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Clinical diagnosis of oral erosive and ulcerative diseases in children |
LIU Chuanxia( ),CHEN Qianming( ) |
Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine & Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China |
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Abstract Mucosal disease is one of the most common oral cavity diseases in children, among which mucosal erosion and ulceration account for about 50%. Oral mucosal erosion and ulcer diseases in children are mostly acute with obvious pain, affecting speech, eating and swallowing. Some oral mucosal diseases are caused by infection and would result in epidemic among children. The onset age, sites, lesions size and quantity could vary, and some would have recurrence. The detailed medical history and comprehensive physical examination are necessary, some diseases can be diagnosed according to the medical history and clinical manifestations. If diagnosis can not be made, biopsy, blood test and immunofluorescence staining, immunohistochemistry, molecular biology detection, gene diagnosis, tuberculin test and other tests should be considered, and further investigation of systemic diseases should also be carried out if necessary. In some cases, multidisciplinary consultation should be sought. For those who still have no abnormal findings, therapeutic diagnosis can be tried out or secondary biopsy should be performed. In this article, the research progress of oral mucosal diseases in children is reviewed and our own clinical experiences of oral erosive and ulcerative diseases in children are summarized.
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Received: 25 January 2021
Published: 18 June 2021
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Corresponding Authors:
CHEN Qianming
E-mail: 0014806@zju.edu.cn;qmchen@zju.edu.cn
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儿童口腔黏膜糜烂溃疡类疾病的临床诊断
口腔黏膜疾病是除龋病、牙髓病和根尖周病外最常见的儿童口腔疾病,其中糜烂溃疡类疾病约占儿童口腔黏膜疾病的 50%。儿童口腔糜烂溃疡类疾病多为急性发病,患儿疼痛明显,影响言语、饮食和吞咽,部分疾病具有传染性,可引起患儿群体性发病;患儿的发病年龄有一定的规律性,好发部位有一定的差异性,病损大小不一、数量不等,部分具有复发性。对于儿童患者,结合儿童自身的特点进行详细的病史采集,全面的体格检查,部分疾病根据病史特点和临床表现即可作出诊断;不能确诊者完善术前检查后考虑活体组织检查,进行免疫荧光染色、免疫组化、分子生物学检测、基因诊断、结核菌素试验等;仍然不能确诊者,考虑进一步排查全身疾病,必要时寻求多学科会诊和帮助;仍无异常发现者,可试行治疗性诊断,必要时进行二次活检。根据儿童口腔黏膜疾病的研究进展,结合笔者多年的临床诊治经验,本文分析和总结了儿童口腔黏膜糜烂溃疡类疾病的特点和临床诊断思路。
关键词:
口腔黏膜,
儿童,
糜烂,
溃疡,
临床特征,
诊断思路
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