Dental and Medical Problems

Dent Med Probl
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ISSN 1644-387X (print)
ISSN 2300-9020 (online)
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Dental and Medical Problems

2012, vol. 49, nr 3, July-September, p. 443–449

Publication type: clinical case

Language: English

Non-Gingival Soft Tissue Growths in Patients with Chronic Graft-Versus-Host-Disease. Report of Two Cases

Zmiany rozrostowe na błonie śluzowej jamy ustnej u pacjentów z przewlekłą chorobą przeszczep przeciwko gospodarzowi – opis dwóch przypadków

Dorota Olczak-Kowalczyk1,A,D,E, Beata Wolska-Kuśnierz2,B,F, Ewa Krasuska-Sławińska3,B,F, Maja Klaudel-Dreszler2,B, Maciej Pronicki4,A

1 Department of Paediatric Dentristy, Medical University of Warsaw, Poland

2 Department of Immunology, The Children Memorial Health Institute Warsaw, Poland

3 Specialist Clinics The Children’s Memorial Health Institute, Warsaw, Poland

4 Department of Pathology, The Children Memorial Health Institute, Warsaw, Poland

Abstract

Typical manifestations of oral chronic Graft-Versus-Host Disease (cGVHD) include mucosal atrophy, erythema, erosions, pseudomembranous ulcerations, papular or reticular lichenoid hyperkeratosis and xerostomia. Exophytic lesions of soft tissue are observed less frequently. The cyclosporin A (CyA) may play a significant role in the aetiopathogenesis of the lesions. The authors report the presence of exophytic lesions located on the tongue in two male boys with cGVHD, currently aged 2.5 and 11 years, treated with CyA. Persistent mechanical injuries of the lingual mucosa were the local predisposing factors. Histopathology showed nonspecific inflammatory granulation tissue. Surgical treatment proved to be effective only by elimination of local irritations. Prevention of mechanical injuries to the mucosa of the tongue is mandatory in patients with GVHD since they contribute to the development of proliferative lesions.

Streszczenie

Typowymi zmianami występującymi u pacjentów z przewlekłą chorobą przeszczep przeciw gospodarzowi (cGVHD) są: zanik błony śluzowej, jej zaczerwienienie, nadżerki, owrzodzenia, hiperkeratyczne zmiany lichenoidalne oraz kserostomia. Zdecydowanie rzadziej występują zmiany rozrostowe na języku. W ich etiopatogenezie istotne znaczenie ma prawdopodobnie leczenie CsA. W pracy przedstawiono rozrostowe zminy egzofityczne języka występujące u dwóch chłopców w wieku 2,5 i 11 lat z cGVHD, przyjmujących CsA. Miejscowym czynnikiem predysponującym do ich wystąpienia mogły być przewlekłe urazy mechaniczne błony śluzowej języka. Zastosowane leczenie chirurgiczne okazało się skuteczne jedynie w przypadku usunięcia miejscowych czynników drażniących. U pacjentów z cGVHD jest konieczne zapobieganie urazom mechanicznym błony śluzowej jamy ustnej, predysponujących do rozwoju zmian rozrostowych.

Key words

chronic oral Graft-Versus-Host Disease, exophitic lesions, cyclosporine A, mechanical injury

Słowa kluczowe

przewlekła choroba przeszczep przeciw gospodarzowi, zmiany egzofityczne, cyklosporyna A, uszkodzenie mechaniczne

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