| disease | Tuberculous Ulcer |
Oral mucosal infection with subcutaneous nodule bacilli clinically manifests as ulcers, commonly seen in patients with open pulmonary subcutaneous nodules. The subcutaneous nodule bacilli in the patient's sputum often enter tissues through mucosal wounds caused by dental caries, residual roots, or other factors, and can also spread to the skin of the lips via lymphatic vessels from nasopharyngeal subcutaneous nodule bacteria. This disease is more common in adults. The key to prevention is early and effective treatment of the primary subcutaneous nodule infection, while avoiding trauma to the oral mucosa. Before the disease is cured, the patient's utensils and tableware should be isolated to prevent infecting others.
bubble_chart Clinical Manifestations
1. Ulcers are prone to occur in the parapharyngeal area, retromolar region, and buccal mucosa.
2. The shape of the ulcer presents with undermined edges, clear but irregular borders resembling rodent bites. The base is soft, granulation-like, dark red, and may be painful.
3. The disease progresses slowly.
bubble_chart Auxiliary Examination
Since the vast majority of this disease is secondary to patients with open pulmonary subcutaneous nodules, based on the clinical characteristics of the disease, chest X-ray fluoroscopy should be performed first. If no subcutaneous nodule lesions are found in the lungs, a pathological biopsy of ulcer tissue may be considered for definitive diagnosis.
1. History of subcutaneous node outside the oral cavity or contact history with subcutaneous node patients.
2. The ulcer margin appears undermined, resembling a rodent bite, with a soft granulation-like base that is dark red.
3. Acid-fast staining of the lesion smear reveals subcutaneous node bacilli.4. Histopathology shows subcutaneous node granulomatous manifestations.
5. Chest X-ray may reveal pulmonary subcutaneous node lesions. {|104|}
bubble_chart Treatment Measures
1. Systemic anti-subcutaneous node treatment.
2. For patients with obvious pain, use Yaodui syndrome treatment.
3. Strengthen nutrition and maintain oral hygiene.
When using medication, in order to reduce the drug's anti-medicinal property, it is best to choose a combination of two basic drugs to enhance efficacy. During the medication process, liver and kidney function should be monitored. For those with low body resistance or physical weakness, appropriate treatments such as human albumin or blood transfusion can be administered.
1. Cure: Symptoms and signs disappear, ulcer heals.
2. Improvement: Symptoms and signs significantly improve, ulcer shrinks.
3. No cure: Symptoms and signs show no improvement, ulcer fails to heal over time.
Subcutaneous nodular ulcers are sometimes misdiagnosed as cancerous tumors. If the primary cause of the subcutaneous nodule is unclear, a histopathological biopsy can be performed for differential diagnosis.
