儿童苔藓样肉芽肿性口炎1例报道及文献回顾  

Childhood lichenoid granulomatous stomatitis:a case report and literature review

作　　者：徐婧 夏荣辉[1] 杨涟漪 沈雪敏[1] 杜观环[1] XU Jing;XIA Ronghui;YANG Lianyi;SHEN Xuemin;DU Guanhuan(Department of Oral Mucosal Diseases,Shanghai Ninth People’s Hospi-tal,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University&Na-tional Center for Stomatology&National Clinical Research Center for Oral Diseases&Shanghai Key Laboratory of Sto-matology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔黏膜病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《口腔疾病防治》2024年第2期137-142,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82101008);上海交通大学医学院附属第九人民医院医院管理研究项目(YGB202115)。

摘　　要：目的探讨口腔苔藓样损害的分类、临床表现、诊断、鉴别诊断及治疗,为临床提供参考。方法获得医院伦理审批及患者知情同意,报道1例儿童口腔苔藓样损害病例,结合文献对口腔苔藓样损害的诊疗进行回顾分析。结果患儿舌背反复破溃伴疼痛3年余,舌背大面积糜烂面,形状不规则,糜烂周围见珠光白色纹,左侧糜烂区伴组织增生,约1.5 cm×2.0 cm,质地韧,宽蒂。舌背白色网纹组织切取活检病理诊断为苔藓样损害;舌背增生物切除活检病理诊断为苔藓样损害伴肉芽肿性炎。根据患者口内损害特征、系统病史、用药史、组织病理学检查结果,最终诊断为苔藓样肉芽肿性口炎。文献回顾表明,口腔苔藓样损害病因不明,临床上需与口腔扁平苔藓、口腔苔藓样药物反应、口腔苔藓样接触性损害、慢性溃疡性口炎等疾病鉴别。临床上治疗口腔苔藓样损害以糖皮质激素的局部和/或全身使用为主。结论目前口腔苔藓样损害的分类和诊断仍无统一标准,主要依靠病史询问、临床表现和组织病理学检查结果,治疗方法主要为糖皮质激素的局部和/或全身使用。Objective To investigate the classification,clinical manifestations,diagnosis,differential diagnosis and treatment of oral lichenoid lesions and provide a reference for clinical practice.Methods Hospital ethical approval and patient informed consent were obtained.We report a case of oral lichenoid lesion in children and review the diagno-sis and treatment of oral lichenoid damage in the literature.Results The patient experienced repeated rupture of the dorsal surface of the tongue with pain for more than 3 years.There was a large area of tongue back surface erosion with an irregular shape,surrounded by pearly-white lines.The left erosive area was accompanied by tissue hyperplasia,which was approximately 1.5 cm×2.0 cm,with tough texture and broad masses.The pathological diagnosis of the pa-tient was oral lichenoid lesion.After biopsy of the dorsal surface of the tongue,the pathological diagnosis of the patient was granulomatous inflammation.The final diagnosis of lichenoid granulomatous stomatitis was made on the basis of the patient's intraoral damage features,systemic history,medication history and histopathological findings.A review of the literature suggests that oral lichenoid lesions have an unknown etiology and need to be clinically differentiated from oral lichen planus,oral lichenoid drug reactions,oral lichenoid contact damage and chronic ulcerative stomatitis.The clini-cal treatment of oral lichen planus is based on the topical and/or systemic use of glucocorticoids.Conclusion There are still no uniform criteria for the classification and diagnosis of oral lichenoid lesions.They rely mainly on history tak-ing,clinical manifestations and histopathological findings,and the treatment is mainly based on the topical and/or sys-temic use of glucocorticoids.

关 键 词：口腔苔藓样损害 苔藓样肉芽肿性口炎 口腔扁平苔藓 口腔苔藓样药物反应 口腔苔藓样接触性损害 移植物抗宿主病相关性苔藓样损害 慢性溃疡性口炎 类天疱疮样扁平苔藓 儿童 糖皮质激素 

分 类 号：R78[医药卫生—口腔医学]