• Journal of Oral Medicine and Pain
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• 제48권4호
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• pp.174-180
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• 2023

Pemphigus vulgaris (PV) is a chronic autoimmune bullous disease caused by autoantibodies to proteins in the oral mucosa and skin. It is a rare disease with an annual incidence of 2.059 per million in South Korea. In many patients with PV, oral mucosal lesions precede other lesions elsewhere, and oral lesions can be the only manifestation. Early diagnosis is important because the disease has a high mortality rate if untreated appropriately in the early stages, and rapid treatment initiation is associated with rapid disease control. Oral PV lesions are clinically variable. In this study, we describe oral PV lesions in a 60-year-old woman, a 75-year-old man, and a 60-year-old man presenting with various clinical presentations. Oral PV lesions can affect any part of the oral mucosa, including the buccal mucosa, gingiva, tongue, palate, and free mucosa, and can vary in appearance from desquamative gingivitis, painful ulcers, and erosions to aphthous-like stomatitis. Clinicians should be aware of the difficulty of early diagnosis in PV, particularly when oral lesions are the only manifestation, and should consider many factors, including the patient's age, to make an accurate diagnosis and manage oral lesions to improve the patient's quality of life and avoid delayed diagnosis.

• Journal of Oral Medicine and Pain
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• 제38권1호
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• pp.7-17
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• 2013

구강점막질환과 성격유형과의 관련성을 규명하고자 경기도 지역 대학에 재학중인 학생 393명(평균연령 $21.2{\pm}3.1$세, 남자 184명, 여자 209명)을 대상으로 MBTI 검사와 설문조사를 실시하여 다음과 같은 결과를 얻었다. 1. 미각이상(p<0.05)과 구강 건조증(p<0.01)은 외향성(E)보다 내향성(I)에서 높은 빈도를 보였다. 2. 헤르페스성 구내염, 재발성 아프타성 궤양, 설염, 미각이상, 구강 작열감 증후군, 구강 건조증은 직관형(N)보다 감각형(S)에서 빈도가 높은 경향을 보였다. 3. 16가지 성격유형 중 NF를 포함하는 유형은 구강점막질환 증상 발생빈도가 높은 경향을 보였다. 4. 구강점막질환 증상 발생 시 대처 방법에 있어서는 저절로 낫기를 기다리며 그냥 둔다는 응답이 가장 많았으며(p<.0001), 이 응답자 중 헤르페스성 구내염(p<0.01)과 미각이상(p<0.05) 경험자의 경우 내향성(I)이 외향성(E)보다 많았다. 5. 성격이 예민한 편이거나 신경질적인 경우가 구강점막질환 증상 발생빈도가 높은 경향을 보였다. 따라서 구강점막질환 치료시 환자의 개별적인 성격 유형에 맞는 지침을 개발하는 것이 필요하리라 사료된다.

• Journal of Oral Medicine and Pain
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• 제21권1호
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• pp.141-152
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• 1996

Oral Lichen Planus(OLP) is a idiopathic chronic inflammatory disease with more difficult to clear and higher recurrent rate than cutaneous lesions. But, there has been no estabilished theories about the proper treatment for OLP. The purpose of this study is to examine the clinical feature, relationship with systemic disease and dental treatment of OLP patients of Korea and to gain helpful information about clinical characteristics and treatment of OLP. The subjects chosen for the study were 54 patients who had visited Department of Oral Diagnosis & Oral Medicine at Yonsei University Dental Hospital Dental Hospital and diagnosed as OLP. Previous clinical records has been reviewed and questionnaires, oral examination, laboratory examination were done and recorded. The following results were obtained : 1. Of the 54 patients, 21 were men and 33 were women with an average age of 47.8 years. 2. The most common intraoral site was bilateral buccal mucosa, followed by unilateral buccal mucosa, gingiva, vesibule, lip mucosa, glossal mucosa, palatal mucosa and mouth floor. 3. The mixed, erosive and reticular form of OLP was most frequent(83.3%) clinical form. 4. OLP patients with liver disease were 5, and drug medication patients were 7. But, we could not find its evidence of association with OLP. 5. Associated events on onset of symptom were stress, denture wearing, dental treatemtn, and common cold. 6. Associated symptoms were dry mouth, tingling, sore throat, and altered taste perception. 30.8% of patients had no specific associated symptoms. 7. Aggravating factors of symptom were peppery food, hot food, fatigue, toothpaste, salty food, sour food, tension, and conversation. Reducing factors were cold food, sleeping. 69.2% of patients had no specific reducing factors. 8. There were no significant differences between normal papulation and OLP patients in CBC, SGOT< SGPT, Serum iron, Total iron binding capacity. 66.7% of subjects were positive response to fungus study for Candida Albicans. The incidence of stress and dental treatment on onset of symptom appeared high in OLP patients. Especially, high incidence of positive response to fungus study for Candida albicans, prescription of anti-fungal agents and dental treatment considerations may be helpful to treatment of OLP.

• Journal of Oral Medicine and Pain
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• 제42권3호
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• pp.81-84
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• 2017

Oral submucous fibrosis (OSF) is a premalignant condition characterized by juxtaepithelial fibrosis of the oral cavity. The clinical manifestations include burning sensation to spicy food, blanched oral mucosa with palpable fibrous bands, trismus, depapillation of tongue, and dry mouth. As OSF is predominantly seen in people of the Indian subcontinent, cases of this disease have been rarely reported in South Korea. We present a case of OSF in a Sri Lankan man living in South Korea and emphasize the importance of enhancing knowledge of this disease while the number of immigrants is increasing.

• 대한기관식도과학회지
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• 제10권2호
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• pp.72-75
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• 2004

Pemphigus vulgaris is a rin, chronic intraepidermal bullous disease with potentially fatal outcome. Oral lesions precede skin lesions in at least $70\%$ of cases, and in cutaneous disease, concomitant oral lesions are encountered in $90\%$ of patients. This disorder involve the skin and mucous membranes, especially the oral and pharyngeal mucosa, but may also involve the nasal, oropharyngeal, laryngeal and esophageal mucosa. Oral lesions are initially vesicobullous but rapidly rupture, leaving a painful erosion that shows little tendency to heal. Pemphigus vulgaris affecting the oral mucosa is still diagnosed only after considerable delay, because oral ulceration in common, and clinicians believed the lesions to be caused by more common conditions such as recurrent aphthous stomatitis rather than a rare disorder such as pemphigus vulgaris. The definitive diagnosis of pemphigus vulgaris should be undertaken as early as possible, so that treatment can be started at an earl·y stage. Because of the presence of nonspecific oral ulcer, high degree of suspicion is often required to ultimately make the diagnosis of pemphigus vulgaris and then we report a case of pemphigus vulgaris with a literature review.

• Journal of Oral Medicine and Pain
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• 제6권1호
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• pp.83-90
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• 1981

This study was undertaken to study the changes of epithelium of oral mucosa caused by diabetic disease in terms of keratinization and morphology of epithelial cells of oral mucasa, and to diagnose the oral diseases caused by systemic origns in terms of oral exfoliative cytology as a diagnostic tool. The author has studied the changes of epithelial cells on the cheek mucosa and upper antirior gingiva of 20 adult diabetic patients by Oral Exfoliative Cytology. And 50 healthy adults were selected as control group. The cytologic smears were stained by Papanicolaou method. The results were as follows : 1. In diabetic patient's cheek mucosa, Yellow staining cells were reveald as 11.8%, which was higher than the control group(4.2%). 2. In diabetic patients' upper anterior gingiva, Yellow staining cells were reaveale as 12.4%, which was lower than the control group(68.2%) 3. The changes of nucleus and cytoplasmic changes were not significantly different in diabetic patients and control group.

• 대한치과의사협회지
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• 제50권12호
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• pp.732-742
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• 2012

White lesions of the oral mucosa are a common clinical finding that often present first to general dentist. Some white lesion may have possibility of malignancy. Leukoplakia is the most common "potentially malignant disorder" of the oral mucosa. Leukoplakia is at present defined as "A white plaque of questionable risk having excluded (other) known disease or disorders that carry no increased risk for cancer.". Therefore, it is important for general dentist to be familiar to clinical differential diagnosis of leukoplakia from the known white lesions such as candidiasis, lichen planus, leukoedema, frictional keratosis, and so on. It is also important to decide whether such lesions require further investigation through the biopsy. As a result of biopsy, the presence of epithelial dysplasia in the leukoplakia is still the strongest predictor of future malignant transformation. In this article, oral white lesions that must be differentiated from potentially malignant disorders or early invasive squamous cell carcinoma will be reviewed together with presenting clinical cases.

• Journal of Oral Medicine and Pain
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• 제23권3호
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• pp.257-261
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• 1998

Angiokeratoma is a cutaneous vascular disorder that occurs at any sites as trunk,extremities, fingers and toes etc. Although solitary or multiple cutaneous lesions have been reported, oral lesions have been very care. A 72-year-old man who had an exophtic, essile mass with dark red, black colored which located on buccal mucosa, was treated with excisional biopsy. He had no specific systemic history except for the medication of allopurinol, for treatment of gout since 10 years. Final diagnosis was determined as angiokeratoma by evaluation of clinical and histopathological finding, and the lesion has not been recurred for two months by decrease of allopurinol. It has been emphasized that the relationship between oral mucosal disease and the complication of allopurinol. Allopurinol is widely used for gout treatment, which we will report a case on the allopurinol-associated angiokeratoma in the oral mucosa.

• Journal of Oral Medicine and Pain
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• 제45권3호
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• pp.71-78
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• 2020

While oral melanotic macule is regarded as the most frequent oral pigmented lesion without any harmful symptom, oral melanoma is a very rare and life-threatening disease among oral pigmented lesions. Oral melanotic macule has previously been described as benign, with no malignant potential. However, a few case reports have raised the question of malignant potential of oral melanotic macule. In this case report, we present a case of coexistence of oral melanotic macule and oral melanoma. A 66-year-old man with a chief complaint of black pigmentation on gingiva showed the lesion spread out on the right palatal gingiva, the right maxillary buccal gingiva and the right buccal mucosa, appearing to merge with one another. Biopsies were performed on the right palatal gingiva and the right buccal mucosa. While the lesion on the right palatal gingiva was diagnosed as an oral melanotic macule, the other lesion on the right buccal mucosa was diagnosed as an oral melanoma. The present case implied the possibility of malignant potential of oral melanotic macule. Therefore, oral melanotic macule needs careful periodic observation for early detection and prompt treatment of the transformed oral melanoma.

• Journal of Oral Medicine and Pain
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• 제26권2호
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• pp.121-126
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• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.