慢性溃疡性口腔炎(CUS)是一种罕见的粘膜疾病,其特征与其他自身免疫性疾病相似。这项研究的目的是对文献进行系统回顾,以恢复所有报告的CUS病例,以总结哪些是临床,人口统计学,微观,CUS的免疫学特征及其对不同药物的治疗反应。在系统评价和荟萃分析(PRISMA)的首选报告项目陈述之后,对文献进行了系统评价。搜索是在PubMed电子数据库中进行的,Scopus,EMBASE,LILACS,Opengrey,谷歌学者纳入标准是报告至少一例最终诊断为CUS的文章或摘要。通过数据库共识别出696条记录,选择了25项研究,报告81例。CUS影响更多女性(92%),在白种人患者中报告了更多的病例(53%)。患者年龄20~86岁,平均年龄60岁(±13.86),15%的病例报告伴随皮肤病变。CUS的临床和组织病理学特征与口腔扁平苔藓非常相似。直接免疫荧光(DIF)仍然是金标准诊断资源,在69例病例中进行。揭示了分层上皮特异性抗体(SES-ANA)的点状沉积模式。收集38例患者的血清进行间接免疫荧光(IIF)的表现,使用上皮底物如猴和豚鼠食管通常导致SES-ANAIgG阳性。大多数患者接受抗疟药治疗,被证明有效的治疗方法是羟氯喹(HCQ)。在其他自身免疫性疾病的鉴别诊断中必须考虑该实体,因为它可能被低估了。
Chronic ulcerative stomatitis (CUS) is a rare disease of the mucous membranes with characteristics similar to other autoimmune diseases. The aim of this study was to conduct a systematic
review of the literature to recover all reported cases of CUS in order to summarize what are the clinical, demographic, microscopic, immunological features of CUS and its therapeutic response to different drugs. A systematic
review of the literature was carried out following the statements of preferred reporting items for systematic reviews and meta-analyses (PRISMA). The searches were performed in the electronic databases PubMed, Scopus, EMBASE, LILACS, Opengrey, and Google scholar. Inclusion criteria were articles or abstracts reporting at least one case with a final diagnosis of CUS. A total of 696 records were identified through databases, and 25 studies were selected reporting 81 cases. CUS affects more females (92%), and a greater number of cases are reported in Caucasian patients (53%). The age of patients ranged from 20 to 86 years with a mean age of 60 years (±13.86), and 15% of cases reported concomitantly skin lesions. The clinical and histopathological characteristics of CUS are very similar to those of oral lichen planus. The direct
immunofluorescence (DIF) remains the gold-standard diagnostic resource and was performed in 69 cases, revealing a dotted pattern of deposition of stratified epithelium-specific antibodies (SES-ANA). The serum of 38 patients was collected for the performance of the indirect
immunofluorescence (IIF), and the use of epithelial substrates such as monkey and guinea pig esophagus often resulted in positive SES-ANA IgG. Most patients were treated with antimalarials, and the treatment of choice that proved to be effective is hydroxychloroquine (HCQ). This entity must be considered in the differential diagnosis of other autoimmune diseases, as it may be underreported.