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患者为女性,31岁,高加索人。主诉在3唇侧牙龈有黑斑逐渐加深且变大。患者否认有能引起口腔粘膜色素沉着的肾上腺疾病,胃肠疾病,以及遗传性疾病。有口服避孕药史和吸烟史,而且最近吸烟量增大。衔烟的部位正对着牙龈色素沉着的部位。病变范围局限于边缘龈。按之不退色,同位素放射示踪检查,病变区无明显核素聚集。患者角化龈带很宽。手术切除病变活检,镜下可见牙龈上皮为多层鳞状上皮细胞,有角化,粘膜下为纤维结缔组织,基底层有大量棕褐色细胞团块,可以发现有黑色素颗粒沉着,最后诊断为“吸烟者黑变病”。讨论1977年Hedin报告了由于单纯吸烟造成的
The patient is female, 31 years old, Caucasian. The chief complained that dark spots on the gums of the 3 lips gradually deepened and became larger. The patient denied adrenal diseases, gastrointestinal disorders, and hereditary diseases that can cause oral mucosal pigmentation. There is a history of oral contraceptives and smoking history, and the amount of recent smoking has increased. The position of the cigarette is facing the pigmented area of the gum. The extent of the lesion is limited to the border. According to the non-fade, isotope radioactive tracer examination, there was no significant nuclide accumulation in the lesion area. The patient’s keratosis is very wide. Surgical resection of lesion biopsy showed that the gingival epithelium was multilamellar squamous epithelial cells with keratinization, fibrous connective tissue under the mucous membrane, and a large number of tan cell clumps in the basal layer. It was found that the melanin pigment was calm and finally diagnosed as “ Smokers are melanotic.” Discussion Hedin reported in 1977 that it was caused by pure smoking