RESUMO
Epstein-Barr virus-positive ulcer (EBV + U) is a recently reported B cell lymphoproliferative disorder in the oral cavity, oropharynx, gastrointestinal tract and skin, principally in immunosuppressed patients. A 53-year-old female patient with rheumatoid arthritis treated with methotrexate, presenting ulcers of unknown duration on the dorsum and the lateral left border of the tongue. Excisional biopsy, histopathological analysis and histochemical stains for syphilis (Warthin-Starry), mycotic diseases (Grocott silver methenamine), tuberculosis (Ziehl-Neelsen), immunohistochemistry tests for herpesvirus type 8 (CMV), EBV (LMP-1) and DNA extraction for polymerase chain reaction (PCR) assay to CMV, EBV and herpes simplex virus-1 were performed. Posterior to PCR assay, the final diagnosis was EBV + U in the oral cavity. Acyclovir® was prescribed, showing clinical improvement. A case of EBV + U with clinical characteristics similar to other lesions or conditions has been reported. Special assays are necessary for an accurate diagnosis and treatment.
RESUMO
Resumen Los receptores ECA2 presentan una expresión génica importante en las células escamosas de la lengua y glándulas salivales, mecanismo que es conveniente para la inoculación de SARS CoV2 toda vez que busca hacer el complejo de ensamblaje mediante su glicoproteína o proteína espiga hacia el receptor ECA2 de la mucosa bucal. Una vez inoculado y favorecido por las proteasas es la llave que permite la entrada del virión en la célula huésped para su posterior replicación, aumento de carga viral y potencial desaminación e infección; los estomatólogos deben estar alerta de los mecanismos de infección en cavidad bucal para protección propia y de los pacientes que son atendidos por este personal de salud.
Abstract ECA2 receptors have an important gene expression in the squamous cells of the tongue and salivary glands, a mechanism that is convenient for the inoculation of SARS CoV2 since it seeks to make the assembly complex through its glycoprotein or spike protein towards the ECA2 receptor of the oral mucosa. Once inoculated and favored by proteases, it is the key that allows the entry of the virion into the host cell for its subsequent replication, increase of viral load and potential deamination and infection; dental professionals must be alert to the mechanisms of infection in the oral cavity for their own protection and that of the patients who are treated by this health personnel.