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Treatment of exfoliative cheilitis with Traditional Chinese Medicine：a systematic review

Journal of Traditional Chinese Medicine 2017年第2期37卷 147-158页

作者： Sun Kai Liu Lijun Chen Xiaojie Jiang Weiwen Department of Oral Mucosal Diseases Shanghai Ninth People'sHospital Shanghai Jiao Tong University School of MedicineShanghai 200011 China

OBJECTIVE:To systematically review treatments of exfoliative cheilitis based on symptom patterns in terms of Traditional Chinese Medicine.METHODS:Pub Med, Cochrane Central Register of Controlled Trials and Wanfang data were screened for case reports, case series or clinical trials that were published in English or Chinese from January,1973 to September, 2015.The keyword of "exfoliative cheilitis or scaling cheilitis or factitious cheilitis" was used.Effectiveness or ineffectiveness was investigated as outcome for Meta analysis, which is based on effective index in each study.Response to treatment was described for case reports or case series.RESULTS:From 38 screened studies, 17 were randomized controlled trials(RCTs), 5 were single-arm trials, and 16 were case reports or case series.Three RCTs were eligible for Meta analysis and all of them compared managements between Traditional Chinese Medicine and corticosteroids for exfoliative cheilitis, which involved 223 participants.Interestingly, data of Meta analysis showed similar effect of Traditional Chinese Medicine and corticosteroids for patients with exfoliative cheilitis [relative risk ratio:1.10; 95% CI(1.00-1.21), P = 0.06].CONCLUSION:Traditional Chinese Medicine might be a substitute for corticosteroids on exfoliative cheilitis.However, the evidence and recommendation of exfoliative cheilitis managements need to be taken with caution because of the low quality of evidence in the studies obtained.

关键词：基于证据的药牙科 Exfoliative 症候群 cheilitis 治疗学药汉语传统肾的外皮荷尔蒙评论

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Expression of matrix metalloproteinases 9 and 12 in actinic cheilitis

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World Journal of Experimental Medicine 2013年第3期3卷 43-49页

作者： Athanasios K Poulopoulos Dimitrios Andreadis Anastasios K Markopoulos Department of Oral Medicine and Oral Pathology School of Dentistry Aristotle University of Thessaloniki 54124 Thessaloniki Greece

AIM: To investigate the role of matrix-degrading metalloproteinases 9, 12(MMPs), as mediators of functional connective tissue damage in actinic cheilitis.METHODS: Thirty five formalin-fixed, paraffin embedded specimens of actinic cheilitis, and twelve specimens of normal lower lip vermillion, which were obtained by the archives of the Department of Oral Medicine and Maxillofacial Pathology, were examined. From each block, 5 μm thick sections were cut and routinely stained with Hematoxylin and Eosin. Immunohistochemical studies were performed on 4-μm thick sections of formalin-fixed paraffin embedded actinic cheilitis lesions and of normal lower lip vermillion, for MMP-9 and MMP-12 in serial sections of our specimens. Appropriate positive and negative controls were performed to confirm the specificity of the staining reaction. MMP immunohistochemistry was evaluated using a semiquantitative immunoreactive score.RESULTS: Haematoxylin and eosin staining revealedin actinic cheilitis lesions atrophic stratified squamous cell epithelium, or focally and irregularly hyperplastic of variable thickness, in some areas was observed marked keratin production. Varying degrees of epithelial dysplasia were noticed with a wide spectrum of change within the same specimen. Characteristic was the appearance of chronic inflammatory infiltration, and a band of amorphous acellular, basophilic change like solar elastosis(elastin replacement of collagen). In normal lower lip specimens weak and scanty positive expression of MMP-9 and MMP-12 was observed. Anti-MMP-9 antibody showed a weak reaction, in actinic cheilitis lesions, focal in the elastotic material, in chronic inflammatory cells and mostly in macrophages and neutrophils. Strong and in some cases diffused immunohistochemical expression of MMP-12 was detected in actinic cheilitis lesions in the areas of the fragmented, distorted and thickened elastic fibers. MMP-12 was also expressed in chronic inflammatory cells and mostly macrophages. MMP-12 was significantly higher in actinic ch

关键词： Actinic cheilitis Metalloproteinase-9 Metalloproteinase-12 Immunohistochemistry

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Melkersson-Rosenthal syndrome

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World Journal of Stomatology 2015年第1期4卷 8-11页

作者： Ioannis Chatzistefanou Petros Zikos Grigorios Venetis Konstantinos Vahtsevanos Konstantinos Antoniades Department of Oral and Maxillofacial Surgery "G. Papanikolaou" General HospitalAristotle University of Thessaloniki

Melkersson-Rosenthal syndrome(MRS) is a rare, noncaseating granulomatous disorder of unknown etiology and undefined diagnostic criteria. The classical triad of recurrent orofacial edema, relapsing facial paralysis, and fissured tongue, is not frequently seen in its complete form, and many patients remain misdiagnosed or undiagnosed for years. The purpose of this study is to review the findings in the literature describing theMelkersson-Rosenthal syndrome with aim to identify its clinical and histopathological characteristics and correlate them with definitive diagnostic criteria and effective treatment modalities. A systematic review and analysis of more than 100 publications met eligibility criteria performed by the authors. Orofacial edema of unknown etiology is the most typical clinical feature of the Melkersson-Rosenthal syndrome. Its coexistence with of facial nerve palsy or fissured tongue could be characterized as an oligosymptomatic MRS. Many investigators suggest cheilitis granulomatosa as a monosymptomatic form of MRS, while patients with facial palsy and fissured tongue, without orofacial edema, should not be considered having MRS.Histological evidence is not necessary. Corticosteroids are generally accepted as the mainstay treatment.

关键词： Melkersson-Rosenthal syndrome Orofacial swelling cheilitis granulomatosa Facial nerve palsy Fissured tongue

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Actinic prurigo of the lip: Two case reports

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World Journal of Clinical Cases 2014年第8期2卷 385-390页

作者： Ana MO Miranda Thiago M Ferrari Juliana T Werneck Arley Silva Junior Karin S Cunha Eliane P Dias Department of Pathology Federal Fluminense UniversityNiteroiRio de Janeiro 24220-008Brazil

Actinic prurigo is a photodermatosis that can affect the skin, conjunctiva and lips. It is caused by an abnormal reaction to sunlight and is more common in high-altitude living people, mainly in indigenous descendants. The diagnosis of actinic prurigo can be challenging, mainly when lip lesions are the only manifestation, which is not a common clinical presentation. The aim of this article is to report two cases of actinic prurigo showing only lip lesions. The patients were Afro-American and were unaware of possible Indian ancestry. Clinical exam, photographs, videoroscopy examination and biopsy were performed, and the diagnosis of actinic prurigo was established. Topical corticosteroid and lip balm with ultraviolet protection were prescribed with excellent results. The relevance of this report is to show that although some patients may not demonstrate the classical clinical presentation of actinic prurigo, the associated clinical and histological exams are determinants for the correct diagnosis and successful treatment of this disease.

关键词： Actinic prurigo Follicular cheilitis Photodermatosis High-altitude Lip diseases

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