文献简介

出版社:JAMA Dermatology

作  者:Faizan Alawi, DDS; Martin S. Greenberg, DDS; Eric T. Stoopler, DMD

编  号:

关键字:低纤溶酶原血症

年  份:2014   点击量:160

文献摘要 全文翻译

A white woman in her 50s presented for evaluation of recurrent gingival ulcers of 8 years’ duration. She reported that at the time of initial onset, multiple painful ulcers had appeared on the anterior maxillary gingiva. She stated that the lesions had resolved spontaneously without treatment but recurred 8 years later as swelling and ulceration of the maxillary and mandibular gingiva. She denied involvement of cutaneous surfaces and reported a history of ligneous conjunctivitis since childhood (Figure, A). Her medical history was significant for hypothyroidism, seizures, and functional heart murmur. Medications included levothyroxine sodium, mometasone furoate, levocetirizine, and benzonatate. Review of systems was significant for easy bruising and prolonged bleeding. Intraoral examination revealed generalized mild edema with rolled margins of the maxillary and mandibular gingival accompanied by nodular ulceration of the left maxillary gingiva (Figure, B). Biopsy specimens were obtained from the gingival ulcer (Figure, C and D) and buccal mucosa for routine histological and direct immunofluorescence analysis, respectively. Also obtained were a complete blood cell count with differential and comprehensive metabolic panel; no abnormal findings were identified.

患者白人女性,50余岁,因评估持续8年的复发性牙龈溃疡就诊。患者自述,最初发病时,上颌前牙龈上出现了多处疼痛性溃疡。这些皮损开始未经治疗自行消退,但8年后复发,上颌和下颌牙龈肿胀和溃疡。患者否认皮肤表面受累,且自述自小有结膜炎病史(图A)。患者甲状腺功能减退症、癫痫和功能性心脏杂音用药史具有重要意义。药物包括左甲状腺素钠、糠酸莫米松、左西替利嗪和苯佐那酯。系统检查对容易瘀伤和长期出血具有重要意义。口腔内检查显示轻度水肿,上颌和下颌牙龈边缘卷起,左侧上颌牙龈结节性溃疡(图B)。从牙龈溃疡(图C和D)和颊粘膜处获得活检标本,分别用于常规组织学检查和直接免疫荧光分析。还获得了具有差异完整血细胞计数和综合代谢检查;未发现异常表现。