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Abstract(s)
As úlceras orais constituem um tipo de lesão que possui elevado índice de prevalência na mucosa oral. Este tipo de lesões, na maioria das vezes, possuem aparência clínica similar, no entanto, a sua etiopatogenia pode ser variada. A etiologia pode ser local através de irritação mecânica, malignidade e reações adversas a fármacos ou representar uma manifestação de diversas patologias sistémicas, tais como doenças mucocutâneas, gastrointestinais e infeciosas.
O diagnóstico diferencial, realizado através da análise de todas as causas possíveis de ulceração da cavidade oral, é necessário para estabelecer um tratamento apropriado a cada paciente que apresente úlceras orais. Neste sentido e com o objetivo de contribuir para o estudo diferencial das lesões ulceradas, através da sua associação com doenças sistémicas e realçando a importância da história clínica e do diagnóstico diferencial, realizou-se a análise de 20 casos clínicos de pacientes que apresentavam úlceras orais na Clínica Universitária da Universidade Católica – Pólo de Viseu. Os casos clínicos foram descritos, efetuando caracterização clínica de cada caso, avaliando a possível origem das lesões ulceradas através da recolha de toda a informação médica necessária e realizando uma análise crítica e cuidada da situação clínica de cada paciente.
Verificou-se que três pacientes avaliados apresentavam estomatite aftosa recorrente. As análises sanguíneas revelaram que existia uma diminuição dos valores normais de capacidade de fixação de ferro e ferritina em dois dos pacientes com ulceração recorrente. O tratamento de substituição administrado aos pacientes demonstrou ser eficaz, uma vez que se verificou a redução do número e severidade das úlceras orais, assim como da duração dos episódios recorrentes após um mês do tratamento. Em conclusão, pode afirmar-se que as deficiências de ferro e ferritina são parte integrante da patogénese da ulceração oral recorrente, conforme descrito anteriormente na literatura científica.
Oral ulcers represent a type of lesion that has a high prevalence rate in the oral mucosa. This type of oral lesions often possess similar clinical appearance, however, their etiology may be varied. The etiology can be local via mechanical irritation, malignancy and drug reactions or it can be a manifestation of various systemic diseases, such as infections or mucocutaneous and gastrointestinal diseases. The differential diagnosis, performed by analyzing all possible causes of oral ulceration, is necessary to establish an appropriate treatment for each patient with oral ulcers. In order to contribute to the differential study of ulcerated lesions, through its association with systemic diseases and revealing the importance of clinical history and differential diagnosis, it was conducted the analysis of 20 patients with oral ulceration at the Clinic of the Catholic University - Campus of Viseu. The clinical cases were described by performing the clinical characterization of each case, evaluating the possible origins of the ulcerated lesions and collecting all the necessary medical information to perform a careful and critical analysis of each patient’s clinical status. It was found that three of all the evaluated patients had recurrent aphthous stomatitis. Blood tests revealed that there was a decrease of the normal levels of iron-binding capacity and ferritin in two patients with recurrent ulceration. The replacement treatment given to the patients was effective, since it reduced the number and severity of oral ulcers, as well as the duration of the recurrent episodes after one month of treatment. In conclusion, it can be stated that iron and ferritin deficiencies are an integral part of the pathogenesis of recurrent oral ulceration, as previously described in the scientific literature
Oral ulcers represent a type of lesion that has a high prevalence rate in the oral mucosa. This type of oral lesions often possess similar clinical appearance, however, their etiology may be varied. The etiology can be local via mechanical irritation, malignancy and drug reactions or it can be a manifestation of various systemic diseases, such as infections or mucocutaneous and gastrointestinal diseases. The differential diagnosis, performed by analyzing all possible causes of oral ulceration, is necessary to establish an appropriate treatment for each patient with oral ulcers. In order to contribute to the differential study of ulcerated lesions, through its association with systemic diseases and revealing the importance of clinical history and differential diagnosis, it was conducted the analysis of 20 patients with oral ulceration at the Clinic of the Catholic University - Campus of Viseu. The clinical cases were described by performing the clinical characterization of each case, evaluating the possible origins of the ulcerated lesions and collecting all the necessary medical information to perform a careful and critical analysis of each patient’s clinical status. It was found that three of all the evaluated patients had recurrent aphthous stomatitis. Blood tests revealed that there was a decrease of the normal levels of iron-binding capacity and ferritin in two patients with recurrent ulceration. The replacement treatment given to the patients was effective, since it reduced the number and severity of oral ulcers, as well as the duration of the recurrent episodes after one month of treatment. In conclusion, it can be stated that iron and ferritin deficiencies are an integral part of the pathogenesis of recurrent oral ulceration, as previously described in the scientific literature
Description
Keywords
Ulceração oral Úlceras orais recorrentes Classificação de úlceras orais Diagnóstico de úlceras orais Anomalias hematológicas Doenças sistémicas e úlceras orais Oral ulceration Recurrent oral ulcers Oral ulcer classification Oral ulceration diagnosis Hematologic abnormalities Systemic diseases and oral ulcers