Diagnosis and treatment of oral mucus lesions: case series of four patients

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Abstract

 

One of the pressing issues in dermatovenerological and stomatological practices pertains to diseases of the oral mucosa. This challenge is primarily attributed to the intricacies associated with diagnosing these conditions in their early stages, the resemblance of clinical presentations to various oral mucosal lesions, and the potential lack of awareness among healthcare practitioners. Diseases such as lichen planus, herpes simplex, erythema multiforme exudative with skin lesions and vulgar pemphigus are characterized by a particularly persistent long-term course, thereby reducing the patient's ability to work and the overall quality of life. A multitude of endogenous and exogenous factors can influence the state of the oral mucosa. Endogenous factors encompass genetic predisposition, endocrine disturbances, carbohydrate metabolism disorders, neurogenic disorders, autoimmune conditions and infectious diseases. Exogenous factors, as a rule, include taking medications (non-steroidal anti-inflammatory drugs, antibiotics), galvanism, excessive use of alcohol and narcotic substances, and others.

It should be noted that the condition of the oral mucosa is also influenced by a wide range of different trigger factors.

The narrative delves into the complexities of diagnosing these conditions early on and explores the challenges inherent in devising effective treatment strategies.

About the authors

Natalia P. Teplyuk

I.M. Sechenov First Moscow State Medical University

Email: teplyukn@gmail.com
ORCID iD: 0000-0002-5800-4800
SPIN-code: 8013-3256

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Mikhail A. Stepanov

I.M. Sechenov First Moscow State Medical University

Email: Doctor.stepanov@gmail.com
ORCID iD: 0000-0002-1872-9487
SPIN-code: 6524-5665

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow

Mariya I. Dodina

I.M. Sechenov First Moscow State Medical University

Email: midd@list.ru
ORCID iD: 0009-0004-1972-871X
SPIN-code: 5069-9431

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Baira Sh. Damdinova

I.M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: baira_d@mail.ru
ORCID iD: 0000-0002-4162-2928
Russian Federation, Moscow

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Supplementary files

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1. JATS XML
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2. Fig. 1. Patient B., 72 years old, oral lichen planus, erosive-ulcerated form (a); dorsal and lateral surfaces of the tongue (b).

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3. Fig. 2. Histological findings (haematoxylin and eosin staining, ×200).

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4. Fig. 3. Patient B, 64 years old, pemphigus vulgaris of oral mucous membrane, multiple erosions and ulcers in the root of tongue and palatine curtain (a); erosive-ulcerated lesions on the tongue (b).

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5. Fig. 4. Biopsy of the oral mucosa: a ― histological findings (haematoxylin and eosin staining, ×200); b ― direct immunofluorescence result (reticular pattern of fixation of IgG around keratinocytes in the stratum spinosum).

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6. Fig. 5. Patient E., 43 years old, herpes simplex complicated by allergic stomatitis (a); grouped blisters on the palatine curtain of oral mucous membrane (b); edematous and hyperemic mucous membrane in the area of hard palate (c).

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7. Fig. 6. Histological findings.

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8. Fig. 7. Patient K., 43 years old, multiforme exudative erythema on the oral mucous membrane (a) and vermillion border (b); targetlike rashes on the palm of the hand (c).

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