背景:口腔扁平苔藓是一种慢性炎症性疾病,由于法国缺乏具体指南,其诊断管理和随访是异质的。我们的目标是制定法国口腔扁平苔藓管理的多学科指南。
方法:根据制定实践指南的“正式共识”方法,来自德·德·穆奎斯·布卡莱(GEMUB)的工作组制定了研究问题清单和相应的建议。将这些建议提交给专家组,并由评分组评估每个建议的一致程度。
结果:22个研究问题,分为3个主题(新闻学分类和初步评估,诱导口腔苔藓样病变,和后续行动)提出了22项建议。在没有网状病变的情况下,建议进行组织学的初始活检。建议对溃疡进行直接免疫荧光活检,侵蚀性,大疱性类型和弥漫性红斑性牙龈炎。管理应包括牙周和牙齿检查,以及口腔外病变的调查。只有在存在危险因素的情况下,才建议进行丙型肝炎检测。Definitions,阐明了“诱导的口腔苔藓样病变”的触发因素和管理。口腔扁平苔藓必须由熟悉该疾病的医生每年至少监测一次,使用客观工具。
结论:这项多学科专家的正式共识为口腔扁平苔藓的管理和监测提供了临床实践指南。
Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific
guidelines in France. Our objective was to develop French multidisciplinary
guidelines for the management of oral lichen.
Working groups from the Groupe d\'Etude de la Muqueuse Buccale (GEMUB) formulated a list of research questions and the corresponding recommendations according to the \"formal
consensus\" method for developing practice
guidelines. These recommendations were submitted to a group of experts and the degree of agreement for each recommendation was assessed by a scoring group.
Twenty-two research questions, divided into 3 themes (nosological classification and initial assessment, induced oral lichenoid lesions, and follow-up) resulted in 22 recommendations. Initial biopsy for histology is recommended in the absence of reticulated lesions. Biopsy for direct immunofluorescence is recommended for ulcerated, erosive, bullous types and for diffuse erythematous gingivitis. Management should include a periodontal and dental check-up, and investigation for extra-oral lesions. Hepatitis C testing is recommended only if risk factors are present. Definitions, triggering factors and the management of \"induced oral lichenoid lesions\" were clarified. Oral lichen must be monitored by a practitioner familiar with the disease at least once a year, using objective tools.
This formalised
consensus of multidisciplinary experts provides clinical practice
guidelines on the management and monitoring of oral lichen.