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SARS-CoV-2感染症患者における口腔粘膜病変。4 例の報告。これらはCOVID-19病変の真の徴候なのか？
Oral mucosal lesions in patients with SARS-CoV-2 infection. Report of four cases. Are they a true sign of COVID-19 disease?
PMID: 32882068 DOI: 10.1111/scd.12520.
抄録
背景:
SARS-CoV-2感染症陽性患者では，口腔粘膜に小水疱性および黄斑性の病変が報告されている．それにもかかわらず，口腔内症状の意義や生理機能は，感染症の臨床的進行や転帰において明確には確立されていない．
BACKGROUND: Vesiculobullous and macular lesions in the oral mucosa have been reported in patients positive for SARS-CoV-2 infection. Nonetheless, the significance and physiopathology of oral manifestations have not been clearly established in the clinical progression or outcome of the infection.
エイム:
SARS-CoV-2感染が確認された4人の患者における臨床病理学的口腔粘膜病変について述べる。
AIM: To describe the clinico-pathological oral mucosal lesions in four patients with confirmed SARS-CoV-2 infection.
方法と結果:
ポリメラーゼ連鎖反応（PCR）によりCOVID-19病変が確認された4例は狭心症性水疱性出血性病変、血管障害、非特異的口内炎を呈し、1例は組織学的に血管周囲反応性リンパ節炎、局所的毛細血管血栓症、出血を呈した。他の局所的・全身的疾患との鑑別、口腔症状と全身症状の同期発症から、COVID-19に関連すると思われる口腔病変と診断された。
METHODS AND RESULTS: Four patients with COVID-19 disease and confirmed by polymerase chain reaction (PCR) presented angina bullosa hemorragica-like lesion, vascular disorder, and nonspecific stomatitis, one patient with histological analysis demonstrated perivascular reactive lymphocitic infliltrate, focal capillary thrombosis, and hemorrhage. According to the discrimination of other local and systemic conditions and the synchronous onset of oral and systemic symptoms, the diagnosis of oral lesions probably associated with COVID-19 was established.
結論:
SARS-CoV-2感染は，様々な臨床症状を伴う口腔症状をもたらす可能性があり，血栓形成と血管炎の仮説を支持するものと考えられる．
CONCLUSION: Infection with SARS-CoV-2 may result in oral manifestations with various clinical presentations, which presumably support the hypothesis of thrombi formation and vasculitis; nevertheless, these findings need more evidence and a long-term follow up of patients to accurately establish the significance of the oral mucosa affection in the COVID-19 disease.
© 2020 Special Care Dentistry Association and Wiley Periodicals, Inc.