Lichen planus of the tongue
Introduction
Introduction to Tongue Flat Moss Lichenplanus is a chronic inflammatory disease of the skin and mucous membranes and is one of the common diseases of the oral mucosa. The cause is still inconclusive. May be related to infection, mental, endocrine, systemic diseases, genetics and immunity. It is believed that lichen planus is caused by low immune function, which may lead to susceptibility to an unidentified virus, and suggests that the patient has a humoral immune disorder. Other scholars considered that the level of IgA in erosive lichen planus was higher, and immune complexes were deposited in the basement membrane area, indicating that cellular immunity was involved in the pathogenesis of lichen planus. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: sublingual gap infection
Cause
Cause of tongue lichen planus
Infection factor (25%):
It was thought to be related to viral and bacterial infections in the early days, but there is no conclusive evidence. There are many female patients with this disease, and the fluctuation of the condition is related to pregnancy, menopause and some drugs that affect endocrine function. In patients with estradiol, testosterone levels are much lower than normal.
Mental factors (3%):
Due to various reasons such as environment, family, work, personal life, etc., the physical and mental activities are affected, the spirit is traumatized, nervousness, anxiety, depression, etc., causing a series of changes in the body, such as psychology, pathology, biochemical metabolism, etc. disease.
Genetic factors (8%):
Some people have found that this disease has a family history tendency. Many scholars have carried out family disease research, but the pedigree analysis does not conform to the single gene inheritance law. Many studies have been conducted from HLA (human leukocyte antigen). The HLA-type gene carried in patients with familial lichen planus was significantly higher than that of non-familial lichen planus, suggesting that the incidence of lichen planus may be related to genetic factors.
Immunity factor (5%):
It is now believed that lichen planus is caused by low immune function, which can lead to susceptibility to an unidentified virus, and suggests that patients have humoral immune disorders. Other scholars considered that the level of IgA in erosive lichen planus was higher, and immune complexes were deposited in the basement membrane area, indicating that cellular immunity was involved in the pathogenesis of lichen planus.
Trace element
When detecting trace elements in the hair of patients, it was found that zinc, iodine, etc. were lower than normal, and nickel was higher than normal.
2. Systemic disease factors
Patients with lichen planus are often associated with a variety of systemic diseases or symptoms. Many patients with pathogenesis and disease development are associated with certain systemic diseases such as diabetes, hepatitis, hypertension, and gastrointestinal dysfunction.
3. Local stimuli
Different metal restorations form a potential difference in the mouth. In addition, the stimulation of the filling, etc., can cause a mossy change in the oral mucosa.
Prevention
Tongue lichen planus prevention
1, to eliminate mental stress, to maintain a comfortable mood, to avoid depression, to miss over thinking, and to strive for a regular life.
2, at the same time to establish good oral hygiene habits. Remove the lesion, treat the affected tooth, scrape off the calculus on the buccal surface of the molar, remove or replace the defective prosthesis that can cause the potential difference; avoid the local mucous membrane of the toothbrush.
3, the diet should be light and delicious, rich in nutrition, can not be over-eating cream, fried, grilled products, alcohol quit smoking, eat spicy, but also actively treat systemic diseases, such as correcting hyperviscosity, regulating menstruation, conditioning the stomach Digestive function, etc.
Complication
Tongue lichen planus complications Complications sublingual infection
The tip of the tongue is less common and can infect the tongue ligament.
Symptom
Symptoms of Tongue lichen planus Common symptoms Oral mucosa ulcers Mirror surface Tongue skin Mild erosion Oral mucosa Diffuse congestion
The lichen planus of the tongue accounts for 44% of the oral lesions. The lesions occur in the tip of the tongue in the 2/3 area of the tongue, the tongue and the tongue and abdomen. The early damage of the tongue is papular, gray and blue, and the filamentous nipple is involved. A round or oval gray-white plaque is formed, which has a rough feeling. When the tongue nipple shrinks, it becomes a bright red or dark red smooth spot, which can be erosive, and the tongue back lesion can also have a mixed lesion of nipple proliferating keratinization and partial atrophy. If the lesion has obvious hyperplasia, it is easy to be confused with leukoplakia. The tongue and abdomen lesions are mostly reticular, dendritic or striped, and the tip of the tongue is less common. It can invade the tongue ligament, and the ventral lesion of the tongue has long-term congestion and ulceration. It should be followed up and, if necessary, biopsy to rule out cancer.
Examine
Examination of lichen planus
The advent of oral endoscopy has brought a new paradigm for oral examination and treatment, without the need for more description or expertise when the patient's pathology is presented to the patient. Patients can also understand the urgency of treatment.
Oral endoscope normal value: normal person's mouth is smooth, smooth, smooth, oral mucosa is pink.
The clinical significance of oral endoscopy: doctors can further discover the patient's oral lesions with the help of clear and intuitive images, and take various treatment measures in time. Abnormal results are abnormal signs caused by the disease, such as redness and swelling of the oral mucosa, blisters, ulceration or spots.
Diagnosis
Diagnosis and differentiation of tongue lichen planus
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Identification with oral leukoplakia.
Oral leukoplakia is sometimes similar in morphology to lichen planus plaques, leukoplakia occurs in middle-aged men, lichen planus occurs in middle-aged women, lichen planus is a compound disease of the skin and mucous membranes, and leukoplakia is only found in mucous membranes, if there is no obvious chronic Stimulating factors, there are reticular lesions in the lesion area, regardless of the size of the area, the possibility of lichen planus is large. For isolated plaque oral mucosa lichen planus, biopsy is often needed to make a correct diagnosis.
