Recurrent aphthous stomatitis / Шинэ санаа Шинэ нээлт

@#Aphthae are common oral lesions that affect approximately 10% to 20% of the population. Recurrent Aphthous Ulcers (RAU) are usually classified into three different types: minor, major and herptiform RAU. The etiology of aphthous stomatitis is unknown but according to increasing evidence, its development has an immunogenic process that causes the ulceration of the involved oral mucosa. Similar-appearing lesions may arise in following systemic disorders: 1. Behcet’s disease 2. Sweet’s syndrome 3. Cyclic neutropenia 4. Benign familial neutropenia 5. MAGIC syndrome 6. A periodic syndrome with fever and pharyngitis 7. Various nutritional deficiencies with or without underlying gastrointestinal disorders Several studies from the UK, United States, and Spain have demonstrated that hematinic deficiency (iron, folic acid, or vitamin B12) are twice as common in RAS patients than incontrols. Case report: A 10 year old male patient presented a 3-year history of episodes of multiple minor recurrent Ulcers, this year major aphthae on the anterior ventral surface of the soft palate. Patient had difficulty in eating and in speech. Clinical examination revealed multiple symptomatic ulcers with a perilesional erythematous halo covered with a pseudomembrane. The size of major aphthae was than 20 mm in diameter. The ulcers were not associated with any type of discharge. The ulcers were tender on palpation. The medical history and the family history were non-contributory. A clinical diagnosis of major aphthous ulcers was made on the basis of the history and the clinical examinations. The patient was subjected to a therapeutic regimen consisting of daily topical application of Prednizoloni 0.05%, topical lidoksor and systemic vitamin and Cefatoxime Natrii, Immunomodulators Biferon, Amphotericin B. Recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) remains a common oral mucosal disorder in most communities of the world. Proper systemic evaluation is important before prescribing the medication.

STUDY OF “AKHIZUNBER” SOLUTION FOR THE TREATMENT OF INFLAMMATORY ORAL STOMATITIS / Шинэ санаа Шинэ нээлт

@#ABSTRACT. Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.

Utility of dermatoglyphics as a non-invasive diagnostic tool inrecurrent aphthous stomatitis / Utilidade da dermatoglifia como ferramenta diagnóstica não invasivapara estomatite aftosa recorrente

Introduction: Dermatoglyphics is an advancing branch of medical science in which the dermal ridge patterns are studied and used in prediction of genetic disorders. Objective: To assess the usefulness of dermatoglyphics, as a non-invasive early predicator in RAS, since genetics plays a role in both. Materials and methods: This case control study comprised of 40 patients with recurrent aphthous stomatitis compared to 30 control subjects of similar age and sex. All subjects were investigated for their dermatoglyphic patterns of both hands, which were obtained by smearing the ink uniformly over the palm and fingers and pressing the hands firmly against the good quality paper. Qualitative analysis of prints was done for arches, loops and whorls and quantitative analysis included Total Finger Ridge Count (TFRC) and atd angle. Fisher’s Exact Tests were used to evaluate the significance between recurrent aphthous stomatitis and the dermatoglyphic features. Results: Among various dermatoglyphic parameters analyzed, recurrent aphthous stomatitis patients showed 9% arches, 62% loops and 29% whorls as the finger ridge configuration. In comparing the results between the two groups, the frequency of arches was observed more in study group while composite whorl and the nar pattern were more frequent in control group, the results were statistically significant (p < 0.05). In addition to this, study group patients demonstrated higher frequency of total finger ridge count, and control group showed higher frequency for atd angle on both hands, statistically significant difference is observed (p < 0.05). Conclusion: The study found significant correlation between palmar dermatoglyphics and recurrent aphthous stomatitis, suggesting that genetics is one of the host risk factor associated with the latter, and could aid in early detection of the disease.

Introdução: Dermatoglifia é um avançado ramo da ciência médica em que os padrões de cristas dérmicas são estudados e utilizados para predizer distúrbios genéticos. Objetivo: Avaliar a utilidade da dermatoglifia, como método de diagnóstico não invasivo para a estomatite aftosa recorrente, uma vez que a genética desempenha um papel em ambos. Materiais e métodos: Estudo caso-controle composto por 40 pacientes com estomatite aftosa recorrente comparados a 30 controles de mesma idade e sexo. Todos os sujeitos foram avaliados quanto a seus padrões dermatóglifos de ambas as mãos. Os padrões dermatóglifos foram obtidos espalhando uniformemente uma tinta sobre a palma da mão e os dedos e pressionada firmemente contra um papel de boa qualidade. A análise qualitativa das impressões foi feita por arcos, laços e espirais e a análise quantitativa pela contagem total da polpa do dedo (TFRC) e ângulo atd. Teste de Fischer foi utilizado para avaliar a significância entre estomatites recorrentes e características dermatoglíficas. Resultados: Entre os vários parâmetros dermatoglíficos analisados, os pacientes com estomatite aftosa recorrente mostraram 9% de arcos, 62% de laços e 29% de espirais na configuração da polpa digital. Ao comparar os resultados entre os dois grupos, a frequência de arcos foi mais observada no grupo de estudo, enquanto verticilos e padrão tênar foram mais frequentes no grupo controle, com resultados estatisticamente significativos (p < 0,05). Além disso, os pacientes do grupo de estudo demonstraram maior frequência de contagem total da polpa digital e o grupo controle apresentou maior frequência para o ângulo atd em ambas as mãos, com diferenças estatisticamente significativas (p < 0,05). Conclusão: O estudo encontrou correlação significativa entre a dermatoglifia palmar e estomatites recorrentes, sugerindo que a genética é um dos fatores de risco de hospedeiro associado com estomatite aftosa recorrente, e poderia ajudar na detecção precoce da doença.

Expresión de moléculas de adhesión y subpoblaciones linfocitarias en lesiones de pacientes con Estomatitis Aftosa Recurrente

Introducción: La Estomatitis Aftosa Recurrente (EAR) es una condición muy común, caracterizada por la recurrencia de úlceras en la mucosa bucal no queratinizada. Actualmente las investigaciones dirigidas a determinar la etiología de la EAR, se enfocan hacia el componente inmunológico, la evidencia más relevante indica que los individuos afectados, presentan alteración de la respuesta inmunológica mediada por células. Adicionalmente, existe atención en destacar la importancia y participación de las moléculas de adhesión en el reclutamiento del infiltrado inflamatorio en esta condición. Objetivo: Determinar la expresión de las moléculas de adhesión ICAM-1, VCAM-1 y las subpoblaciones de linfocitos T CD4+ y CD8+, en lesiones de pacientes con EAR. Material y Método: Se incluyeron 19 pacientes de los cuales 15 presentaban EAR Menor y 4 tenían EAR Mayor. El grupo control incluyó muestras de encía de 10 pacientes sin historia de EAR. A los pacientes les fue realizada una biopsia de la lesión que fue procesada por inmunohistoquímica. Resultados y Conclusión: Se observó un marcado aumento en las subpoblaciones de linfocitos, especialmente de los CD8+, lo que sugiere la implicación de los linfocitos T, y de una respuesta inmune mediada por células activadas, en la patogénesis de esta entidad. La expresión de las moléculas de adhesión de los pacientes con EAR, fue mayor en comparación con el grupo control, siendo estas diferencias estadísticamente significativas. Con respecto a ICAM-1, se observó un fuerte marcaje en el corion-infiltrado seguido del corion-endotelio y epitelio, mientras que en relación a VCAM-1 fue similar en corion-infiltrado y corion-epitelio. Estos resultados implicarían a las moléculas de adhesión jugando un papel importante en las interacciones celulares y en el reclutamiento del infiltrado celular inflamatorio, pudiéndose convertir en blanco para el daño citotóxico y contribuyendo de esta forma, a la ruptura del tejido que ocurre en los sitios de ulceración.

Recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease characterized by aphthous ulcerations in the oral mucosal. Actually the investigations have been directed to determine the etiology of the RAS with special attention to the cellular immune response. Aditionally, is very important to determine the rol of the adhesion molecules in this condition. The purpose of this work was to determine the of the adhesion molecules expression, ICAm-1, VCAM-1, CD4 and CD8 cell count in patients with RAS. We evaluated 19 patients, 15 with RAS minor and 4 with major RAS. The control group included oral health tissue of subjects without RAS. We observed a higher level of CD8 cell count that suggest the implication of T cells and cellular immune response in the pathogenesis of this entity. The adhesion molecules expression was higher than in the control group. These results suggest that the adhesion molecules may play an important role in the cell interactions that we observed in this entity.