例患者均因口腔黏膜损害而首诊口腔科，男性2例女性2例；年龄28～45岁，平均36.7岁；病程1～5个月，平均1.4个月。疾病确诊后追问病史，有婚外不洁性交史3例，配偶有性病史1例，其中1例患者有口交史。4例患者发病初期均自认为口腔溃…     

二期梅毒口腔黏膜损害6 例临床特点分析

报告和分析6 例二期梅毒口腔黏膜疹患者.男性4 例,女性2 例,年龄22～63 岁.主要表现为口腔黏膜及舌部白斑、糜烂、红斑和咽部充血,伴有轻度疼痛.实验室检查6 例患者快速血浆反应素环状卡片试验(RPR)和梅毒螺旋体明胶凝集试验(TPPA)均为阳性.经苄星青霉素或头孢曲松等治疗后2 周内口腔黏膜损害消退.1 例随访至6 月失访, 5 例2 年内RPR转阴.     

二期梅毒口腔临床表现及血清学检测结果分析

目的    分析二期梅毒患者血清学检测结果与其口腔临床表现的相关性,为临床诊疗提供参考依据。方法   选取2016年1月至2020年12月于南京大学医学院附属口腔医院·南京市口腔医院就诊的二期梅毒患者30例进行回顾性分析,研究患者口腔临床表现（包括病损数目和临床病损分级）与血清学检测结果［快速血浆反应素环状卡片试验（rapid plasma reactin ring card test,RPR）滴度］的相关性。结果    纳入研究的30例患者中,男14例,女16例;青年组（≤ 44岁）11例,中年组（45 ~ 59岁）10例,老年组（≥ 60岁）9例;各年龄组患者的性别分布差异无统计学意义（P > 0.05）。患者的口腔黏膜病损表现为黏膜斑、黏膜炎,好发部位依次为唇、舌、咽、腭和颊部。与低RPR滴度组（< 1∶128）相比,高RPR滴度组（≥ 1∶128）患者口腔黏膜病损数目较多、临床病损分级较高,差异均有统计学意义（均P < 0.05）。结论    伴有口腔黏膜病损的二期梅毒患者RPR滴度与口腔黏膜病损数目及临床病损分级密切相关。     

口腔梅毒19例临床分析

近年来,随着性观念的开放及性传播疾病发病率的不断增加,梅毒已逐渐成为一种常见的性传播疾病,以口腔黏膜损害为首发症状的梅毒患者也日见增多,但由于医务人员的认识不足,在临床上经常造成误诊误治,既贻误患者病情,又可能导致疾病的传播与扩散[1].因此,我们对2003-02~2008-03间就诊于南昌大学附属口腔医院牙周黏膜科,经临床及实验室检查确诊为梅毒的19 例患者的临床资料加以回顾、分析与总结,报告如下.     

口腔梅毒的早期诊治

我院自1993年到1997年，对性病病人进行监测，总计发现梅毒病人432例。其中以口腔溃疡为主要症状，在口腔科初诊发现的早期梅毒病人有8例。由于口腔梅毒临床表现不典型，易与其他口腔黏膜溃疡相混淆。本文就口腔梅毒的早期诊治分析如下。1．传染途径 梅毒是以病人为传染源。主要通过性接触传染，也可通过血液、唾液、哺乳及意外直接接触受染。2．临床表现 早期主要表现在口腔黏膜， 最常发生部位是舌部、颊部、唇内侧。损害为圆形、椭圆形、环形、黄红色或暗红色的单个溃疡， 边界整齐， 稍隆起， 上覆盖黄白色薄膜(如图1，2)，不易除去， …     

口腔黏膜恶性黑色素瘤1例病例报告及文献复习

目的探讨口腔黏膜恶性黑色素瘤的临床诊断及鉴别诊断要点。方法主诉拔牙后持续牙龈出血患者1例,其临床表现为口腔黏膜大面积黑色病损,经全面临床检查结合常规病理及免疫组织化学检查明确诊断。结果临床表现、病理检查和免疫组织化学检查证实为口腔黏膜恶性黑色素瘤。结论对发生于口腔黏膜的黑色损害特别是进展迅速且有破溃出血者应高度警惕口腔黏膜恶性黑色素瘤的可能,并结合临床表现、病理表现及免疫组织化学进行早期诊断和鉴别诊断。     

父子梅毒黏膜斑1例

梅毒黏膜斑是二期梅毒特征性损害，其正确诊断对梅毒的早期诊断具有重要意义。梅毒是常见的性传播疾病，直接接触为主要的传播方式。此外，也有通过间接沾染而传播。本文报道父亲和儿子均以梅毒黏膜斑为主要临床表现的梅毒病例。     

149例口腔黏膜疾病活检术分析

目的:分析口腔黏膜病临床和病理活检资料,以提高口腔黏膜活检术的效率和成功率。方法:对149例进行口腔黏膜组织活检术患者的临床和病理资料及手术方式进行回顾性分析。结果:128例患者获得病理确诊并与第一临床诊断相符,以口腔黏膜斑纹类疾病为主,共74例(57.81%),其中口腔扁平苔藓32例(25.00%),口腔白斑17例(13.28%),慢性盘状红斑狼疮25例(19.53%)。天疱疮类疾病27例(21.09%),其他类疾病共27例(21.09%)。临床诊断与病理诊断符合率为85.91%,其中口腔扁平苔藓临床诊断与病理确诊符合率为78.05%,口腔白斑为94.44%,慢性盘状红斑狼疮为96.15%,天疱疮为84.38%。结论:口腔黏膜活检术临床和病理诊断符合率较高,以斑纹类疾病为主;完善黏膜活检术的细节,可以提高口腔黏膜活检术的效率和成功率。     

Diagnostic approaches in unsuspected oral lesions of syphilis

Awareness of the increased prevalence of syphilis is essential for early diagnosis and treatment, and to prevent the spread of the disease. Although serological studies are the primary tool used to confirm the diagnosis of secondary syphilis, biopsy of unsuspected oral lesions is not uncommon in the routine oral pathology laboratory. In these cases, histopathological characteristics are likely to indicate the possibility of syphilis, and an immunohistochemical reaction can confirm it. The aim of the present study was to highlight the histological features and test the efficacy of immunohistochemistry in the detection of Treponema pallidum in oral lesions biopsied with the assumption of a non-syphilitic disease. Thirty-nine tissue samples from patients for whom the possibility of syphilis was suggested on the basis of histopathological findings, were retrieved from the surgical oral pathology service files and submitted to immunohistochemical staining for T. pallidum. The study was approved by the institutional ethics committee. Eighteen of the tissue samples were positive for T. pallidum. Following this, the contributing clinicians were contacted to check whether they had asked for serological examinations when the diagnostic report was received; for all 18 positive cases, the clinicians confirmed that the patients had tested positive at that time. This study shows the importance of clinical–pathological correlation and the value of immunohistochemistry in the diagnosis of unsuspected syphilis.     

Secondary syphilis initially diagnosed from oral lesions. Report of three cases

Three cases of secondary syphilis presenting as painful oral lesions without evidence of systemic disease are reported. In each case the oral lesions led to the diagnosis of secondary syphilis. While two of the cases had well-defined grayish white oral lesions with occasional serpentine or crescent-like configuration, the third case presented extensive oral erosive lesions with hitherto undescribed painful fissures of the tongue. The significance of oral lesions and the dentist's role in their detection are discussed.     

The histopathology of syphilis of the oral mucosa

BACKGROUND: Reported cases of syphilis in the United States, Europe and elsewhere are increasing in number. Clinical manifestations are protean, and oral biopsies may be taken where the diagnosis is unsuspected, but data on the histopathology of oral mucosal syphilis are sparse. METHODS: The histopathology of five oral lesions in patients with serologically proven syphilis was reviewed. RESULTS: There were two cases of primary syphilis, one secondary and two tertiary. Epithelial hyperplasia was present in three cases, and was pseudocarcinomatous in one case of primary syphilis, and psoriasiform in the secondary lesion, where heaped-up epithelium surrounded a defined crater covered by flatter epithelium. Plasma cell (primary and secondary disease) and granulomatous (tertiary) infiltrates were prominent. Other features observed were endarteritis (5/5), plasma cell neuritis (3/5) and spirochetes (4/5). CONCLUSIONS: Although no single microscopic feature is specific, a diagnosis of syphilis should be considered where there is unusual epithelial hyperplasia, granulomatous or plasma cell-predominant chronic inflammation, endarteritis and neuritis.     

Oral manifestations of secondary syphilis in the elderly – a timely reminder for dentists

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. Cases of syphilis have increased in frequency and are challenging when affecting the elderly. The main causes of increased prevalence of syphilis are sexual promiscuity, lack of knowledge about the disease and decreasing use of barrier protection. Clinically, the oral manifestation of syphilis may resemble other entities, which hampers the correct diagnosis. We report a case of a 79‐year‐old male with weight loss and feeding difficulties. In the oral cavity there were ulcerative lesions in the hard palate and bilaterally in the buccal mucosa. The incisional biopsy revealed only a non‐specific ulceration of the oral mucosa. After 20 days, the patient was re‐evaluated and presented maculopapular lesions in the palmar and plantar areas. Positive serological venereal disease reference laboratory (VDRL) tests confirmed the diagnosis of secondary syphilis. The patient was treated with Benzathine penicillin G. After two weeks of treatment the oral lesion disappeared and the patient returned to normal feeding and gained weight. This case report reinforces the need to alert physicians and dentists to include sexually transmitted infections such as syphilis in the differential diagnosis of oral ulcerative lesions in elderly sexually active patients.     

A diagnostic and epidemiologic survey of 15,783 oral lesions

Tissue specimens submitted to an oral pathology biopsy service during a 17 1/2-year period were studied to determine the types of diagnoses rendered, the general types of pathological processes represented, and the epidemiologic distribution of patients. A total of 15,783 cases were studied. Normal structures were observed in 480 cases, mostly dental follicles, and were eliminated from the study. The remaining 15,303 cases had been diagnosed as pathological entities. A majority of the oral biopsies were taken from either infectious or reactive conditions. Fibromas, periapical granulomas, periodontitis, mucoceles, and radicular cysts were the most frequently encountered lesions. Neoplasms constituted nearly 15% of all the specimens, with approximately 18% of these being malignant. An additional 360 lesions (2.4% of the total number of specimens) harbored dysplasia and might be considered premalignant. The peak age groups represented in these patients were the third through sixth decades of life. More oral biopsies were performed on females than males. A majority of the patients were white. The purpose of this study was to determine the relative frequency of oral lesions that were considered to be of sufficient clinical significance to merit a biopsy. Although this data might be used as a guide for forming clinical impressions about oral lesions, the clinician must always be aware of the possible occurrence of more rare lesions.     

Gingival involvement in oral paracoccidioidomycosis

BACKGROUND: Paracoccidioidomycosis, a deep mycosis endemic in parts of Latin America, often presents with oral lesions involving the gingiva. Nevertheless, the periodontal literature is devoid of references to oral paracoccidioidomycosis. The purpose of this study was to characterize the gingival involvement in oral paracoccidioidomycosis and to contrast clinical and histopathologic diagnosis of the disease. Differential diagnosis and management of oral paracoccidioidomycosis were reviewed. METHODS: From January 1995 to October 2006, the files of the Oral Pathology Laboratory, School of Dentistry, Alfenas Federal University, were reviewed to identify cases referred because of a clinical diagnosis of oral paracoccidioidomycosis. Data collected included patient demographics (age, gender, race, and occupation), clinical information (oral lesion location), and histopathologic diagnosis. RESULTS: Forty-six cases were identified, and 34 were histopathologically confirmed as paracoccidioidomycosis. Of the remaining 12 cases, one-half were diagnosed as either carcinoma or dysplastic leukoplakia. Of the 34 confirmed paracoccidioidomycosis cases, 45% presented with multiple site involvement, whereas the gingiva/alveolar process was the most prevalent site overall (52%). The gingiva/alveolar process was the most prevalent site in both multiple and single site cases. The majority of patients were men (88%), white (75%), and in their fourth decade of life (47%). Statistical analysis revealed that patients with gingival/alveolar process involvement were demographically indistinguishable from those without. CONCLUSIONS: Oral paracoccidioidomycosis has a strong predilection for the gingiva, whereas patients with gingival lesions do not differ from patients lacking such involvement. Early diagnosis of gingival/oral lesions may prevent life-threatening complications of this mycosis.