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作者报告一例念珠菌性粘膜白斑患者,经用氟氯康那唑(Fluconazole)全身治疗11天后,临床症状及病变消失。患者男性,53岁,因口角区疼痛性病变一年而就诊.有吸烟及饮酒史。检查两口角区可见皮肤红斑,两唇吻部及颊粘膜上有白色斑块,无牙(牙合),戴全口义齿约10年。疑为念珠菌性粘膜白斑伴口角区唇炎.初诊时在两口角部、前鼻孔区,腭部和上颌义齿的组织面取细菌拭子,收集口腔清洗液,查血中VitB_(12)、铁蛋白、叶酸、血糖水平和全血计数,切取拭子区组织作病理检查。嘱戒烟,漱口并给Fluconazole 胶囊(50mg/日)抗霉菌治疗。给药后1,2,3周复诊,见患者口角区唇炎消散,颊粘膜白斑明显减轻。给药后3周就诊,在右唇吻区白斑上再切取活检。患者2个月无症状,并长期作随访。初次活检显示角化上皮增生,表面过角化层厚,有明显的嗜中性白细胞浸润并含中量真菌菌丝,上皮中度
The authors report a case of candidal leukoplakia, clinical symptoms and lesions disappeared after systemic treatment with fluconazole for 11 days. A 53-year-old man with a history of painful lesions in the mouth area had a history of smoking and drinking. Check the two mouth area visible skin erythema, lips kiss and buccal mucosa with white plaques, no teeth (occlusion), wearing a complete denture for about 10 years. Suspected candida fungus leukoplakia with cheilitis area chewing gum.At first visit in the two corner, anterior nostril area, palate and maxillary denture tissue surface to take bacterial swab, collected oral cleaning fluid, check blood VitB_ (12), Ferritin, folic acid, blood glucose levels and whole blood count, cut swab tissue for pathological examination. Quit smoking, gargle and give Fluconazole capsules (50mg / day) anti-mold treatment. 1, 2, 3 weeks after referral, see cheek area cheek inflammation dissipated, buccal mucosal leukoplakia significantly reduced. Three weeks after the treatment, a biopsy was taken on the white spot on the right lip kiss. Patients 2 months asymptomatic, and long-term follow-up. The first biopsy showed keratinized epithelial hyperplasia, superficial keratosis layer, with significant neutrophil infiltration and medium mycosis fungus, moderate epithelium