Frequent oral ulcers, be careful of sexually transmitted diseases

　　Behcet's disease is characterized by recurrent Oral ulcers is characterized by many genital ulcers of Behcet's disease that are often misdiagnosed as sexually transmitted diseases

　　In addition to common simple recurrent oral ulcers, other disease For example, oral candidiasis, lupus erythematosus, syphilis, leukemia, lymphoma, etc. may manifest as oral ulcers.

　　Ah Jun recently discovered that he was suffering from "andritis", with red rashes and ulcers appearing on his penis. I went to the STD department several times but still no improvement. In addition, his oral ulcers "come to his door" almost every two months. Last month, Arjun accidentally touched the ulcer and the pain became unbearable, so he went to the oral cavity Hospital See a doctor. After examination, the doctor told Arjun that judging from the condition of the oral ulcers, he was not suffering from a sexually transmitted disease, but probably Behcet's disease related to rheumatic immune deficiency, and suggested that he undergo further re-examination.

　　Experts said that in the oral ulcer clinic, in addition to patients with simple oral ulcers, patients with Behcet's disease, sexually transmitted diseases, leukemia, Sjögren's syndrome, hand-and-mouth-foot disease, lupus erythematosus, herpes zoster, etc. are also found from time to time. He reminded that oral ulcers may be a "window" to discover other systemic diseases and are symptoms of many systemic diseases in the oral cavity. Therefore, patients who have more than three oral ulcers per year and suspect that the oral ulcers are unusual are recommended to go to the dental department for treatment. After the disease is clearly diagnosed, they can be transferred to a specialist for treatment in a timely manner.

　　Medical guidance/Professor Yin, Director of the Mucosal Disease Department of Guangdong Stomatological Hospital

　　Behcet's disease and vaginal ulcers are often misdiagnosed as sexually transmitted diseases

　　According to Professor Yin Cao, director of the Mucosal Disease Department of the Guangdong Provincial Stomatological Hospital, Behçet's disease is a systemic immune system disease that occurs frequently in the Mediterranean, the Middle East and the Far East. Therefore, it is called the "Silk Road disease." The incidence is similar in men and women, but male Symptoms are usually severe. The cause and pathogenesis of Behcet's disease are currently unclear. Vasculitis is the main pathological damage. Antibodies against human oral mucosa can be found in the blood circulation of 50% of patients. Most patients only invade small blood vessels under the mucosa, causing mucosal ulcers, but a few patients involve large and small blood vessels throughout the body, leading to damage to large blood vessels or internal organs.

　　The most common lesions of Behcet's disease are oral ulcers and vulvar ulcers. Recurrent oral ulcers are usually the basic damage of Behcet's disease and are not much different from general recurrent oral ulcers. Generally, 3 to 5 rice-shaped ulcers appear on the soft palate or oropharynx, which may be deep or shallow. They are usually painful and have a yellow necrotic base in the center. The ulcer lasts for 1 to 2 weeks and does not leave scars after healing. Genital ulcers in Behcet's disease are more specific. If male genital ulcers occur on the glans and penis, the symptoms are relatively obvious, while the symptoms of scrotal ulcers are mild. female Genital ulcers can occur in the labia majora or vaginal wall, but symptoms vary in severity and may even be asymptomatic. Gynecology Inspection found. According to reports, clinical Many genital ulcers caused by Behçet's disease are often misdiagnosed as sexually transmitted diseases and cannot be cured after long-term treatment. If such patients are accompanied by frequent oral ulcers, it is probably not a sexually transmitted disease but Behcet's disease.

　　In addition to oral and genital ulcers, Behcet's disease can also affect other parts of the body. Such as skin, folliculitis, erythema nodosum, Acne rash, vasculitis, etc.； Eye involvement occurs with iritis, uveitis, and optic neuropathy ； Arthritis, which can affect the knees and ankles ； In addition, lesions may also occur in the lungs, gastrointestinal tract, kidneys, and nervous system. If recurrent oral ulcers occur and the following two conditions are met, Behcet's disease can be diagnosed: 1. Recurrent genital ulcers ； 2. Eye lesions ； 3. skin disease Change； 4. Acupuncture test. Yin Cao said that Behcet's disease is currently incurable, but controlling the disease through immunomodulatory therapy can improve the patient's quality of life.

　　Oral ulcers are a warning sign of certain sexually transmitted diseases”

　　Professor Yin said that in the outpatient clinic, he also encountered patients who were treated for oral ulcers but were found to be infected with syphilis, AIDS, and genital warts. The symptoms were mainly caused by oral sex and showed redness and congestion, oral ulcers, and white spots, but the symptoms were different from those of recurrent oral ulcers. Such patients cannot simply treat oral ulcers, but require systemic treatment combined with dermatology and venereal diseases.

　　1. Syphilis. Professor Yin said that some patients did not know that they had syphilis and only came to see them for oral ulcers, but after preliminary examination, they were suspected of having syphilis. Patients usually develop mucosal plaque ulcers and erosions on the lower lip, which are raised gray-white plaques that feel as hard as coins. Unlike the yellow capsule and red edges that are common in recurrent oral ulcers, there is no obvious pain. Doctors generally ask the patient's medical history and combine it with a syphilis serological test to confirm the diagnosis.

　　2.AIDS. Most AIDS patients have oral manifestations. Oral erosion occurs in the early stages of the disease, and they often go to the dental department first. AIDS patients have large gray-white pseudomembranes on the oral mucosa, especially on the soft palate, which can be wiped off, but generally there is no pain, and can be diagnosed through HIV antibody screening.

　　3. Genital warts. Oral genital warts are mostly transmitted through oral sex. Patients will develop red papillary or cauliflower-like growths on the roof of the mouth or under the tongue, which can range from gray to white or pink.

　　4. Gonorrhea. When a patient is infected with gonococcal stomatitis, the mucous membrane will be congested and red, and the ulcer will be covered with a yellow-white capsule, which can be easily wiped off, forming a bleeding wound.

　　Experts remind:

　　Oral ulcers are found

　　The "window" for systemic diseases”

　　Professor Yin introduced that oral mucosal ulcers can be divided into benign and malignant. Among benign oral ulcers, the most common is recurrent oral ulcers, with an incidence rate of about 20% in the population. Simple oral ulcers are characterized by periodicity, recurrence, and pain. Recurrent oral ulcers can be divided into three types: 1. Mild recurrent oral ulcers generally number 3 to 5, are round or oval in diameter less than 1 cm, have a capsule on the surface, and do not leave scars after healing. ； 2. Severe recurrent oral ulcers are more than 1 cm in diameter, and the ulcers look like deep pits, leaving scars after healing. ； 3. Herpetiform recurrent oral ulcers (also known as stomatitis-type aphthous ulcers) have a large number of ulcers, with dozens or dozens of them, like "starry sky". In addition to recurrent oral ulcers, benign oral mucosal diseases also include traumatic ulcers caused by bites, toothbrushing, burns or bruises, self-injurious ulcers caused by biting the lip or tongue, and oral ulcers caused by herpes virus infection. The latter two are more common in children.

　　Malignant oral ulcers have various manifestations, and the most common one is oral cancer. Yin Cao said that he currently diagnoses and treats patients with oral cancer almost every week. Among them, the most common ones are tongue cancer and leukoplakia, as well as lip cancer, gum cancer, and floor of the mouth cancer.

　　It is worth noting that malignant tumors from other systemic diseases can manifest as ulcers in the oral cavity. For example, a patient with gum ulcers was diagnosed with leukemia.； Malignant lymphoma was diagnosed in oral ulcer ； Some patients have mucosal plaques on their oral mucosa and have been diagnosed with syphilis, AIDS and other sexually transmitted diseases. ； There are also patients with Sjögren’s syndrome, lupus erythematosus, and herpes zoster. Therefore, other problems “lurking” behind canker sores should not be ignored.

　　He suggested that patients who have more than three oral ulcers per year and suspect that the oral ulcers are unusual should see a doctor to find out the disease they are suffering from, and then transfer them to a specialist for treatment in a timely manner.