NEJM:地图舌-案例报道

2016-02-18 MedSci MedSci原创

男性,73岁,3个月前他的私人医生发现其舌背部出现一些异常的剥脱性病变。

男性,73岁,3个月前他的私人医生发现其舌背部出现一些异常的剥脱性病变。




据该男子主诉,其以往有吸烟史,曾因患有高血压、高胆固醇血症和高尿酸血症进行过治疗。
口腔检查可见,在舌背部可观察到圆形的红色的区域,在舌头处也可见一大块的斑块(如图A所示)。会诊医师根据该患者的临床症状诊断其为地图舌,又称为游走性舌炎。

地图舌,在国际上受影响的总人口约达2%,主要是由于局部的炎症及丝状乳头分化不良导致。患有地图舌的患者通常会出现移动性的椭圆形红色区域,在红色区域的周边会有明显的白色边缘。
对于本案例中的患者,在后续的随访中,8个月和20个月时亦可见到明确的白色的边缘(如图B和图C所示)。

一般情况下,患有地图舌的患者是不会出现任何特殊的异常症状的,但当患者在吃辛辣或酸性的食物时容易引发疼痛或灼烧感。当地图舌患者不表现出症状时,可不作任何的治疗。但在32个月内,仍需不定时地进行跟踪随访。

原始出处:

Elena Varoni, Sem Decani,Geographic Tongue,N Engl J Med 2016; 374:670February 18


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    2016-09-13 1e10c84am36(暂无匿称)

    好文章,还会关注

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  2. [GetPortalCommentsPageByObjectIdResponse(id=124713, encodeId=8f1f124e13cf, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124432, encodeId=2e1c124432b2, content=赞一个!好文章拜读学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83356, encodeId=b328833569c, content=知识一点一点的积累了, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 30 07:03:00 CST 2016, time=2016-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78722, encodeId=8856e872263, content=可以学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 16 13:10:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
    2016-09-13 ylzr123

    赞一个!好文章拜读学习了。

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  3. [GetPortalCommentsPageByObjectIdResponse(id=124713, encodeId=8f1f124e13cf, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124432, encodeId=2e1c124432b2, content=赞一个!好文章拜读学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83356, encodeId=b328833569c, content=知识一点一点的积累了, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 30 07:03:00 CST 2016, time=2016-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78722, encodeId=8856e872263, content=可以学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 16 13:10:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
    2016-04-30 吴玲

    知识一点一点的积累了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=124713, encodeId=8f1f124e13cf, content=好文章,还会关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Sep 13 11:02:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=124432, encodeId=2e1c124432b2, content=赞一个!好文章拜读学习了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Tue Sep 13 10:16:00 CST 2016, time=2016-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=83356, encodeId=b328833569c, content=知识一点一点的积累了, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 30 07:03:00 CST 2016, time=2016-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78722, encodeId=8856e872263, content=可以学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=163, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160602/IMG574F7F78D7F702220.jpg, createdBy=5d0b1713419, createdName=吴玲, createdTime=Sat Apr 16 13:10:00 CST 2016, time=2016-04-16, status=1, ipAttribution=)]
    2016-04-16 吴玲

    可以学到很多

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