Avaliação clínica das lesões orais associadas a doenças dermatológicas

Abstract

BACKGROUND: Dermatologic diseases are not only represented by lesions affecting the skin but also by manifestations that may involve the mucous membranes, including oral mucosa. OBJECTIVES: To evaluate the frequency of oral manifestations associated with dermatologic diseases considering location and clinical characteristics of the lesions found and also gender, age and race of patients. METHOD: It was an observational, cross-sectional study of patients who sought for treatment at the Dermatology Service of the University Hospital (Hospital Presidente Dutra-HUPD); UFMA, between October 2007 and October 2008 (n=88) . RESULTS: Age varied from 5 to 88 and there was predominance of female patients. 35% of the cases studied were diagnosed as lichen planus; 33% as lupus erythematosus; 24% as erythema multiforme; 7% as pemphigus vulgaris and 1% as pemphigoid group. Oral manifestations were more common among patients suffering from lichen pplanus (51%) and lupus erythematosus (20%). The most common clinical presentation found was reticular lichen planus located most predominantly in the buccal mucosa. CONCLUSIONS: It is essential that dentists know these pathologies to be able to diagnose them in an early stage of the disease and to direct patients to adequate treatment. Furthermore, intraoral examination should be included as a routine practice in dermatological services. Keywords: Dermatology; Diagnosis, oral; Oral manifestations Resumo: FUNDAMENTOS: As doenças dermatológicas não estão representadas apenas pelas lesões que afetam a pele, mas, também, por manifestações que podem envolver as mucosas, inclusive a mucosa oral. OBJETIVOS: Avaliar a frequência das manifestações orais em pacientes com doenças dermatológicas, considerando-se a localização e as características clínicas das lesões encontradas, o sexo, a idade e a raça dos acometidos. MÉTODOS: Estudo observacional, do tipo transversal, com pacientes que procuraram atendimento no Serviço de Dermatologia do Hospital Universitário Presidente Dutra (HUPD) da Universidade Federal do Maranhão (UFMA) entre outubro de 2007 e outubro de 2008 (n=88). RESULTADOS: A idade variou entre cinco e 88 anos, e o sexo feminino foi o mais atingido (2:1). Dos casos examinados, 35% eram de líquen plano, 33% de lúpus eritematoso, 24% de eritema multiforme, 7% de pênfi-go vulgar e 1% do grupo penfigoide. As lesões orais foram mais frequentes nos portadores de líquen plano (51%) e lúpus eritematoso (20%). O líquen plano reticular foi a forma clínica mais comum e a mucosa jugal, o sítio mais acometido. CONCLUSÕES: O conhecimento dessas patologias pelo cirurgião-dentista é de fundamental importância, cabendo-lhe uma parcela de responsabilidade pelo diagnóstico precoce e orientação para o tratamento adequado. Além disso, o exame intraoral deve ser incorporado como prática de rotina durante o atendimento dermatológico.

Estudo epidemiológico das doenças dermatológicas imunologicamente mediadas na cavidade oral

“…20 Diagnosis is confirmed by histopathology, which reveals intraepidermal acantholytic blisters just above the basal layer. 6,14,21 With respect to frequency, this disease is characterized by being rare. According to Bystryn et al, it occurs in 0.75 to 5 cases per million individuals per year; however, these figures also depend on geographical location.…”

“…Clinically, the blisters are taut, with serous and/or hematic contents and are situated over erythematous, urticarious or normal skin. 6,8,17,19,24 Schellinck et al estimate the incidence of BMMP at 1.5 to 9.6 new cases per 100,000 inhabitants per year. 25 In the present study, only 5 cases were found, with a greater prevalence in women and in individuals over 50 years of age, confirming reports found in the literature.…”

“…2,4 Pemphigus vulgaris is characterized by the formation of intraepithelial blisters that result from the disintegration or loss of cellular adhesion, with the consequent loss of intercellular connections known as acantholysis. 5,6 After the blisters have burst, diffuse ulceration follows, leading to debilitating pain, fluid loss and electrolyte imbalance. Its pathogenesis is characterized by the abnormal production of autoantibodies against the surface glycoproteins of the epithelial cells known as desmoglein 1 and desmoglein 3, which are components of the desmosomes.…”

A study on oral mucosal lesions in 3500 patients with dermatological diseases in South India

“…in 2009, evaluated 88 patients with dermatological diseases and suggested the frequency of oral mucosal lesions was 35.7%. [8] Suliman et al . in 2001, observed the prevalence of oral mucosal lesions in patients with dermatological diseases was 57.9% in Sudanese population.…”

Systemic Lupus Erythematosus and implications for the oral cavity

“…In the study by Umbelino Junior et al (2), in which the incidence of oral manifestations in SLE was assessed, a prevalence of oral lesions of 6.5% was observed, hairy leukoplakia in 3.7% and candidiasis in 20.0% of SLE cases. Although there is a frequency of oral lesions in SLE, overall, the specific prevalence of oral manifestations in females is low (47,49).…”