RESUMO
Objective: The aim of this report is present a rare case of oral Mucous Membrane Pemphigoid (MMP) in a 9-year-old-boy successfully treated with low doses of systemic corticosteroid. Case description: A 9-year-old boy was referred to our service with the complaint of painful gingiva and generalized burning mouth sensation over 1 year. Intraoral examination revealed desquamative lesions affecting the entire attached gingiva of both the maxilla and the mandible. After the incisional biopsy the MMP diagnosis was confirmed, and the patient was initially treated with dexamethasone 0,1mg/Ml mouth rinse twice daily for 24 weeks. Due the difficulty in eating and the presence of persistent large oral lesions, systemic prednisone 20 mg (1 mg/Kg) was prescribed for 4 weeks with a 5 mg gradual reduction per week over 3 weeks. After initiating the systemic corticosteroid therapy, the patient showed total regression of the lesions, and no indication of recurrence has been observed in the past 6 months. Conclusion: There is no cure for MMP; however, treatment can provide complete and long-lasting remission. Based on this premise, it is plausible to consider not only topical but also low doses of systemic corticosteroids in resistant cases of oral MMP, even in children. These measures could improve the quality of life of these patients by reducing pain and, consequently, improving the child's eating behavior.
Objetivo: O objetivo deste relato é apresentar um caso raro de Penfigóide Benigno das Membranas Mucosas (PBMM) em um menino de 9 anos de idade tratado com sucesso com baixas doses de corticosteróide sistémico. Relato de caso: Um menino de 9 anos de idade foi encaminhado ao nosso serviço com a queixa de gengiva dolorida e sensação de queimação na boca há aproximadamente 1 ano. Ao exame físico intraoral constatou-se a presença de lesões descamativas que afetavam toda a gengiva inserida, tanto na maxila quanto na mandíbula. Após a realização de uma biópsia incisional o diagnóstico de PBMM foi confirmado, e o paciente foi inicialmente tratado com elixir de dexametasona 0,1mg / ml duas vezes por dia durante 24 semanas. Devido a dificuldade em comer e a presença de grandes lesões orais persistentes, foi prescrito prednisona sistêmica 20 mg (1 mg / Kg) por 4 semanas com uma redução gradual de 5 mg por semana durante 3 semanas. Depois de iniciar a corticoterapia sistêmica, o paciente apresentou regressão total das lesões, e nenhum sinal de recorrência tem sido observado nos últimos 6 meses. Conclusão: Não há cura para o PBMM; no entanto, o tratamento pode proporcionar a remissão completa e de longa duração. Com base nesta premissa, é plausível considerar a terapia tópica, mas também a utilização de corticosteroides sistêmicos em casos resistentes de PBMM oral, mesmo em crianças. Estas medidas poderiam melhorar a qualidade de vida desses pacientes, reduzindo a dor e, consequentemente, melhorando a alimentação da criança.
RESUMO
Complementary DNA (cDNA) is valuable for investigating protein structure and function in the research of life science, but it is difficult to obtain by traditional reverse transcription. In this study, we employed a novel strategy to clone the human leukemia inhibitory factor (hLIF) gene cDNA from genomic DNA directly isolated from the mucous membrane of mouth. The hLIF sequence can be acquired within a few hours by means of amplification of each exon and splicing using overlap-PCR. Thus, the new approach developed in this study is simple, time- and cost-effective, and it is not limited to particular gene expression levels of each tissue.
Assuntos
Humanos , DNA Complementar/genética , Fator Inibidor de Leucemia/genética , Mucosa Bucal , Sequência de Bases , Clonagem Molecular , Splicing de RNA/genética , Éxons/genética , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
El liquen plano oral (LP) es una enfermedad mucocutánea crónica, de carácter inflamatorio, etiología desconocida y naturaleza autoinmune, en la que se produce una agresión por parte de los linfocitos T dirigida frente a las células basales del epitelio de la mucosa oral. Clínicamente se manifiesta como formas reticulares o atrófico-erosivas y potencialmente puede afectar a la piel y mucosas, siendo frecuente que las lesiones bucales precedan a las cutáneas o que sea única la localización intraoral. El diagnóstico del LPO debe basarse en la observación clínica y confirmarse con la descripción de las características histopatológicas. Hay una serie de criterios clínicos e histopatológicos importantes para sentar el diagnóstico de una manera concluyente. La etiopatogenia es desconocida, aunque hay suficientes datos que permiten suponer que los mecanismos inmunológicos son fundamentales en la iniciación y perpetuación del proceso. Hoy día se acepta que el LPO representa una respuesta inmune mediada por células en la que existe una interacción linfocito-epitelio dirigida contra antígenos de los queratinocitos basales del epitelio que culmina con la degeneración del estrato basal del epitelio. Se presenta caso clínico de paciente femenino de36 años de edad que acudió a consulta odontológica en la Facultad de Odontología de la Universidad de Cartagena por presentar descamaciones ubicadas en encía vestibular zona de de antero superiores de varios meses de evolución, sintomática. La paciente manifiesta episodios de stress constante en los últimos meses. Se le realizó biopsia incisional y se envió a patología donde se confirmó el diagnóstico de Liquen Plano
Oral lichen Planus (LP) is a chronic mucocutaneous disease, an inflammatory autoimmune nature and unknown etiology, which produces an aggression directed against T lymphocyte cells of the basal epithelium of the oral mucosa. Clinically it shows reticular or atrophic-erosive forms and can potentially affect the skin and mucous membranes, where oral lesions often precede the skin or intraoral location is unique. The diagnosis of OLP should be based on clinical observation and confirmed with the description of the histopathological changes. There are an important number of clinical and histopathological criteria important to establish the diagnosis of a conclusive manner. The pathogenesis is unknown, although there are sufficient data suggesting that immunological mechanisms are essential in the initiation and perpetuation of the process. Today it is accepted that the LPO is a cell-mediated immune response in which there is a lymphocyte interaction directed against epithelial antigens of the basal keratinocytes of the epithelium leading to the degeneration of the basal layer of the epithelium. We present clinical the case of a 36 years old female patient who visited the Dental School of Dentistry, University of Cartagena for showing a descamative lesion in the upper vestibular gingival, located in the anterior area with several months of development, with no symptoms, as.the patient referred, In addition, the patient commented to be under stressfull episodes in the latest months. Incisional biopsy was performed and sent to pathology which confirmed the diagnosis of lichen planus