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Chronic ulcerative stomatitis is an extremely chronic erosive and ulcerative lesion associated with a specific type of antinuclear antibodies. The causes of this condition are unknown. The lesions are most often located on the mucosa of the gums, palate and cheeks.
Chronic ulcerative stomatitis
Chronic ulcerative stomatitis is a rare dermatological disease affecting the mucosa, less common on the lips and hard palate. Changes occurring in its course are most often ulcers and erosions and occur mainly in women in their 50s and 60s. The first case of this ailment was described for the first time in 1990. Some cases where the disease affected the mucosa of the genital organs and the conjunctiva were discussed. Lichen eruptions are seen in patients with chronic ulcerative stomatitis. They cause unpleasant pain, which makes patients have problems with normal functioning, e.g. eating, swallowing and speaking. The chronic nature of the disease means that it can last for years with periods of remission and relapse.
Causes of chronic ulcerative stomatitis
The pathogenesis of chronic ulcerative stomatitis is unknown. Patients’ serum is said to contain antibodies against nuclear antigens of the basal layer of the squamous epithelium, which cannot be detected on routinely used substrates (rat liver or Hep-2 cells). Thus, the condition may have features of an autoimmune disease. The antigen in this disease has not been characterized so far, it is supposed that it is a complex of DNA with a non-histone protein (genetic predisposition).
It is always worth supporting the appropriate quality of the bacterial flora present in the oral cavity. For this purpose, we recommend LACTIBIANE Buccodental for oral infections and caries.
Symptoms of chronic ulcerative stomatitis
The disease is characterized by erosions and ulcers, which are typical of this type of ailments. Most often, erosions are located on the mucous membranes of the cheeks, palate, gums and tongue. They cause the patient pain, which is sometimes severe to such an extent that it prevents the patient from functioning normally, e.g. eating food or swallowing liquids. Nevertheless, the condition of the patients is generally good.
Chronic ulcerative stomatitis can last up to 20 years (periods of remission and relapse).
- For inflammation in the mouth, it is worth using Dental gel for inflammation of the oral mucosa and gums Dentomit® gel, which soothes swelling and pain.
How is chronic ulcerative stomatitis diagnosed?
An initial diagnosis of chronic ulcerative stomatitis can be made based on existing erosions or ulcers on the oral mucosa. However, immunological studies are decisive. Very often it is the dentist who plays a very important role in the diagnosis of the disease. It is he who may be the first person to whom a sick person will report his / her ailments.
It is used in diagnostics by the IIF method (only on monkey or guinea pig esophagus substrate) ANA antibodies, usually in high titer, ie> 10, are detected. These antibodies bind in vivo in the epidermis, which can be determined by direct immunofluorescence (DIF). In the case when the lesion located on the mucosa is of suspect origin, it is recommended to take a sample for histopathological examination. The histopathological picture of chronic ulcerative stomatitis is not characteristic – a non-specific inflammatory infiltrate is usually observed.
The clinical picture of this disease is not specific and should be differentiated from other ailments, e.g .:
- pemphigus vulgaris,
- erosive form of lichen planus,
- acquired blistering epidermis,
- aphthosis,
- pemfigoidem.
Prophylactically and as an auxiliary during the treatment of stomatitis, use SeptOral Profilactic toothpaste for bleeding gums, which strengthens enamel and prevents the development of caries, and SeptOral Med gel for irritated oral mucosa, which you can buy at a promotional price at Medonet Market.
Chronic ulcerative stomatitis
The general treatment of the disease is usually performed by a dermatologist. On the other hand, the dentist’s task is to carry out oral hygiene treatments and eliminate irritating factors, e.g. sharp edges of teeth or dentures.
To alleviate inflammation in the mouth, it is worth buying Dermes’ Juice, the use of which has a soothing and astringent effect. We also recommend a special SeptOral Profilactic antifungal mouthwash for periodontitis and bleeding gums, which is currently available at a promotional price on Medonet Market.
In treatment, the use of antimalarial preparations (combined use of antimalarial preparations (Arechin 250 mg / day), and in the case of contraindications – dapsone with small doses of corticosteroids) brings beneficial effects. The prognosis of the disease is favorable, although its clinical course is long. The selection of the right treatment usually brings results and eliminates lesions, although there are patients who are very resistant to treatment. Rinses, e.g. based on chlorhexidine, can be used as an auxiliary. Important! Patients should avoid alcohol-containing preparations with strong astringent properties.
In patients with relapses, sometimes additionally small doses of steroids are administered. In patients with contraindications to the use of antimalarial preparations, dapsone is administered in combination with small amounts of steroids.
- Microdacyn 60 can be used on wounds in the mouth – a hydrogel for disinfecting and healing wounds, which accelerates healing and prevents the multiplication of viruses and bacteria.
Lit .: [1] Jabłońska S., Chorzelski T .: Erythematous, erythematous-exfoliating and follicular dermatoses. [In:] Skin diseases for students and doctors. Ed. Bow. PZWL, Warsaw 1997, 154-56. [2] Islam MN, Cohen DM, Ojha J. et al .: Chronic ulcerative stomatitis: diagnostic and management challenges-four new cases and review of literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007, 104 (2); 194-203.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House