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  • Title: Substantiation of diagnosis and treatment of chronic recurrent aphthous stomatitis in crohn's disease.
    Author: Feleshtynska OY, Dyadyk OO.
    Journal: Wiad Lek; 2020; 73(3):512-516. PubMed ID: 32285824.
    Abstract:
    OBJECTIVE: The aim: To substantiate the diagnosis and treatment of chronic recurrent aphthous stomatitis in Crohn's disease. PATIENTS AND METHODS: Materials and methods: The analysis of diagnostic and treatment of 52 patients with chronic recurrent aphthous stomatitis in Crohn's disease (main group), mean age 31.8 + 2.3 was performed. The comparison group consisted of 50 patients with chronic recurrent aphthous stomatitis not associated with Crohn's disease (mean age 34.7 + 1.8). Patients in both groups were studied for clinical manifestations, morphological and immunohistochemical studies the aphthae on the oral mucosa were performed. RESULTS: Results: An objective evaluation of the oral mucosa showed that the aphthae on the oral mucosa in patients of both groups did not differ visually. In the morphological study, the patients in the main group had granulomatous inflammation of the oral mucosa, characteristic of Crohn's disease, while the patients in the comparison group had fibrinous inflammation. Immunohistochemical study of the cell infiltrate phenotype in the area of the lesion revealed that the patients in the main group there prevailed CD68+macrophages, the appearance of both intraepithelial and cell infiltrates of T-lymphocyte suppressors, which is characteristic of Crohn's disease. CONCLUSION: Conclusions: Diagnosis of chronic recurrent aphthous stomatitis in Crohn's disease is based on biopsy of the aphthae on the oral mucosa and their morphological examination, the results of which confirm the presence of granulomatous inflammation, with a large number of macrophages, the presence of T-lymphocytes, characteristic of Crohn's disease, while recurrent aphthous stomatitis of another genesis morphologically detect fibrinous inflammation. The choice of therapeutic tactics for chronic recurrent aphthous stomatitis depends on the results of the morphological study. When granulomatous inflammation is detected in patients with chronic recurrent aphthous stomatitis, which is characteristic of Crohn's disease, in addition to topical treatment of the oral mucosa, specific therapy with mesalazine drugs is prescribed.
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