Клінічні прояви саркоїдозу на червоній облямівці губ і слизовій оболонці порожнини рота, тактика лікаря-стоматолога

Abstract

Останніми десятиліттями спостерігається неухильне зростання захворюваності на саркоїдоз. Особливе значення має той факт, що уражує ця патологія людей молодого і середнього віку. Для встановлення правильного діагнозу при рідкісних хворобах стоматолог мусить мати високий професійний рівень, використовувати міждисциплінарний підхід у діагностиці та веденні пацієнтів із цією патологією; В последние десятилетия наблюдается неуклонный рост заболеваемости саркоидозом. Особое значение имеет тот факт, что поражает эта патология людей молодого и среднего возраста. Для установления правильного диагноза при редких болезнях стоматолог должен иметь высокий профессиональный уровень, использовать междисциплинарный подход в диагностике и ведении пациентов с данной патологией; The statistics indicates on the tendency of morbidity rate of sarcoidosis to increase. The pathology affects young and older people notably. Sarcoidosis becomes a common chronic disease, which is often difficult to diagnose. Insufficient experience in recognition of this disease leads to misdiagnosis and ineffective treatment. All mentioned above highlights the extreme relevance of this issue. Sarcoidosis is a multisystem inflammatory nature disease of unknown etiology. The hereditary predisposition is taken to be but the whole family cases are also known. An abnormal immune response is also considered among the theories of the development of the disease. The infectious factor is also regarded as the cause of the disease. The increasing activity of lymphocytes, which start to produce substances promoting the formation of the granulomas, which are considered to be the basis for the pathological process, can initiate the onset of the disease. The maximum morbidity rate of sarcoidosis is observed between the ages of 35 to 55 years. Two age periods of the peak in male population are 35-40 years and about 55 years. The rate of sarcoidosis morbidity among female population is 65%. Up to 700 new cases of sarcoidosis are registered in Ukraine annually. The clinical signs of sarcoidosis vary. This pathology is more often manifested by the bilateral lymphadenopathy of lung roots, eyes and skin lesions. The liver, spleen, lymph nodes, heart, nervous system, muscles, bones and other organs can also be affected. In dental practice sarcoidosis can be manifested on the prolabium, oral mucosa and salivary glands. Blood laboratory indices (the increased level of calcium) are changed in sarcoidosis. Chest X-ray, MRI and CT also demonstrate changes in the lungs. The test for detection of granulomas shows positive Kveim reaction (the formation of purple-red nodules due to administration of antigen). Biopsy and bronchoscopy facilitate detection of both direct and indirect signs of sarcoidosis of the lungs. A general treatment of sarcoidosis is provided by a pulmonologist, who can assess the severity of the lesion and provide appropriate treatment. The core of treatment is based on corticosteroids. In severe cases immunosuppressors, antiinflammatory drugs, antioxidants are prescribed. A dentist performs oral cavity sanation, professional hygiene. Mouth rinses with Dekasan solution, sublingual Lisobakt pills are prescribed to prevent inflammatory lesions. Patients with sarcoidosis are recommended to avoid solar radiation and contact with chemical and toxic substances harmful to the liver, reduction of the consumption of foods rich in calcium. Healthy life-style is crucial in prevention of exacerbations of sarcoidosis. In the remission period regular medical check-ups and oral cavity sanation are recommended. The correct diagnosis in rare diseases requires highly qualified dental professionals, the interdisciplinary approach in the diagnosing and management of patients with this pathology