Allergy to copper derived from dental alloys as a possible cause of oral lesions of lichen planus.
Allergy to copper derived from dental alloys as a possible cause of oral lesions of lichen planus.
复制标题
对牙科合金中的铜过敏可能是导致扁平苔藓口腔病变的原因。
作者：
Frykholm Ko;L. Frithiof;Fernstrom Ai;G. Moberger;Blohm Sg;E. Björn
扁平苔藓是皮肤和/或粘膜的炎性疾病。Cooke（14）、Hällen和Sund贝格（27）、Shklar和Meyer（47）1、Shklar和McCarthy（48）、Pindborg（43）、Herr Schlmann（25）和Abramova（r）描述了口腔扁平苔藓病变的临床和组织学特征。科尔比、克尔和罗宾逊（13）描述了累及颊粘膜的扁平苔藓的肉眼外观，表现为轻微隆起的白色、细点和细线（威克姆纹）。可能有广泛的白色斑块、结节和糜烂性改变。舌背面扁平苔藓的临床表现与舌白斑相似（13）。牙龈上的病变往往形成网状图案，给人一个花边lattice工作的外观（1 4，48）。口腔扁平苔藓病变的不同类型通常发生在粘膜上皮瘤样变上（14）。在一些病例中，牙龈扁平苔藓与脱屑性牙龈炎并存（14，48）。在早期阶段，涉及口腔粘膜的扁平苔藓的组织学变化可能是离散的，类似于轻度非特异性口腔炎的变化。上皮细胞的特征性变化和炎性细胞浸润直到后期才发生，组织学检查结果才被诊断。Andreasen和Pindborg（3）回顾了有关扁平苔藓的文献，发现一些研究者观察到口腔病变的恶性变化，频率从1%到10%不等。Koberg等人（32）回顾了48例恶性发展的公开病例，增加了3例他们自己观察到的病例。然而，口腔扁平苔藓与口腔癌的关系至今尚未得到明确的证实。口腔黏膜癌前病变与非癌前病变的临床鉴别诊断存在很大困难，对患者进行全面检查是最重要的。扁平苔藓的病因尚不清楚。药物反应可能表现为皮肤和粘膜的扁平苔藓病变[Baker，Hughes and Pcgum（5），Baer and Kopf（4），Dins Schmiddalc，Ormerod and步行者（15）]。有
Lichen planus is an inflammatory disease of the skin and/or mucous membranes. The clinical and histological features of oral lesions of lichen planus have been de scribed by Cooke (14), Hällen and Sund berg (27), Shklar and Meyer (47) 1 Shklar and McCarthy (48), Pindborg (43), Herr mann ( 25) and Abramova ( r). Colby, Kerr and Robinson (13) de scribecl the macroscopic appearance of lichen planus involving the buccal mucosa as slightly raised white, fine dots and thin lines (Wickham's striae). There may be extensive white plaques, nodules and ero sive changes. The clinical appearance of lichen planus on the dorsal surface of the tongue is said to resemble that of leuko plakia ( 13). Lesions on the gingiva often form a reticular pattern, giving a lace lat tice work appearance ( 1 4, 48). The various patterns of oral lesions of lichen planus usually occur on an erythcmatous mucosa ( 14). Cases have been encountered in which lichen planus involving the gingiva coexisted with desquamative gingivitis (14, 48). At an early stage the histological changes in lichen planus involving the oral mucosa may be discrete resembling the changes seen in mild non-specific stomatitis. Char acteristic changes in the epithelium and the inflammatory cell infiltrate clo not occur un ti I a later stage, the histological findings being then diagnostic. Andreasen and Pindborg (3) reviewed the literature concerning lichen planus and found that several investigators had ob served malignant changes in oral lesions, the frequency ranging from one to ten per cent. Koberg er al. (32) reviewed 48 pub lished cases in which malignancy devel oped, adding 3 cases which they themselves had observed. Ho,, vever, thc relationship between oral lichen planus and carcinoma has so far not been conclusi.vely demon strated. The clinical differential diagnosis between pre-cancerous lesions of oral tis sues and non-precanccrous lesions presents gn�at difficulties and a tborough examina tion of the patient is most important. The aetiology of lichen planus is not known. Drug reactions may manifest them selves as lichen planus lesions of the skin and mucous membranes [Baker, Hughes and Pcgum (5), Baer and Kopf (4), Dins dalc, Ormerod and Walker (15)]. There is