Oral lesions

口腔病变
  • 文章类型: Case Reports
    Tori是牙槽骨的反应性或发育性局部过度生长,不是癌性的。一个瘦,弱血管化的粘膜围绕着密集的皮质,低密度骨髓块称为托里或外生骨。Tori在中年时更常见。上颌骨(Toruspalatinus)和下颌骨(Torusmandibularis)都表现出Tori。说话困难和其他问题是与托里相关的常见障碍。Tori的直径范围从几毫米到几厘米。托里手术切除是治疗大托里妨碍言语的主要方法,咀嚼,或舌头的位置。以下病例研究包括一名36岁的男性患者,其下颌犬和前磨牙区域与骨生长有关。
    Tori are reactive or developmental localized overgrowths of alveolar bone that are not cancerous. A thin, weakly vascularized mucosa surrounds a densely cortical, low-density mass of bone marrow known as tori or exostosis. Tori are more frequently observed in middle age. Both the maxilla (torus palatinus) and the mandible (torus mandibularis) exhibit tori. Difficulty in speaking and other issues are common obstacles associated with tori. Tori range in diameter from a few millimeters to several centimeters. Surgical excision of tori is the mainstay of treatment for large tori obstructing speech, mastication, or tongue position. The following case study includes a 36-year-old male patient with an association of mandibular canine and premolar regions with bony outgrowth.
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  • 文章类型: Journal Article
    口腔病理学是一个具有挑战性但有趣的主题。通过将病理特征与我们通常遇到的事物进行比较,有可能减少记忆这些品质的难度。因此,各种类比方法的使用,比如隐喻的用法,传达两个项目之间的相似性或相似性,可以帮助学生。许多病理特征与我们经常看到的动物相似。学生可能会发现比较,当将信息与熟悉的动物进行比较时,更容易检查和理解口腔病理学。本文试图汇编与口腔病理学有关的动物隐喻。
    Oral pathology is a challenging yet intriguing subject. By comparing pathological traits to things we typically encounter, it is possible to reduce the difficulty of memorising these qualities. Hence, the usage of various analogical methods, like the usage of metaphors, conveys likeliness or similarities between two items and can help the students. A lot of pathological features have a resemblance to animals we see on a frequent basis. Students might find comparing, examining and comprehending oral pathology easier when the information is compared with familiar animals. This article is an attempt to compile animal metaphors related to oral pathology.
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)的诊断由于其非特异性临床症状和组织病理学特征而面临许多挑战。因此,诊断过程应包括全面的临床病史,免疫学测试,和组织病理学。我们的研究旨在通过将直接免疫荧光(DIF)结果与临床数据相结合来开发基于人工神经网络的多变量预测模型,从而提高OLP的诊断准确性。使用DIF评估了80例患者的各种标记(G类免疫球蛋白,A,和M;补体3;纤维蛋白原1型和2型)和临床特征,如年龄,性别,和病变位置。使用Statistica13中的机器学习技术进行统计分析。评估了以下变量:性别,病变发作当天的年龄,直接免疫荧光的结果,白色斑块的位置,侵蚀的位置,治疗史,药物和膳食补充剂的摄入量,牙齿状况,吸烟状况,使用牙线,用漱口水.在初始评估后,为机器学习选择了四个具有统计学意义的变量。最终的预测模型,基于神经网络,在测试样本中达到85%,在验证样本中达到71%的准确率。重要的预测因素包括发作时的压力,舌头下面的白色斑点,和下颌牙龈上的糜烂。总之,虽然模型显示出希望,需要更大的数据集和更全面的变量来提高OLP的诊断准确性,强调需要进一步研究和协作数据收集工作。
    The diagnosis of oral lichen planus (OLP) poses many challenges due to its nonspecific clinical symptoms and histopathological features. Therefore, the diagnostic process should include a thorough clinical history, immunological tests, and histopathology. Our study aimed to enhance the diagnostic accuracy of OLP by integrating direct immunofluorescence (DIF) results with clinical data to develop a multivariate predictive model based on the Artificial Neural Network. Eighty patients were assessed using DIF for various markers (immunoglobulins of classes G, A, and M; complement 3; fibrinogen type 1 and 2) and clinical characteristics such as age, gender, and lesion location. Statistical analysis was performed using machine learning techniques in Statistica 13. The following variables were assessed: gender, age on the day of lesion onset, results of direct immunofluorescence, location of white patches, locations of erosions, treatment history, medications and dietary supplement intake, dental status, smoking status, flossing, and using mouthwash. Four statistically significant variables were selected for machine learning after the initial assessment. The final predictive model, based on neural networks, achieved 85% in the testing sample and 71% accuracy in the validation sample. Significant predictors included stress at onset, white patches under the tongue, and erosions on the mandibular gingiva. In conclusion, while the model shows promise, larger datasets and more comprehensive variables are needed to improve diagnostic accuracy for OLP, highlighting the need for further research and collaborative data collection efforts.
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  • 文章类型: Journal Article
    虽然罕见,正畸患者的过敏反应的口腔表现由于其异质性表现而构成了重大的临床挑战。会引起不适和疼痛,可能影响患者的生活质量和正畸治疗持续时间和预后。这篇全面的综述旨在阐明口头,口周,以及正畸患者过敏反应的全身表现,专注于固定器具的患者,可移动电器,和清晰的对准器,详细说明他们的流行病学,宏观和微观特征,过敏测试,临床意义,和具体的管理策略。(立即和延迟)过敏反应的口腔和口腔外表现很少发生,并且是由于正畸矫治器中金属和非金属离子的释放。它们通常表现为红斑,糜烂性溃疡性病变,和牙龈增生,组织病理学发现显示炎性浸润。镍是一种重要的过敏原,和诊断测试,如补丁测试是必不可少的管理这些反应。可能是由于与口腔组织长时间接触,与可移动矫治器和清晰的矫治器相比,固定的正畸矫治器具有更高的风险。早期识别和去除过敏原,结合有效的治疗方法,可以解决症状并防止复发。保持牙科和医疗记录更新,了解家庭和个人病史,有助于临床医生选择适当的材料,并就潜在的风险向患者提供咨询。正确的病人教育,定期监测,使用低过敏性材料是管理这些反应的关键策略。
    Although rare, oral manifestations of hypersensitivity reactions in orthodontic patients pose a significant clinical challenge due to their heterogeneous presentations, and can cause discomfort and pain, possibly impacting patients\' quality of life and orthodontic treatment duration and outcomes. This comprehensive review aimed to elucidate the oral, perioral, and systemic manifestations of hypersensitivity reactions in orthodontic subjects, focusing on patients with fixed appliances, removable appliances, and clear aligners, and detailing their epidemiology, macroscopic and microscopic features, allergy testing, clinical implications, and specific management strategies. Oral and extra-oral manifestations of (immediate and delayed) hypersensitivity reactions occur rarely and are due to the release of metal and non-metal ions from orthodontic appliances. They typically present as erythema, erosive-ulcerative lesions, and gingival hyperplasia, with histopathological findings showing inflammatory infiltrates. Nickel is a significant allergen, and diagnostic tests like patch tests are essential for managing these reactions. Likely due to prolonged contact with oral tissues, fixed orthodontic appliances pose a higher risk compared to removable appliances and clear aligners. Early identification and removal of allergenic materials, combined with effective treatments, can resolve symptoms and prevent recurrence. Keeping dental and medical records updated and knowing family and personal medical histories helps clinicians choose appropriate materials and counsel patients about potential risks. Proper patient education, regular monitoring, and using hypoallergenic materials are key strategies for managing these reactions.
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  • 文章类型: Journal Article
    目的:探讨干燥综合征(SS)患者口腔念珠菌病的临床特点及危险因素,为SS患者口腔念珠菌病的防治提供依据。
    方法:对2018-2020年山西医科大学第二医院收治的479例SS患者的病历资料进行分析,探讨影响SS患者口腔念珠菌感染发生的临床特征和危险因素。
    结果:口腔念珠菌病患者年龄大于无口腔念珠菌病患者(P<0.05)。男性SS患者口腔念珠菌病率较高(P<0.05)。未刺激的全唾液(UWS)和刺激的全唾液(SWS)均显示与口腔念珠菌感染不利相关(P<0.001)。Logistic回归分析显示,低UWS是SS患者口腔念珠菌感染的独立危险因素(OR:0.004,P=0.023)。白细胞计数更大(OR:1.22,P<0.001),较低的血红蛋白水平(OR:0.97,P=0.007),降低血清白蛋白水平(OR:0.88,P<0.001),较低的IgG水平(OR:0.91,P=0.011),降低IgA水平(OR:0.75,P=0.011),口腔念珠菌感染患者的IgM水平较低(OR:0.91,P=0.015)。使用免疫抑制药物的患者(OR:0.32,P=0.011),特别是雷帕霉素(P<0.001),口腔念珠菌感染率降低。
    结论:患有口腔念珠菌病的患者年龄大于没有口腔念珠菌病的患者。男性SS患者更有可能患有口腔念珠菌病。UWS和SWS较低的个体更容易受到口腔念珠菌感染。SS患者的口腔念珠菌感染取决于其免疫状态。雷帕霉素可能增加Treg细胞的丰度以减少SS患者口腔念珠菌感染。
    OBJECTIVE: To investigate the clinical features and risk factors of Sjogren\'s Syndrome (SS) patients suffering from oral candidiasis and to provide a foundation for the prevention and treatment of oral candidiasis in SS patients.
    METHODS: The medical records of 479 SS patients admitted to the Second Hospital of Shanxi Medical University from 2018 to 2020 were analysed to determine the clinical characteristics and risk factors that influence the occurrence of oral candidiasis infection in SS patients.
    RESULTS: Patients with oral candidiasis were older than those without oral candidiasis (P < 0.05). Male SS patients had greater oral candidiasis rates (P < 0.05). Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) were both shown to be adversely associated with oral Candida infections (P < 0.001). Logistic regression revealed that a low UWS was an independent risk factor for oral Candida infections in SS patients (OR: 0.004, P = 0.023). Greater WBC counts (OR: 1.22, P < 0.001), lower haemoglobin levels (OR: 0.97, P = 0.007), lower serum albumin levels (OR: 0.88, P < 0.001), lower IgG levels (OR: 0.91, P = 0.011), lower IgA levels (OR: 0.75, P = 0.011), and lower IgM levels (OR: 0.91, P = 0.015) were found in patients with oral Candida infections. Patients on immunosuppressive medications (OR: 0.32, P = 0.011), particularly rapamycin (P < 0.001), had a decreased rate of oral Candida infections.
    CONCLUSIONS: Patients with oral candidiasis were older than those without oral candidiasis. Male SS patients are more likely to have oral candidiasis. Individuals with lower UWS and SWS are more susceptible to oral Candida infection. Oral Candida infections in SS patients depend on their immunological status. Rapamycin may increase the abundance of Treg cells to reduce oral Candida infection in SS patients.
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  • 文章类型: Journal Article
    全球约有3900万人感染人类免疫缺陷病毒(HIV)。抗逆转录病毒疗法(ART)改善了这些人的预期寿命,生活质量(QoL)是一个至关重要的方面。然而,关于住院HIV患者口腔健康相关生活质量(OHRQoL)的信息有限.这项研究采用了横断面设计,包括43名非政府机构的居民,他们被确诊为HIV并有静脉吸毒史。西班牙语版的口腔健康指数概况-14(OHIPsp)用于评估OHRQoL,将第50百分位数作为生活质量好或差的界限。所有43例患者都有一个或多个口腔病变,44.1%患有艾滋病相关口腔病变(AROLs)。超过一半的参与者(48.8%)报告OHRQoL较差,与男性相比,女性在所有方面的生活质量都较差。患有AROL的受试者的OHRQoL较差的可能性是没有AROL的受试者的三倍(p=0.03;OR=3.1IC1.04-9.6)。这些结果凸显了对HIV患者的全面治疗计划的必要性,包括口腔健康,特别是对于生活在不稳定条件下或被制度化的妇女。改善口腔健康可以显著提高生活质量。
    Approximately 39 million people worldwide live with human immunodeficiency virus (HIV), and antiretroviral therapy (ART) has improved life expectancy for these individuals, with quality of life (QoL) being a crucial aspect. However, there is limited information on oral health-related quality of life (OHRQoL) for institutionalized patients with HIV. This study used a cross-sectional design and included 43 residents of a non-governmental institution who had a confirmed HIV diagnosis and a history of intravenous drug use. The Spanish version of the Oral Health Index Profile-14 (OHIPsp) was used to assess the OHRQoL, with the 50th percentile serving as the cutoff for good or poor quality of life. All 43 patients had one or more oral lesions, with 44.1% having AIDS-related oral lesions (AROLs). Over half of the participants (48.8%) reported a poor OHRQoL, and females experienced worse quality of life in all dimensions compared to males. Subjects with AROLs were three times more likely to have poor OHRQoL than those without AROLs (p = 0.03; OR = 3.1 IC 1.04-9.6). These results highlight the need for a comprehensive treatment plan for patients with HIV that includes oral health, particularly for women living in precarious conditions or who are institutionalized. Improving oral health can significantly enhance quality of life.
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  • 文章类型: Journal Article
    COVID-19,一种呼吸道疾病,对全球数百万人产生影响,最近与影响各种身体系统的表现有关,包括口腔。研究强调口头问题,比如溃疡,水泡,和白色斑块,除了嗅觉和味觉功能障碍,影响个人的生活质量。在这种情况下,我们的研究旨在评估口腔病变的频率,嗅觉和味觉紊乱,和COVID-19引起的口干症。对414例患者进行了一项观察性研究,以评估COVID-19引起的口腔症状的频率。患者被诊断为轻度症状,并通过口腔临床检查和评估功能改变的问卷进行评估。结果显示,414例患者中有139例出现临床表现,口腔病变最普遍(19.1%),其次是味觉障碍(18.1%),口干症(14.2%),嗅觉功能障碍(14%)。最常见的口腔病变是溃疡(n=51),念珠菌病(n=8),和红斑或红色斑块(n=7)。不幸的是,50例(12.1%)患者在本研究中死亡。因此,口腔病变,嗅觉和味觉功能障碍,口干症是与COVID-19相关的常见症状。
    COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual\'s quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.
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  • 文章类型: Systematic Review
    背景:Birt-Hogg-Dube综合征(BHDS)是一种具有不同皮肤的常染色体显性综合征,肺,和肾脏表现。它通常在生命的第三个十年被诊断出来,患者气胸和肾癌的风险增加。
    方法:在PubMed中发表的文章,和Medline从1977年到2023年9月被纳入系统评价。纳入标准适用于病例报告,案例系列,和一项回顾性队列研究,描述临床,组织病理学,以及有口腔和/或腮腺病变的BHDS患者的遗传发现。
    结果:确定了16个患有BHDS的家庭/个体进行分析。患者的年龄从20岁到74岁不等,平均49.4年。男性受影响的时间为52.2%,女性,39.1%。87%的病例报告了皮肤纤维囊瘤,和口腔病变记录为47.8%。在43.5%的患者中记录了腮腺肿瘤,其中30.4%为嗜酸细胞瘤,4.3%双侧嗜酸细胞瘤,和4.3%的“嗜酸性细胞癌”。
    结论:因为BHDS并不常见,其临床表现谱可能被低估,特别是这种疾病大多在晚期报道。部分BHDS患者可能有嗜酸细胞性腮腺肿瘤和口腔病变。在这方面,出现这些病变和其他BHDS适应症的患者应考虑进行肾脏筛查.
    BACKGROUND: Birt-Hogg-Dube syndrome (BHDS) is an autosomal dominant syndrome with different skin, lung, and renal manifestations. It is diagnosed commonly in the third decade of life, and patients have an increased risk for pneumothorax and renal carcinomas.
    METHODS: Articles published in PubMed, and Medline from 1977 to September 2023, were included in the systematic review. Inclusion criteria were applied to case reports, case series, and a retrospective cohort study, describing clinical, histopathological, and genetic findings in patients with BHDS with oral and/or parotid lesions.
    RESULTS: Sixteen families/individuals with BHDS were identified for analysis. Patients ranged in age from 20 to 74 years, with an average of 49.4 years. Males were affected 52.2% of the time and females, 39.1%. Skin fibrofolliculomas were reported in 87% of cases, and oral lesions were documented in 47.8%. Parotid tumors were documented in 43.5% of patients, 30.4% of which were oncocytomas, 4.3% bilateral oncocytomas, and 4.3% \"oncocytic carcinoma\".
    CONCLUSIONS: Because BHDS is uncommon, its spectrum of clinical manifestations may be underrecognized, especially as the disease is mostly reported at advanced stage. And some of the patients with BHDS may have oncocytic parotid tumors and oral lesions. In this regard, patients presenting these lesions and other indications of BHDS should be considered for renal screening.
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  • 文章类型: Journal Article
    小儿口腔病理学包括影响儿童口腔的多种疾病和病症。在这项研究中,我们对沙特阿拉伯一个学术中心的数据集进行了分析,以调查儿科患者各种口腔病变的患病率。
    为了进行这项研究,我们分析了2012年1月至2022年12月期间在我们机构的口腔病理实验室接受活检的儿科患者(年龄范围:0-18岁)的口腔病理报告。我们收集的数据包括人口统计信息和诊断结果。进行统计分析以确定不同变量的患病率和相关性。
    该研究共分析了183例患有口腔疾病的儿科病例。观察到的最常见的情况是粘液囊肿(12%),根尖周围肉芽肿(7.7%),牙质囊肿(6.6%),和根性囊肿(6.6%)。一些情况显示,患病率因年龄和性别而异。例如,黏液囊肿在6-12岁的女性患者中更为普遍.
    这项回顾性研究为儿童口腔疾病的患病率和人口统计学特征提供了有价值的见解。通过了解该人群的患病率,并认识到与其他研究中引用的分布差异,我们强调了考虑区域和人口影响的重要性。需要进一步的前瞻性研究来调查可能导致这些变化的因素。
    UNASSIGNED: Pediatric oral pathology encompasses a wide range of diseases and conditions affecting the oral cavity in children. In this study we conducted an analysis on a dataset from one academic center in Saudi Arabia to investigate the prevalence of various oral lesions in pediatric patients.
    UNASSIGNED: To conduct this study we analyzed oral pathology reports of pediatric patients (age range: 0-18 years) who underwent biopsies at our institution\'s oral pathology laboratory between January 2012 and December 2022. The data we collected included demographic information and diagnostic findings. Statistical analysis was performed to determine the prevalence rates of and associations between different variables.
    UNASSIGNED: The study analyzed a total of 183 pediatric cases with oral pathologies. The most common conditions observed were mucocele (12 %), periapical granuloma (7.7 %), dentigerous cyst (6.6 %), and radicular cyst (6.6 %). Some conditions showed variations in prevalence based on age and gender. For example, mucoceles were more prevalent among patients who were 6-12 years of age and female.
    UNASSIGNED: This retrospective study provides valuable insights into the prevalence and demographic characteristics of pediatric oral pathologies. By understanding the prevalence of conditions in this population and recognizing differences in distribution compared with those cited in other studies, we highlighted the importance of considering regional and demographic influences. Further prospective studies are needed to investigate factors that may contribute to these variations.
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  • 文章类型: Journal Article
    大疱性类天疱疮(BP)和单纯疱疹病毒(HSV)感染在口腔粘膜中的表现相似,HSV的实验室检测有一定的局限性,这使得在BP的口腔病变中难以识别HSV感染。此外,BP和HSV感染的治疗存在矛盾。因此,及时发现BP患者的HSV感染非常重要。
    确定单纯疱疹病毒感染在BP口腔病变中的患病率和临床标志物。
    这项前瞻性横断面描述性分析研究是对42例有口腔病变的BP患者进行的。32例无口腔病变的BP患者和41例健康者作为对照组。采用聚合酶链反应检测HSV。比较HSV感染患者与未感染患者的临床和实验室特征。
    共有19例(45.2%)有口腔病变的BP患者,无(0.0%)血压无口腔病变患者,4例(9.8%)健康个体在口腔粘膜上的HSV阳性。在有口腔病变的BP患者中,口腔和皮肤病变之间的不一致活性(p=0.001),口腔病变中没有水泡/血泡(p=0.020),与HSV阴性BP患者相比,HSV阳性BP患者的口腔病变疼痛(p=0.014)更常见;HSV阳性BP患者的糖皮质激素剂量(p=0.023)和最近2周的累积糖皮质激素剂量(2周AGC剂量)(p=0.018)更高。结合以上五个变量作为测试变量,在ROC分析中,AUC为0.898(p<0.001),HSV感染为状态变量。在多变量分析中,发现口腔病变中没有水泡/血泡(p=0.030)和口腔病变疼痛(p=0.038)是HSV感染的独立预测因子。共有14例(73.7%)HSV阳性BP患者接受2周泛昔洛韦治疗,口腔粘膜BPDAI评分显著下降(p<0.001)。
    HSV感染常见于BP口腔病变。口腔和皮肤病变之间的不一致活动,口腔病变中没有水疱,口腔病变疼痛,目前使用的糖皮质激素剂量较高,在BP患者中,较高的2周AGC剂量应提醒医生注意口腔病变中的HSV感染,并及时给予2周泛昔洛韦治疗.
    UNASSIGNED: The manifestations of bullous pemphigoid (BP) and herpes simplex virus (HSV) infection are similar in oral mucosa, and the laboratory detection of HSV has some limitations, making it difficult to identify the HSV infection in oral lesions of BP. In addition, the treatments for BP and HSV infection have contradictory aspects. Thus, it is important to identify the HSV infection in BP patients in time.
    UNASSIGNED: To identify the prevalence and clinical markers of HSV infection in oral lesions of BP.
    UNASSIGNED: This prospective cross-sectional descriptive analytical study was conducted on 42 BP patients with oral lesions. A total of 32 BP patients without oral lesions and 41 healthy individuals were enrolled as control groups. Polymerase chain reaction was used to detect HSV. Clinical and laboratory characteristics of patients with HSV infection were compared with those without infection.
    UNASSIGNED: A total of 19 (45.2%) BP patients with oral lesions, none (0.0%) BP patients without oral lesions, and four (9.8%) healthy individuals were positive for HSV on oral mucosa. Among BP patients with oral lesions, the inconsistent activity between oral and skin lesions (p=0.001), absence of blister/blood blister in oral lesions (p=0.020), and pain for oral lesions (p=0.014) were more often seen in HSV-positive than HSV-negative BP patients; the dosage of glucocorticoid (p=0.023) and the accumulated glucocorticoid dosage in the last 2 weeks (2-week AGC dosage) (p=0.018) were higher in HSV-positive BP patients. Combining the above five variables as test variable, the AUC was 0.898 (p<0.001) with HSV infection as state variable in ROC analysis. The absence of blister/blood blister in oral lesions (p=0.030) and pain for oral lesions (p=0.038) were found to be independent predictors of HSV infection in multivariable analysis. A total of 14 (73.7%) HSV-positive BP patients were treated with 2-week famciclovir and the oral mucosa BPDAI scores significantly decreased (p<0.001).
    UNASSIGNED: HSV infection is common in BP oral lesions. The inconsistent activity between oral and skin lesions, absence of blister in oral lesions, pain for oral lesions, higher currently used glucocorticoid dosage, and higher 2-week AGC dosage in BP patients should alert physicians to HSV infection in oral lesions and treat them with 2-week famciclovir in time.
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