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Allergic stomatitis

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[Intro]

Overview: allergic stomatitis allergic inflammation of oral mucosa. Refers to the allergic constitution of the body through various means (such as contact, orally or by injection, etc.) caused by exposure to allergens.

[Cause]

allergic stomatitis is caused by what the?

1, allergic stomatitis

is a fast-onset type I allergy, but sometimes also the performance of delayed type hypersensitivity to type Ⅳ. As the name suggests, is Benbingfasheng external drugs, and the types of drugs, including impurities, route of administration, the accumulation effect and antigenicity, and many other factors and the incidence of this disease have a certain relationship, but the drug is caused by the antigen disease is the most important reason. Most drugs are small molecules of chemical substances, a semi-antigen, it must be combined with the body to become whole antigen proteins only become allergens. After the first use of drugs, is generally not the disease, when the body re-exposure to the same drugs, can produce allergic reactions. Exposure to allergens in general 24 ~ 48h after onset.

antibiotic agents, anti-inflammatory drugs, hypnotic sedatives, sulfa drugs and other products is caused by four major categories of drug-induced skin - the most common mucosal inflammation drugs. Clinical inquiry, some patients difficult to recall the history of allergic drug use, although this may be because some drugs with different names, but its structure is similar drugs such as sulfa drugs, procaine and ammonia acid inclusive of several drugs in the "aniline" core, therefore, can be used sulfonamides are the first contact occurs when procaine allergy; and penicillium exist in nature, for example, can one allergen, although it is sometimes the first injection of penicillin allergy occurred Zheyi.

2, contact stomatitis

an allergic type Ⅳ, The oral mucous membrane exposure to the substance itself is non-irritating, that the stimulation is also very weak, under normal circumstances will not cause harm, but patients with allergies, this substance as an allergen, can cause allergy and disease .

dental common allergens such as methyl methacrylate denture material, self-curing acrylic resin, silver amalgam; Others, such as bubble gum and synthetic rubber .

[Sign]

early symptoms of allergic stomatitis what?

drug-induced stomatitis

one, based on clinical manifestations

history of recent drug use, the incidence of a clear link with the drug, and whether the past history of allergies should be aware of; oral damage is mainly congestion, edema, erosion, exudation; Also note that if a fixed drug eruption on the skin, then help diagnosis . Also may have eye or genital damage.

clinical manifestations

First, drug-induced stomatitis

oral mucosal lesions often precede the occurrence of skin, sometimes can occur simultaneously. Patients with a drug after a certain incubation period, the longer the incubation period of the initial attack, recurrence is reduced, sometimes within 24h disease.

1, oral mucosa

disease in the oral mucosa, the patient first burning feeling of local discomfort. damage any part of the mouth can occur, such as common in the lips, cheek, tongue, palate, etc. of the mucous membrane congestion, edema, blisters occur if, as words, eating the friction movement and rapid rupture into sizes erosion surface, and seepage. At this point, the patient is feeling pain.

2, skin

disease in the skin, then occur in the hand, foot, face, erythema, papules, etc.; sensitizing drugs, such as re-use, that appeared in the original parts of the round or oval-shaped erythema, clear boundary of the number of different, blisters may also be combined, which is called a fixed drug eruption (fixed drug eruption); sometimes, in addition to the fixed parts of the apart from the rash in the new location. Local burning, swelling and itching. Usually lasts about 1 week, and then subsided.

3, eye

disease in the eye, the common is conjunctivitis, manifested as conjunctival hyperemia, pain and discomfort, increased secretions and so on.

4, genital

disease in the genitals, in the genitalia, anus, etc. can also be erythema, erosion and other phenomena .

Second, contact stomatitis

moderate symptoms, because the oral mucosa contact with antigenic material, the In a few days to at least partial formation of antibodies that have been sensitized epithelium at this time, with the absorption of antigenic material, antigen-antibody reaction in the local produce. But there are also large and irritating because of contact with objects a short incubation period.

common sites of incidence of lip, cheek, palate, alveolar mucosa and vestibule. Exposure to pathogenic material parts of the performance of the inflammatory response, varying severity, usually manifested as congestion, edema, blister, erosion, oozing, or pseudomembrane formation. swelling of the tongue, the performance significantly, the tongue edge of the teeth oppression prints. If after the removal of allergens, in a long time, inflammation is still developing, may have been mixed infection, then gradually healed.

[Aftertreat]

allergic stomatitis ate?

need to ban eating spicy and pungent foods, eat more fruits and vegetables such as green food.

[Prevent]

how to prevent allergic stomatitis?

before treatment should be asked whether the drug or medicated patients with a history of allergies; strictly controlled to prevent drug abuse treatment indications; medication should be simple in order to reduce the incidence of allergic diseases; and pay attention to drugs cross allergic reactions; caution or disable the original sensitizing drugs with chemical structures similar to the drug; pay attention to their drug allergy testing, such as penicillin skin test, should also be ready for emergency medicine, just in case. on account of diagnosed patients should be clear, to avoid future re-use of this drug.

[Treat]

treatment of allergic stomatitis Notes?

prevention

one to remember "those poisonous drugs", that is to understand drugs can "cure" can also be "disease." Do not superstitious medicines universal, not just drugs, it is best if you need medication under the guidance of doctors, tried to be scientific medicine, rational drug use and safe medication.

Second, there is the awareness and knowledge of drug allergies, or re-application in the first period with a drug, if unexplained fever, skin rash with itching, or a sudden occurrence of chest tightness, palpitations, dizziness, cold sweats, nausea, vomiting and other phenomena, it is timely to consider drug allergies and the doctor make a diagnosis and treatment.

Third, if there was a history of allergies to certain drugs, each visit must take the initiative to drug allergy, inform the doctor, in order to avoid recurrence.

four, in the healing process, avoid too much medication, too messy, too complex, but the dose should not be too large. With a drug should not be used for a long time. Also, pay attention to the cross-allergy drugs and polyvalent allergy. For example, people allergic to penicillin. Taboo of oral amoxicillin, because the phenomenon of cross-allergy exists between the two; addition, aminopyrine allergy, contraindications to pain tablets (Cable secret pain), pain due to tablets is the main component of aminopyrine.

five people in long-term open-air work to be alert to drug-induced photosensitive reaction. For example, someone taking sulfa drugs and then by the strong light, in the hands, feet or head and neck and other exposed parts of the occurrence of dermatitis or phototoxic dermatitis; then, can cause photosensitive reactions to other drugs such as griseofulvin, Kui Nitin, phenergan, wintermine, should also be used with caution or, better not open during use.

six had allergic reactions caused by drugs, to record, to avoid repeated use. If you need to make the drug allergy skin test history, in the future even if the skin test, no longer made. In addition, the current drug problem is greater, there are many new drugs are complex preparations or in medicine compound preparation, application of these drugs must be carefully read before the package insert, and special understanding of the drug's composition, the composition containing the prevention of drug allergy was caused by of the drug.

seven, attention problems allergic reaction to medicine. In people's traditional values, the problem of drug allergy is medicine, Chinese medicine does not seem to have similar problems. In fact, some Chinese will also have drug allergies, there are many reports in this regard, it should arouse our attention and prevention. For example, open-air operator after taking a medicine psoralen photosensitivity dermatitis, patients with severe sunburn, feel burning, pain, etc.

Chinese medicine treatment of allergic stomatitis

No related information

western medicine treatment of allergic stomatitis

drug therapy:

one systemic treatment

1. sensitizing drugs look suspicious, and immediately stop using; trace the last few days of the diet, with or without food with drugs diet tonic diet.

2. general supportive therapy

fluids, vitamins, allergens in order to speed up the discharge, and maintain water and electrolyte balance.

3. antihistamine

choice of diphenhydramine 25mg, 3 times a day, orally; flutter Ermin 4mg, 3 times a day, orally; or to astemizole (rectification of names: astemizole, Astemizole) 10mg, once daily, orally.

4. adrenocorticotropic hormone

have anti-inflammatory, immuno-suppression effect can be severe hydrocortisone 200 400mg intravenously; prednisone daily 30 ~ 60mg, or dexamethasone daily 4.5 ~ 9mg, oral.

5. gluconate and vitamin C0.5 ~ 1.0g, 1 day, slow intravenous injection to reduce leakage.

Second, the local treatment

application of anti-inflammatory, analgesic, anti-infective drugs, such as patching a variety of antibiotics locally membrane, or 2.5% chlortetracycline glycerol coating, apply powder and other traditional Chinese medicine powder, such as ulcers, severe pain can be 1% procaine solution rinse, or 0.5% dyclonine coating solution to pain.

[Examine]

allergic stomatitis should do what check?

(a) drug-induced stomatitis

1. patch test

patch test is to measure the body's allergic to a complementary diagnostic method. Basing on the nature of the preparation of an appropriate concentration of the extract, solution, ointment or used directly for the original reagents, the test solution soaked gauze layer 4 1cm2 size, or the test substance placed on the gauze, and placing the forearm flexor side, on which slightly covered with transparent cellophane, surrounded by plaster fixed, 48h remove test materials and test results.

results found "-" negative: subjects without any reaction site;

"±" suspicious: skin mild itching or redness;

"+" weakly positive: a simple skin rash, itching;

"+ + "moderately positive: skin edema, erythema, papules;

"+++" strongly positive: significant skin erythema, papules and blisters.

2. basophil degranulation test

take the rabbit basophil plus serum and suspicious allergenic substances mixed with the incubation solution, such as allergic serum antibody IgE, the occurrence of basophil degranulation. Number of 200 basophil, if more than 30% cell degranulation phenomenon is positive. changes in cell degranulation for cell swelling, loss of normal round, clear nuclei, particles or dissolved away from the cell overflow. This method is simple, sensitive and reliable, to help determine the type I allergic reaction.

3. allergens lymphocyte transformation test

take the patient's lymphocytes plus suspected allergens , and the control group to observe the transformation of lymphocytes. Transformed cells> 50% (back to progenitor cells) means that is positive.

4. leukocyte migration inhibition test

take additional suspected allergens in patients with white blood cells, leukocyte migration inhibition observed. sensitized lymphocytes in vitro with specific antigen encounter, the release of macrophage migration inhibitory factor (MIF), the macrophage or leukocyte migration was inhibited, the positive reaction. Such as the experimental group / control group <0.8U, expressed antigen reaction. Law can also help identify allergens.

(b) contact stomatitis

patch test

[Diff]

allergic stomatitis diseases easily confused?

1, drug-induced stomatitis

should belong to allergic diseases in contact stomatitis, and more differentiated form of exudative erythema. Especially when the damage occurs in the mouth when a single, easily and clinical manifestations of congestion, edema, blister, erosion of other oral mucosal disease confused.

2, contact stomatitis

should be the differential diagnosis of drug-induced stomatitis. The incidence of disease caused by exposure to the substance is not necessarily the drug; while the incidence of drug-induced stomatitis is a disease-causing substances are certain drugs. In addition, the disease occurs only in the contact area damage, and drug-induced stomatitis in addition to oral damage, but also may have skin, eyes, genitals, etc. associated with more or less damage.

[Disease]

nasal septum perforation may be caused by the diseases?

nasal septum-related diseases

Department of Otolaryngology-traumatic nasal septal perforation of nasal septum perforation trauma trauma sinus nasal septum deviated septum hematoma

more nasal symptoms

saddle nose tuberculosis white residue like nose nose nose nose bleeding foul disease deepened nasolabial fold nasolabial fold shallow sinus tenderness, sinus barotrauma mast nose nose nose out of the fire nose defects diffuse flushing the nose increased nasal secretions of the nose of poor form dry nose, swelling of the nose bridge of the nose and dry throat burning sensation turbinate atrophy

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