Cheilitis

唇炎
  • 文章类型: Case Reports
    背景:慢性非特异性唇炎是一种复杂的疾病,其特征是持续的嘴唇脱皮和不适。该病例报告探讨了患有舌鳞状细胞癌病史并随后进行Tislelizumab治疗的患者的临床进展。表现为持久的嘴唇脱皮。
    方法:患者有舌鳞状细胞癌(T2N0M0)病史,用化疗治疗,手术,和Tislelizumab,出现六个月的持续唇脱皮。临床检查显示慢性非特异性唇炎伴感染性角性唇炎(口腔念珠菌病)的明显特征。量身定制的治疗计划,强调口腔卫生习惯和局部治疗碳酸氢钠,他克莫司软膏,和金霉素软膏.后续访问显示持续改善,强调个性化方法的重要性。
    结论:该病例强调了识别和管理有癌症和免疫治疗史的患者口腔表现的重要性。患者对治疗的反应表明,采用多方面的方法,将局部治疗与生活方式的改变相结合,可以有效治疗与免疫治疗相关的慢性非特异性唇炎。例行随访预约,以个性化医疗原则为指导,有助于持续的患者福祉。
    BACKGROUND: Chronic nonspecific cheilitis is a complex condition characterized by persistent lip peeling and discomfort. This case report explores the clinical progression of a patient with history of tongue squamous cell carcinoma and subsequent Tislelizumab treatment, presenting with persistent lip peeling.
    METHODS: A patient with a history of tongue squamous cell carcinoma (T2N0M0), treated with chemotherapy, surgery, and Tislelizumab, presented with six months of persistent lip peeling. Clinical examination revealed distinct features of chronic nonspecific cheilitis with infectious angular cheilitis (Oral Candidiasis). A tailored treatment plan, emphasizing oral hygiene practices and local treatments with Sodium Bicarbonate, Tacrolimus ointment, and Chlortetracycline ointment. Follow-up visits demonstrated sustained improvement, highlighting the significance of individualized approaches.
    CONCLUSIONS: This case underscores the importance of recognizing and managing oral manifestations in patients with a history of cancer and immunotherapy. The patient\'s response to treatment suggests that a multifaceted approach, combining local therapy with lifestyle modifications, can be effective in managing chronic nonspecific cheilitis associated with immunotherapy. Routine follow-up appointments, guided by personalized medicine principles, contribute to sustained patient well-being.
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  • 文章类型: Journal Article
    Kindler大疱性表皮松解症是一种遗传性皮肤起泡性疾病,与编码kindlin-1的FERMT1隐性遗传致病变异有关。Kindler大疱性表皮松解症的严重口面部表现,包括早期口腔鳞状细胞癌,已被报道。
    为了确定发育不良的凹陷性釉质发育不全是否是Kindler大疱性表皮松解症的特征。
    这个纵向,2中心队列研究于2003年至2023年在大疱性表皮松解症中心进行,弗莱堡大学,德国,和特殊护理牙科诊所,智利大学与智利DEBRA合作。参与者包括所有诊断为Kindler表皮松解性大疱性的患者的便利样本。
    主要结果是存在发育不良的凹陷性牙釉质不全症,口内伤口,牙龈炎和牙周病,牙龈增生,前庭闭塞,唇炎,角状唇炎,慢性嘴唇伤口,微小口腔,和口腔鳞状细胞癌。
    该队列包括36名患者(15名女性[42%]和21名男性[58%];第一次检查时的平均年龄,23年[范围,2周至70年])与Kindler表皮大疱性松解症。随访1~24年。评估了11例患者的牙釉质结构,所有患者均表现为牙釉质结构异常。发育不良的釉质发生不全症的严重程度从广义点蚀到局部点蚀。观察到的其他口面特征包括牙龈炎和牙周病,90%(30名患者中有27名)的评估对象存在,其次是口内病变(22例患者中的16例[73%]),唇角炎(33例患者中的24例[73%]),唇炎(34例患者中有22例[65%]),牙龈过度生长(26例患者中的17例[65%]),微口腔(25例患者中有14例[56%]),和前庭闭塞(16例患者中有8例[50%])。其他特征包括慢性唇溃疡(2例)和具有致死性结果的口腔鳞状细胞癌(2例)。
    这些研究结果表明,发育不良的凹陷性牙釉质不全是Kindler大疱性表皮松解症的一个特征,并强调了Kindler大疱性表皮松解症口腔表现的程度和严重程度以及早期和持续牙科护理的必要性。
    UNASSIGNED: Kindler epidermolysis bullosa is a genetic skin-blistering disease associated with recessive inherited pathogenic variants in FERMT1, which encodes kindlin-1. Severe orofacial manifestations of Kindler epidermolysis bullosa, including early oral squamous cell carcinoma, have been reported.
    UNASSIGNED: To determine whether hypoplastic pitted amelogenesis imperfecta is a feature of Kindler epidermolysis bullosa.
    UNASSIGNED: This longitudinal, 2-center cohort study was performed from 2003 to 2023 at the Epidermolysis Bullosa Centre, University of Freiburg, Germany, and the Special Care Dentistry Clinic, University of Chile in association with DEBRA Chile. Participants included a convenience sampling of all patients with a diagnosis of Kindler epidermolysis bullosa.
    UNASSIGNED: The primary outcomes were the presence of hypoplastic pitted amelogenesis imperfecta, intraoral wounds, gingivitis and periodontal disease, gingival hyperplasia, vestibular obliteration, cheilitis, angular cheilitis, chronic lip wounds, microstomia, and oral squamous cell carcinoma.
    UNASSIGNED: The cohort consisted of 36 patients (15 female [42%] and 21 male [58%]; mean age at first examination, 23 years [range, 2 weeks to 70 years]) with Kindler epidermolysis bullosa. The follow-up ranged from 1 to 24 years. The enamel structure was assessed in 11 patients, all of whom presented with enamel structure abnormalities. The severity of hypoplastic pitted amelogenesis imperfecta varied from generalized to localized pitting. Additional orofacial features observed include gingivitis and periodontal disease, which was present in 90% (27 of 30 patients) of those assessed, followed by intraoral lesions (16 of 22 patients [73%]), angular cheilitis (24 of 33 patients [73%]), cheilitis (22 of 34 patients [65%]), gingival overgrowth (17 of 26 patients [65%]), microstomia (14 of 25 patients [56%]), and vestibular obliteration (8 of 16 patients [50%]). Other features included chronic lip ulcers (2 patients) and oral squamous cell carcinoma with lethal outcome (2 patients).
    UNASSIGNED: These findings suggest that hypoplastic pitted amelogenesis imperfecta is a feature of Kindler epidermolysis bullosa and underscore the extent and severity of oral manifestations in Kindler epidermolysis bullosa and the need for early and sustained dental care.
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  • 文章类型: Journal Article
    循环肿瘤DNA(ctDNA)在早期诊断中作为一种有价值的液体活检生物标志物,治疗,和癌症的预后。这里,在这项研究中,从交流电动力学(ACEK)效应衍生的生物传感方法被构建为简单的,高效,ctDNA的快速检测方法。在概念验证实验中,通过使用叉指金电极作为感测电极结合ACEK效应检测归一化电容变化率来定量来自乳腺癌中PIK3CAE542K突变体的ctDNA。我们通过采用不同的固定策略比较了两种构建方法的格式;一种是通过Au-S键将DNA捕获探针固定在电极表面,而另一种通过酰胺键将探针固定在电极表面的自组装膜上。通过在1分钟内完成ctDNA定量,两种格式均显示出超快的检测速度,并观察到10fM-10pM的线性范围。同时,通过自组装膜的固定产生了改善的稳定性,灵敏度,和特异性比它的Au-S键对应物。使用优化的方法最终实现了1.94fM的检测限。本研究为各种恶性肿瘤的检测提供了一种无标记和微小尺度的通用方法。基于ACEK效应的ctDNA生物传感器根据探针类型或电极结构进行了改进,在肿瘤药物疗效预测中具有潜在的应用前景。耐药性监测,高危人群筛查,鉴别诊断,监测微小残留病变,和预后判断。
    Circulating tumor DNA (ctDNA) appears as a valuable liquid biopsy biomarker in the early diagnosis, treatment, and prognosis of cancer. Here, a biosensing method derived from the AC electrokinetics (ACEK) effect was constructed in this study for the simple, efficient, and rapid method of detection of ctDNA. In the proof-of-concept experiment, ctDNA from the PIK3CA E542K mutant in breast cancer was quantified by detecting a normalized capacitance change rate using a forked-finger gold electrode as the sensing electrode in combination with the ACEK effect. We compared two formats for the construction of the approach by employing varied immobilization strategies; one is to immobilize the DNA capture probe on the electrode surface by Au-S bonding, while the other immobilizes the probe on a self-assembled membrane on the electrode surface by amide bonding. Both formats demonstrated ultrafast detection speed by completing the ctDNA quantification within 1 min and a linear range of 10 fM-10 pM was observed. Meanwhile, the immobilization via the self-assembled membrane yielded improved stability, sensitivity, and specificity than its Au-S bonding counterpart. A detection limit of 1.94 fM was eventually achieved using the optimized approach. This research provides a label-free and minute-scale universal method for the detection of various malignant tumors. The ctDNA biosensors based on the ACEK effect improved according to the probe type or electrode structure and have potential applications in tumor drug efficacy prediction, drug resistance monitoring, screening of high-risk groups, differential diagnosis, monitoring of tiny residual lesions, and prognosis determination.
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  • 文章类型: Case Reports
    该病例报告描述了使用白介素4受体α拮抗剂dupilumab在成年患者中首次成功治疗剥脱性唇炎。对局部他克莫司没有反应,氢化可的松,氨苯砜,crisaborole或全身性多西环素,低剂量异维A酸,或者甲氨蝶呤,在接受4个月的治疗后,患者接受超标签dupilumab治疗后,患者的病情得到缓解.
    This case report describes the first known successful treatment of exfoliative cheilitis with the interleukin-4 receptor alpha antagonist dupilumab in an adult patient. With no response to topical tacrolimus, hydrocortisone, dapsone, crisaborole or systemic doxycycline, low dose isotretinoin, or methotrexate, she had resolution with off-label dupilumab after 4 months of treatment.
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  • 文章类型: Journal Article
    目的:探讨COVID-19住院与口腔改变的关系,并评估口腔变化是否表明疾病进展至死亡的风险更高。
    方法:本病例对照研究分析了住院患者(大学医院),包括重症监护室和临床病房的病人.研究组包括69例COVID-19阳性患者(PCR检测),对照组包括43例COVID-19阴性患者。一位牙医做了口腔评估,收集唾液样本中的钙,磷酸酶和pH分析。社会人口统计数据,住院信息,血液学检查结果来自电子病历.使用卡方检验评估口腔变化的存在,并使用二元逻辑回归分析预测的死亡风险。
    结果:与COVID-19阴性患者相比,COVID-19阳性患者的口腔改变患病率明显更高。COVID-19阳性患者的任何口腔变化都表明死亡风险高13倍。\"出血性溃疡,压力性溃疡,“角唇炎”和“角唇炎”与COVID-19的住院显着相关。
    结论:COVID-19的住院可能与口腔变化的发展有关,包括出血性溃疡,压疮.和角状唇炎。这些口腔变化可能作为疾病进展的潜在指标,死亡风险增加。
    结论:COVID-19住院患者口腔改变的患病率较高,这表明死亡风险增加。应将口腔医学人员纳入多学科小组,以及时发现和治疗这些口腔变化。
    OBJECTIVE: To investigate the association between hospitalization for COVID-19 and oral changes, and to evaluate whether oral changes can indicate a higher risk of disease progression to death.
    METHODS: This case-control study analyzed patients hospitalized (university hospital), including those in intensive care unit and clinical wards. The study group comprised 69 COVID-19 positive patients (PCR-test), while the control group included 43 COVID-19 negative patients. A dentist performed oral evaluations, and salivary samples were collected for calcium, phosphatase, and pH analysis. Sociodemographic data, hospitalization information, and hematological test results were collected from electronic-medical records. The presence of oral changes was assessed using chi-square tests, and the predicted risk of death was analyzed using binary logistic regression.
    RESULTS: COVID-19 positive patients had a significantly higher prevalence of oral changes compared to COVID-19 negative patients. The presence of any oral changes in COVID-19 positive patients indicated a 13-fold higher risk of mortality. \"Bleeding ulcers,\" \"pressure ulcers,\" and \"angular cheilitis\" were significantly associated with hospitalization for COVID-19.
    CONCLUSIONS: There may be an association between hospitalization for COVID-19 and the development of oral changes, including bleeding ulcers, pressure ulcers. and angular cheilitis. These oral changes may serve as potential indicator for disease progression an increased risk of death.
    CONCLUSIONS: COVID-19 hospitalized patients have a higher prevalence of oral changes, which indicate an increased risk of mortality. Oral medicine staff should be included in multidisciplinary teams to detect and treat these oral changes promptly.
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  • 文章类型: Case Reports
    背景:特应性皮炎(AD)是一种炎性皮肤病,其特征在于激活的Th2免疫反应。局部皮肤微生物菌群失调是AD发生发展的重要因素。致病性凝固酶阳性金黄色葡萄球菌是导致AD进展的主要物种。尽管假中间葡萄球菌是一种动物来源的病原体,它越来越成为人类疾病的关注来源。作为另一种凝固酶阳性葡萄球菌,对从病变部位分离出的假中介链球菌给予更多关注是至关重要的.
    结果:在我们的调查中,我们介绍了1例特应性皮炎(AD)患者的唇炎。我们利用培养和下一代基因组测序(NGS)来鉴定在治疗之前和之后从嘴唇部位采集的皮肤拭子上存在的细菌。我们的发现表明,在AD病变部位定植的主要细菌是假中间链球菌和金黄色葡萄球菌,治疗后均已根除。假中介链球菌和金黄色葡萄球菌的多位点序列分型(MLST)显示了协同的抗生素敏感性,ST2384和ST22是各自的类型。尽管假中介链球菌感染引起的皮肤脓肿面积明显小于金黄色葡萄球菌引起的皮肤脓肿面积,在假中介链球菌感染的小鼠中,细胞因子白细胞介素-4(IL-4)和白细胞介素-5(IL-5)的表达显著升高.
    结论:从AD患者病变部位分离的假中介链球菌菌株在小鼠皮肤上定植时表现出更高的IL-4和IL-5表达,与金黄色葡萄球菌相比。这一观察结果证实了假中介链球菌可以有效地诱导体内Th2反应。我们的发现表明,动物来源的假中介链球菌在皮肤上定植时可能在AD的发展中起作用。强调与动物接触时采取预防措施的重要性。
    Atopic dermatitis (AD) is an inflammatory skin condition distinguished by an activated Th2 immune response. The local skin microbial dysbiosis is a contributing factor to the development of AD. The pathogenic coagulase-positive Staphylococcus aureus is the primary species responsible for the progression of AD. Even though Staphylococcus pseudintermedius is an animal-origin pathogen, it is increasingly becoming a source of concern in human diseases. As another coagulase-positive Staphylococci, it is crucial to pay more attention to S. pseudintermedius isolated from the lesion site.
    In our investigation, we presented a case of cheilitis in a patient with atopic dermatitis (AD). We utilized culture and next-generation genomic sequencing (NGS) to identify the bacteria present on the skin swabs taken from the lip sites both prior to and following treatment. Our findings indicated that the predominant bacteria colonizing the lesion site of AD were S. pseudintermedius and S. aureus, both of which were eradicated after treatment. The Multi-locus sequence typing (MLST) of S. pseudintermedius and S. aureus demonstrated coordinated antibiotic susceptibility, with ST2384 and ST22 being the respective types. Although the skin abscess area resulting from S. pseudintermedius infection was significantly smaller than that caused by S. aureus in mice, the expression of cytokines interleukin-4 (IL-4) and interleukin-5 (IL-5) were significantly higher in the S. pseudintermedius-infected mice.
    The S. pseudintermedius strain isolated from the lesion site of the AD patient exhibited a higher expression of IL-4 and IL-5 when colonized on mouse skin, as compared to S. aureus. This observation confirms that S. pseudintermedius can effectively induce the Th2 response in vivo. Our findings suggest that animal-origin S. pseudintermedius may play a role in the development of AD when colonized on the skin, emphasizing the importance of taking preventive measures when in contact with animals.
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  • 文章类型: Case Reports
    口面肉芽肿病(OFG)代表一组罕见的口面疾病。当影响牙龈时,它表现为慢性软组织炎症,有时会伴有其他口内部位的增大和肿胀,包括嘴唇。牙龈活检显示非干酪样肉芽肿性炎症,与在克罗恩病和结节病中观察到的相似。目前,OFG的病因仍不确定,尽管遗传背景和环境触发因素的参与,如口腔疾病或治疗(包括正畸治疗),有人建议。本研究报告了对一名8岁男性患者进行正畸治疗后发生牙龈口腔肉芽肿的病例进行详细的临床和2D/3D显微镜调查的结果。口内检查显示整个牙龈红斑增生,在安装四螺旋后几周出现颗粒状外观。口腔周围检查发现上唇肿胀和唇角炎。除了弱阳性的抗酿酒酵母IgG自身抗体外,一般调查没有报告持续的口腔外紊乱。二维和三维显微镜检查证实存在牙龈口面肉芽肿病。在3个月的时间内每日使用皮质类固醇漱口水,临床体征略有改善,尽管间歇性炎症复发。这项研究为牙龈口面肉芽肿的微观特征带来了新的见解,从而为口腔从业者提供关键要素,以确保准确及时的OFG诊断。OFG的准确诊断允许随着时间的推移有针对性地管理症状和患者监测,随着口腔外表现的早期发现和治疗,比如克罗恩病。
    Orofacial granulomatosis (OFG) represents a heterogeneous group of rare orofacial diseases. When affecting gingiva, it appears as a chronic soft tissue inflammation, sometimes combined with the enlargement and swelling of other intraoral sites, including the lips. Gingival biopsy highlights noncaseating granulomatous inflammation, similar to that observed in Crohn\'s disease and sarcoidosis. At present, the etiology of OFG remains uncertain, although the involvement of the genetic background and environmental triggers, such as oral conditions or therapies (including orthodontic treatment), has been suggested. The present study reports the results of a detailed clinical and 2D/3D microscopy investigation of a case of gingival orofacial granulomatosis in an 8-year-old male patient after orthodontic therapy. Intraoral examination showed an erythematous hyperplasia of the whole gingiva with a granular appearance occurring a few weeks after the installation of a quad-helix. Peri-oral inspection revealed upper labial swelling and angular cheilitis. General investigations did not report ongoing extra-oral disturbances with the exception of a weakly positive anti-Saccharomyces cerevicae IgG auto-antibody. Two- and three-dimensional microscopic investigations confirmed the presence of gingival orofacial granulomatosis. Daily corticoid mouthwashes over a period of 3 months resulted in a slight improvement in clinical signs, despite an intermittent inflammation recurrence. This study brings new insights into the microscopic features of gingival orofacial granulomatosis, thus providing key elements to oral practitioners to ensure accurate and timely OFG diagnosis. The accurate diagnosis of OFG allows targeted management of symptoms and patient monitoring over time, along with early detection and treatment of extra-oral manifestations, such as Crohn\'s disease.
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