具有恶性潜能的下唇糜烂性溃疡性病变:切口活检后局部透明质酸和全身硒-维生素联合治疗的疗效

Mahmoud Helmy Belal, Mohamed Bahaa Kheidr
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引用次数: 0

摘要

目的:下唇溃疡性病变较为常见。激进的形式导致嘴唇扭曲,影响功能和审美。建议的治疗策略仍面临争议。本研究旨在评估局部透明质酸(HA)和全身硒加维生素a、C和E (ACE)联合使用的潜在治疗效果。方法:选取9例中重度下唇糜烂溃烂区症状性病变患者。年龄范围:47~67岁。通过切口活检进行临床和组织病理学诊断。每日四次使用未稀释的透明质酸凝胶和棉签。每日一次系统处方硒- ace。治疗时间为6周,病变区域随访6个月是否复发。对疼痛和病变严重程度进行评分。结果:所有患者均有日晒,6名重度吸烟者,2名有时饮酒。一般来说,6例患者被诊断为良性病变,愈合顺利,完全解决。其中4例为炎性病变,2例为口腔扁平苔藓。相反,3例患者是恶性的(SCC),没有完全愈合,需要在安全范围内手术切除。未报告对使用过的药物过敏。此外,除了2周和4周没有改善外,良性患者的疼痛感觉和病变大小在整个时间间隔内都有显著改善。相反,在恶性患者中没有明显的改善,无论是病变愈合还是疼痛缓解,除了只有2周和6周的症状缓解。结论:局部透明质酸凝胶联合硒- ace可能是治疗下唇糜烂性溃疡的一种有效的补充治疗方法。
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Erosive-ulcerative lesions on the lower lip with malignant potential: efficacy of incisional biopsy followed by topical hyaluronic acid and systemic selenium-vitamin combination
Objective: Ulcerative lesions on lower lip are common. Aggressive forms lead to lip distortion and affect function and esthetic. Suggested treatment strategies are still facing controversy. This study aimed to evaluate the potential therapeutic efficacy of a combination of topical hyaluronic acid (HA) and systemic selenium plus vitamin A, C and E (ACE). Methods: Nine patients affected with symptomatic lesions on lower lip of erosive-ulcerative areas with moderate severity were enrolled. Age range: 47~67 years. They were diagnosed clinically and histopathologically by incisional biopsy. A topical HA gel was applied undiluted with a cotton bud four times daily. Selenium-ACE was prescribed systemically once daily. Treatments were applied for a 6-week period and lesions’ areas were followed for six months for any recurrence. Pain and severity of lesions were scored. Results: All patients had sun exposure, six were heavy smokers whereas two had sometimes alcohol consumption. In general, six patients were diagnosed as benign lesions that healed uneventfully with complete resolution. Four of them were inflammatory lesions, whereas two were oral lichen planus. On contrary, three patients were malignant (SCC), did not heal completely and referred to surgical resection with safety margin. No allergy was reported to used medications. Furthermore, pain sensation and lesion size were significantly improved within benign patients for the whole intervals except only 2 vs 4 weeks that showed no improvement. On contrary, no significant improvements occurred within malignant patients, neither for lesion healing nor pain alleviation, except only 2 vs 6 weeks that showed alleviation of symptoms. Conclusion: Topical HA gel combined with selenium-ACE may be a useful additional treatment option for erosive ulcerative lesions of the lower lip.
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