• 沒有找到結果。

原文題目

N/A
N/A
Protected

Academic year: 2022

Share "原文題目"

Copied!
4
0
0

加載中.... (立即查看全文)

全文

(1)

口腔病理科 On-Line KMU Student Bulletin

原文題目(出處): Depigmentation of oral mucosa as the earliest possible manifestation of oral submucous fibrosis in Sri Lankan preschool children. J Investigative & Clin Dentistry 2010;1:156-9.

原文作者姓名: Mohaideen Sitheeque1, Anura Ariyawardana1, Ruwan Jayasinghe1 & Wanninayake Tilakaratne

通訊作者學校: Department of Oral Medicine and Periodontology, Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka

報告者姓名(組別): 陳冠憲 實習H組

報告日期: 2011/03/14

內文:

Introduction

Oral submucous fibrosis (OSF) is a chronic, insidious, generalized, and debilitating condition of the oral mucosa that causes burning sensation and progressive limitation in the mouth opening, including a reduced ability to protrude the tongue.

well-known potentially malignant disorder, and is predominantly encountered in South Asian and South–East Asian countries.

etiologically linked to the consumption of the areca nut in flavored formulations or as an ingredient in the betel quid chewed by the communities in these countries.

the other important clinical feature of OSF is the loss of pigmentation of the vermilion border of the lips and the oral mucosa, followed by the development of a leathery texture and blanching of the oral mucosa.

Although OSF is generally considered an adult disease, it has been reported among school children from communities with betel and areca nut chewing habits.

The aim of the present article was to report the presentation of OSF in five 2- to 3-year-old Sri Lankan preschool children. We also aimed to highlight that loss of pigmentation appears to be the earliest manifestation of the condition.

Case reports

five children who presented to the oral medicine clinic of the University Dental Hospital, Peradeniya, Sri Lanka, between 2000 and 2009, with loss of pigmentation of the lips as the sole complaint

- 1 -

(2)

口腔病理科 On-Line KMU Student Bulletin

01 HM: Mildly-atrophic, stratified squamous epithelium with increased amount of collagen in the upper corium Fibrosis extends into muscle in a few foci. No associated inflammatory infiltrate.

02 NCK: Mild, atrophic changes in the surface epithelium and features suggestive of OSF seen, although no significant increase in fibrosis found in the underlying corium.

Histopathological features in this patient appeared to be of a lesser degree.

Discussion

OSF has not been reported previously in 2- to 3-year-old children in the English-published literature.

Sri Lanka has a moderately-high prevalence of OSF

The oral medicine clinic of the University Dental Hospital possesses a large databank of patients with OSF and has no previous record of 2- to 3-year-old children with the disease.

- 2 -

(3)

口腔病理科 On-Line KMU Student Bulletin

It is important to note that depigmentation of the lips was the only complaint in these children, and this would appear to be the earliest feature of OSF.

OSF in the literature concerns young adults or older individuals with moderately-advanced or late-stage disease. OSF presenting in such stages in the natural history of the disease would exhibit many classical symptoms and signs.

None of the five 2–3 year olds in the present study displayed any such advanced clinical features of OSF due to the disease having been detected at a very early stage.

The paucity of information on lip depigmentation presenting as an early symptom might be due to the fact that OSF patients generally present after the disease has progressed and causes burning sensation and/or significant limitation in the mouth opening. Concurrently features, such as a leathery texture and blanching of the mucosa.

Although depigmentation and blanching are described in the literature as overlapping entities, our clinical experience shows that these are two distinct stages

A depigmented oral mucosa still retains its glossy appearance, whereas blanched mucosa exhibits a matt appearance. These differences are conceivable when the probable underlying factors are considered.

Depigmentation might occur as a result of diminishing melanocytes, due to an early reduction of vascularity of the mucosa, whereas blanching probably results from the disappearance of the capillary bed in the corium, which is associated with increasing fibrosis.

Differential diagnosis

The only other conditions that need to be considered in the differential diagnosis of oral mucosal depigmentation are vitiligo and lichen sclerosus et atrophicus硬化性萎 縮性苔蘚

Among the different subtypes of vitiligo, vitiligo vulgaris, the generalized type, could be easily excluded, as there was no depigmentation in other parts of the body in any of the patients.

The segmental type can also be excluded because the condition is usually distributed within a trigeminal dermatome, and is thus likely to extend beyond the mucocutaneous junction onto the facial skin, which was not the case in any of our patients.

The only type that needs to be differentiated is focal-type vitiligo.

The definite association with the consumption of areca nuts in each of these five cases can be considered sufficient evidence for the diagnosis of OSF, as it is highly improbable that all five children with vitiligo were areca nut consumers.

The use of a Wood’s lamp test was not considered suitable to exclude vitiligo in these cases, as the test is not specific to vitiligo.

Lichen sclerosus et atrophicus of the oral mucosa is very rare and has never been

- 3 -

(4)

口腔病理科 On-Line KMU Student Bulletin

- 4 -

reported in children. Histologically, the absence of vascular lumen obliteration or reduction distinguishes lichen sclerosus et atrophicus from submucous fibrosis.

Review of previous reports of OSF in children

All of these children had a habit of chewing areca nuts, with or without betel quid, and almost all of them had been diagnosed with moderately-advanced OSF.

None of these reports highlighted the loss of pigmentation of lips or oral mucosa as an early finding.

In conclusion, although OSF has been previously reported in children, its occurrence in 2- to 3-year-old preschool children has not been reported in the English published literature.

It is noteworthy that the loss of pigmentation had been the sole clinical feature of OSF in these children, and it would appear to be the earliest feature to develop in the natural history of this condition.

Thus, it would be prudent to ascertain the consumption of areca nuts when a patient presents with depigmentation of the lips in the absence of other clinical features of OSF.

題號 題目

1 Which one is not the clinic feature of OSF?

(A) Trismus

(B) Burning sensation

(C) Tongue becomes immobobile, decreases in size

(D) Erythema

答案(D ) 出處: Oral & Maxillofacial Pathology P350

題號 題目

2 Which one is the earliest clinic feature of OSF?

(A) Erythema

(B) Burning sensation

(C) Depigmentation

(D) Limitation of mouth opening

答案(C) 出處:Oral & Maxillofacial Pathology P350

參考文獻

相關文件

In an oilre nery a storage tank contains 2000 gallons of gasoline that initially has 100lb of an additive dissolved in it. In preparation for winter weather, gasoline containing 2lb

Abstract: According to Professor Igor Dolgachev, it has been a long standing problem if there is a smooth projective surface such that the automorphism group is discrete

You are given the wavelength and total energy of a light pulse and asked to find the number of photons it

39) The osmotic pressure of a solution containing 22.7 mg of an unknown protein in 50.0 mL of solution is 2.88 mmHg at 25 °C. Determine the molar mass of the protein.. Use 100°C as

The difference in heights of the liquid in the two sides of the manometer is 43.4 cm when the atmospheric pressure is 755 mm Hg.. 11) Based on molecular mass and dipole moment of

Reading Task 6: Genre Structure and Language Features. • Now let’s look at how language features (e.g. sentence patterns) are connected to the structure

Dublin born Oscar Wilde (1854-1900) established himself as one of the leading lights of the London stage at the end of the nineteenth century?. A poet and prose writer as well, it

Wang, Solving pseudomonotone variational inequalities and pseudocon- vex optimization problems using the projection neural network, IEEE Transactions on Neural Networks 17