Galvanic Mucositis Occurred at Leukoedema of Bilateral Buccal Mucosa

서지정보

· 발행기관 : 대한구강악안면병리학회
· 수록지 정보 : 대한구강악안면병리학회지 / 38권 / 4호 / 233 ~ 240페이지
· 저자명 : 이상신, 김철, 김성훈, 이석근

초록

Oral galvanism is known to induce chronic irritation on oral mucosa, but the related pathology rarely occurs. A 65 years old malecomplained of linear horizontal ulcerations on his bilateral buccal mucosa for one month. The oral ulcerations were parallel and approximatedto his occlusal plane. He had multiple metallic crowns using gold and nickel cobalt alloy at bilateral upper and lower molarteeth, and also had accustomed to heavy smoking for more than twenty years. Biopsy examination was performed with immunohistochemicalstaining using antisera of PCNA, D2-40, and PARP. The epithelial ulcer had clear margin and was replaced bygranulation tissue containing many dilated lymphatic vessels, which were positive for D2-40, but showed no feature of pseudo-necroticmembrane. Nearby epithelium showed the typical features of leukoedema, characterized by edematous keratinocytes with clear cytoplasmsand pyknotic nuclei, low rete ridges, and rough superficial epithelial layer, where PCNA was rarely positive. Some superficialedematous keratinocytes showed perinuclear cytoplasmic vacuolization, and their peripheral nuclear chromatins were positive for PARP.
Taken together, the present mucosa ulceration was different from aphthous stomatitis, herpes stomititis, oral lichen planus, etc., thusit was postulated that the galvanic current generated from between the upper and lower dissimilar metal crowns could affect the precedentleukoedema caused by heavy smoking habit and produce the linear horizontal buccal ulceration. Therefore, the present case was diagnosedas galvanic mucositis associated with leukoedema, and it was also hypothesized that the mild and persistent galvanic currentwas able to deplete the cytoplasmic fluid of leukoedema keratinocytes via the osmotic pressure difference elicited by increased ionicconcentration of galvanism, and followed by severe keratinocyte apoptosis and oral mucosa ulceration.

참고자료

· 없음