الملخص
Objective@#To investigate the application of mycophenolate mofetil (MMF) in oral mucosal pemphigoid and provide a clinical reference.@*Methods@#One case of glucocorticoids combined with MMF in the treatment of oral mucosal pemphigoid was reported, and the clinical application of MMF in oral mucosa-related bullous diseases was discussed.@*Results@#One patient with a clinical diagnosis of “oral mucosal pemphigoid” was treated with methylprednisolone (36 mg, qd, morning dose) or combined hydroxychloroquine sulfate (0.1 g/time, bid) and thalidomide capsules (50 mg, qd, bedtime) and other drugs. The patient’s disease was slowly controlled but prone to recurrence. The treatment regimen was immediately adjusted, i.e., methylprednisolone (36 mg, qd, morning dose) was combined with MMF (0.5 g/time, bid) for 2 weeks, which resulted in ideal lesion healing control. After 8 weeks of methylprednisolone combined with MMF, the dose of methylprednisolone was gradually reduced to 12 mg, qd, and MMF was reduced to 0.5 g, qd, the patient’s symptoms improved significantly, and no obvious lesions were found in the mouth. The dose was then reduced and maintained according to the principle of pemphigoid treatment. Methylprednisolone (8 mg, qd, morning dose) and MMF (0.5 g, qd) have been used for 6 months of maintenance treatment, and they are still being followed up. As yet, the patient’s condition is stable without obvious lesions and new blisters, and no obvious side effects have been observed. A review of the literature shows that MMF is widely used in the field of dermatology to treat a variety of immune diseases, such as connective tissue diseases and autoimmune blistering diseases. According to the reports of adverse reactions to MMF, digestive system reactions are the most common adverse reactions; therefore, patients with active gastrointestinal diseases should be treated with caution, followed by bone marrow suppression, and it is recommended to monitor liver function and blood routine in patients using MMF. The safety and efficacy of MMF for treating pemphigoid involving the skin have been reported in the literature, but oral mucosal doctors still lack experience for treating mucous membrane pemphigoid.@*Conclusions@#As a new immunosuppressant, MMF has high safety and no obvious side effects and can be considered as a combination adjuvant drug for patients with severe clinical disease and refractory oral mucosal pemphigoid.
الملخص
Objective@# To analyze the clinical characteristics and treatment experience of Vitamin B12 (VB12) deficient patients with recurrent aphthous ulcers (RAU) to improve the clinical efficacy. @*Methods@#A retrospective analysis was performed on 15 cases of recurrent oral ulcers from January 2016 to September 2018. The causes were analyzed according to the patients’ clinical characteristics. @*Results@# In total, 15 patients with RAU had no remission after routine immunotherapy. Further clinical examination suggested that vitamin B12 levels were reduced. The erythrocyte mean corpuscular volume (MCV) was significantly increased, and the average number of red blood cells (RBC) and hemoglobin (Hb) levels were decreased. RAU disappeared after vitamin B12 supplementation. Routine blood work showed that the MCV returned to the normal range, which was statistically significant compared with the pretreatment MCV (P < 0.001). Vitamin B12 serum levels were significantly higher (P < 0.001) than those before treatment.@*Conclusion @#When the main manifestation of vitamin B12 deficiency is recurrent oral ulcer symptoms, dentists should examine the lesions carefully, inquire about the medical history in detail, and perform further serological tests when necessary to avoid the overuse of immunosuppressive drugs for treatment.
الملخص
Objective @#To study the clinical periodontal status of patients with desquamative gingivitis (DG) and analyze the factors that influence clinical periodontal indicators.@*Methods @#A purposive sampling method was used to obtain 42 subjects for a DG case group and a control group. Periodontal clinical indicators were detected, and related factors were analyzed. @*Results @#The DG patients were primarily middle-aged women. Periodontal clinical indicators were more prevalent in individuals with oral lichen planus (OLP) and mucous membrane pemphigoid (MMP) than in the control group. Probing depth (PD) (χ2=53.058, P<0.001; χ2=32.989, P<0.001), clinical attachment (χ2=30.292, P<0.001; χ2=32.470, P<0.001) and the positive rate of bleeding on probing (BOP) (χ2=50.003, P<0.001; χ2=36.236, P<0.001) were higher in the OLP and MMP group than in the control group. The time interval between the onset and treatment of DG was correlated with PD (rs=0.523, P<0.001) and the rate of positive BOP sites (rs=0.377, P=0.014). @*Conclusion@# Patients with DG have obvious periodontal lesions. Early medical intervention is helpful for diagnosing and treating DG-related oral and systemic disease.
الملخص
Objective@# To detect the expression of vascular endothelial growth factor (VEGF), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) in oral lichen planus (OLP).@*Methods @#Thirty OLP patients and fifteen healthy subjects were enrolled in the study. Serum were collected from 15 healthy volunteers as controls. Normal tissues were collected from surgical department as immunohistochemical analysis. The levels of VEGF, ICAM-1, VCAM-1 in serum were measured by ELISA. Immunohistochemical analysis of VEGF, ICAM-1, VCAM-1 were carried out by the means of primary antibodies and anti-VEGF, anti-CD106 antigen (VCAM-1) and anti-CD54 antigen (ICAM-1). @*Results@# ELISA results showed no expression differences for VEGF between the two groups. Whereas, the levels of ICAM-1, VCAM-1 in OLP group were significantly higher than those in control group (P < 0.05). Immunohistochemical results reveal the presence of a significant angiogenesis in OLP patients through the immunoexpression of VEGF, ICAM-1, VCAM-1 according to the percentage of stained cells (P < 0.05).@*Conclusion @# Regarding the results, it seems that high expression of VCAM-1 and ICAM-1 are related to oral lichen planus.