. — P. 51-52.

UDC 616.233-018.7-091.818-079.6

D.M. Logoyda

Department pathological anatomy(Head - Prof. D.D. Zerbino) Lviv Medical Institute

During a histological examination of the lungs of people who died from violent death, the author found desquamation of the epithelial lining of the bronchi. Its degree could not be associated with the type of death: it depended on the time of autopsy and on the temperature of the environment in which the corpses were stored.

Assessment of the Desquamation of Bronchical Epithelium in Corpses

The phenomenon is of purely post-mortem nature. It depends on the cadaveric alterations and post-mortal retraction of the bronchii. No correlation with the cause of death could be found.

Received by the editors 2/III 1967

Assessment of desquamation of the bronchial epithelium in a corpse

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Assessment of desquamation of the bronchial epithelium in a corpse / Logoyda D.M. // Forensic medical examination. - M., 1968. - No. 1. — P. 51-52.

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Histological examination of the lungs of people who died from various diseases reveals desquamation of the bronchial epithelium. Various opinions have been expressed regarding the intravital or posthumous nature of this phenomenon. However, due importance was not given to the temperature conditions of storage of corpses and the duration of death. We studied the lungs of 57 healthy people who died a violent death (mechanical asphyxia, electrical trauma, poisoning carbon monoxide, mechanical damage leading to death immediately or within an interval of up to 11 hours). Autopsies were performed 10–63 hours after death. After fixation in formalin, the pieces were embedded in celloidin-paraffin, paraffin, or celloidin. Sometimes sections were made using a freezing microtome after embedding in gelatin.

We always found desquamation and discomplexation of the epithelium in the bronchi. They were more pronounced or weaker, but their degree did not depend on the type and speed of death.

In different bronchi, the picture was different: larger bronchi were partially or completely devoid of epithelial lining, and epithelial cells lay in layers or scattered in their lumen. In some large bronchi there was no epithelium left at all. In the bronchioles and small bronchi, the lumens were very often clogged by desquamated epithelium in the form of layers and scattered cells. In the alveoli, especially those originating from the respiratory bronchi, bronchial epithelial cells were occasionally found. This displacement of the epithelium of the respiratory tract into the underlying sections of the N.G. Paykov considers this evidence of intravital movement under the influence of a stream of inhaled air. However, we observed this phenomenon not only during delayed death, but also during instant death from injuries, as well as from asphyxia, which prevented inhalation of air.

The most dramatic desquamative changes with the same type of death were noted in the summer. Thus, in one observation, when death occurred in the summer from bullet wound damaged skulls medulla oblongata, and the autopsy was performed 10 hours after death, desquamation was more pronounced than in similar cases in winter, although in winter the corpses were opened 22-23 hours after death. Air temperature influenced the degree of epithelial desquamation even in asphyxial death - in winter it was less pronounced than in summer. The fact that small bronchi are sometimes completely closed by layers epithelial cells, is explained by the “sliding” of the epithelium from the larger bronchi into them, as well as the fact that after death they sharply contract, as a result of which the mucous membrane is collected in longitudinal folds, almost completely filling the lumen.

Coding and selection of the initial cause of death for injuries and poisonings in accordance with WHO updates / Vaisman D.Sh. // Forensic medicine. - 2015. - No. 3. — P. 17-20.

Analysis of examinations of corpses of persons who died from injuries in 2017 in the Perm Regional Clinical Hospital / Shevchenko K.V., Borodulin D.V. // Selected issues of forensic medical examination. - Khabarovsk, 2018. - No. 17. — P. 218-221.

Modern problems of damage research in publications of the journal “Forensic Medical Examination” (2000-2014) / Fetisov V.A., Gusarov A.A., Khabova Z.S., Smirenin S.A. // Forensic medical examination. - M., 2015. - No. 4. — P. 56-62.

Forensic medical aspects of violent death / Kolkutin V.V. // Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. - No. — P. 152.

About completed suicides among elderly and senile people in Kemerovo for 1999-2003. / Maltsev S.V., Ivkin A.A. // Mat. VI All-Russian. Congress of Forensic Physicians. - M.-Tyumen, 2005. - No. — P. 192.

Therapeutic dentistry. Textbook Evgeniy Vlasovich Borovsky

11.9.3. Desquamative glossitis

Etiology and pathogenesis. Not completely clarified. Most often, desquamative glossitis (glossitis desquamativa, geographic tongue, exfoliative, or migratory glossitis) occurs in diseases gastrointestinal tract, vegetative- endocrine disorders, rheumatic diseases (collagenosis). It is also believed that a certain role is played in the occurrence of desquamative glossitis. viral infection, hyperergic state of the body, hereditary factors. The disease occurs equally often in different age groups.

Clinical picture. The process begins with the appearance of a whitish-gray area of ​​opacity of the epithelium several millimeters in diameter. Then it swells and in the center the filiform papillae slough off, revealing a bright pink or red rounded area that stands out against the surrounding slightly raised zone of opacified epithelium (Fig. 11.51). The area of ​​desquamation quickly increases, maintaining an even round outline, but the intensity of desquamation decreases. The area of ​​epithelial desquamation may be different shapes and size and appears as reddish spots. Sometimes areas of desquamation have the shape of rings or half rings. In the area of ​​desquamation, mushroom-shaped papillae are clearly visible, looking like bright red dots. When the focus of desquamation reaches a significant size, its boundaries blur in the surrounding mucous membrane, and in its center, following desquamation, normal keratinization of filiform papillae begins to be restored, while in areas of keratinization, on the contrary, desquamation occurs. Foci of desquamation can be single, but more often they are multiple and, as a result of constantly changing processes of keratinization and desquamation, they are layered on top of each other. Against the background of old lesions, new ones form, as a result of which the shape of the desquamation areas and the color of the tongue are constantly changing, which gives the surface of the tongue a look resembling geographical map. This served as the basis for the names “geographical language” and “migratory glossitis”. A rapid change in the outlines of desquamation foci is characteristic; the picture changes even upon examination the next day. Foci of desquamation are localized on the back and lateral surfaces of the tongue, usually not spreading to the lower surface.

Rice. 11.51. Desquamative glossitis.

Alternating areas of epithelial desquamation with increased keratinization of filiform papillae on the dorsum of the tongue.

In most patients, especially children, changes in the tongue occur without any subjective feelings and are detected by chance during an examination of the oral cavity. Only some patients complain of burning, tingling, paresthesia, pain from irritating foods. Patients are also bothered by the strange appearance of the tongue; Maybe develop cancerophobia. Emotional stress conditions contribute to a more severe course of the process. Desquamative glossitis arising against the background of pathology of the gastrointestinal tract and other systemic diseases, can periodically worsen, which is often due to exacerbation of somatic diseases. Exacerbation of desquamative glossitis is accompanied by an increase in the intensity of desquamation of the epithelium of the mucous membrane of the tongue. Desquamative glossitis is combined with a folded tongue in approximately 50% of cases.

The disease lasts indefinitely, without causing concern to patients, sometimes disappears for a long time, then reappears in the same or other places. There are cases when desquamation occurs predominantly in the same place.

Diagnostics. Recognizing the disease does not present any particular difficulties, since its clinical symptoms are very characteristic. Desquamative glossitis should be differentiated from:

Lichen planus;

Leukoplakia;

Plaques in secondary syphilis;

Hypovitaminosis B 2, B 6, B 12;

Allergic stomatitis.

Histological changes are characterized by thinning of the epithelium and flattening of the filiform papillae in the area of ​​desquamation, parakeratosis and moderate hyperkeratosis in the epithelium of the areas surrounding the affected area. In fact mucous layer- mild swelling and inflammatory infiltrate.

Treatment. In the absence of complaints and discomfort no treatment is provided. If a burning sensation or pain occurs, oral sanitation is recommended. elimination of various irritants, rational oral hygiene. Hygienic recommendations are especially relevant in the case of a combination of desquamative glossitis with a folded tongue, in which anatomical features structures create favorable conditions for the proliferation of microflora in the folds, which can cause inflammation, causing pain. If there is a burning sensation, pain, light antiseptic rinses, irrigations and oral baths with citral solution (25–30 drops of 1% citral solution in half a glass of water), applications of a 5-10% suspension of anesthesin in an oil solution of vitamin E, applications of keratoplastics (oil vitamin A solution, rosehip oil, carotoline, etc.). Treatment with calcium pantothenate (0.1–0.2 g 3 times a day orally for a month) gives good results. In some patients, a positive effect is observed from the use of novocaine blockades in the area of ​​the lingual nerve (10 injections per course). In case of severe pain, it is advisable to prescribe local painkillers. Detection and treatment is mandatory concomitant diseases. This treatment is symptomatic, it is aimed at eliminating or reducing pain and reducing the frequency of relapses. However, there is still no means of completely eliminating relapses of the disease, especially in old age. Cancerophobia often develops. Prevention of such conditions can include individual conversations with patients and correct deontological tactics. The prognosis for life of the disease is favorable; the possibility of malignancy of desquamative glossitis is excluded.

Desquamative glossitis is an inflammatory-dystrophic lesion of the mucous membrane of the tongue, characterized by the formation of smooth, bright red lesions with a whitish border, cracks and furrows due to uneven exfoliation of the epithelium. Desquamative glossitis may be accompanied by a burning sensation, tingling of the tongue, irritation when eating, and a disturbance in the sense of taste.

The diagnosis of desquamative glossitis is based on clinical picture, data from a visual examination of the oral cavity, morphological, biochemical, microbiological, immunological studies, ultrasound. For desquamative glossitis, treatment is aimed at eliminating causative factors.

Desquamative glossitis is a disease of the mucous membrane of the tongue, leading to the formation of areas of desquamation (flaking, peeling) of the epithelium on its surface.

Desquamation areas can have different shapes, located both on the back of the tongue and on its lateral surfaces.

The disease occurs quite often, its occurrence does not fundamentally depend on the gender and age of a person.

Classification of desquamative glossitis

In dentistry, there are three clinical forms of desquamative glossitis.

For surface form The disease is characterized by clearly defined smooth, shiny bright red stripes and spots surrounded by healthy mucous membrane, accompanied by slight itching and burning.

At hyperplastic form Desquamative glossitis is determined by focal compactions due to hypertrophy of the filiform papillae of the tongue with a coating of white, yellow or gray color. Patients experience a sensation foreign body in the mouth.

Lichenoid form desquamative glossitis with migrating foci of desquamation, enlarged fungiform papillae and a burning sensation usually occurs with increased sensitivity of the tongue mucosa to various metals used in dental prosthetics.

Causes of Desquamative glossitis

The etiology and pathogenesis have not been fully elucidated. Most often, desquamative glossitis (glossitis desquamativa, “geographical” tongue, exfoliative, or migratory glossitis) occurs in diseases of the gastrointestinal tract, autonomic-endocrine disorders, and rheumatic diseases (collagenosis).

It is also assumed that a viral infection, a hyperergic state of the body, and hereditary factors play a certain role in the occurrence of desquamative glossitis. The disease occurs equally often in different age groups, more often in women.

Symptoms of Desquamative glossitis

The process begins with the appearance of a whitish-gray area of ​​opacity of the epithelium with a diameter of several millimeters. Then this area bulges and in its center the filiform papillae slough off, revealing a bright pink or red rounded area that stands out against the background of the surrounding slightly raised zone of opacified epithelium. The area of ​​desquamation quickly increases, maintaining an even round outline, but the intensity of desquamation decreases. The zone of desquamation of the epithelium can be of different shapes and sizes and appears as reddish spots. Sometimes areas of desquamation have the shape of rings or half rings. In the area of ​​desquamation, mushroom-shaped papillae in the form of bright red dots are clearly visible. When the focus of desquamation reaches a significant size, its boundaries blur in the surrounding mucous membrane, and in the center, following desquamation, the normal keratinization of filiform papillae begins to be restored, while in areas of keratinization, on the contrary, desquamation occurs.

Foci of desquamation may be single; but more often they are multiple and, as a result of constantly changing processes of keratinization and desquamation, they are layered on top of each other. Against the background of old lesions, new ones form, as a result of which the shape of the desquamation areas and the color of the tongue are constantly changing, which gives the surface of the tongue a look reminiscent of a geographical map. This served as the basis for the names “geographical language” and “migratory glossitis”. A rapid change in the outlines of desquamation foci is characteristic; the picture changes even upon examination the next day. Foci of desquamation are localized on the back and lateral surfaces of the tongue, usually not spreading to the lower surface.

In most patients, especially children, changes in the tongue occur without any subjective sensations and are detected by chance during an examination of the oral cavity. Only some patients complain of burning, tingling, paresthesia, pain from irritating foods. Patients are also bothered by the strange appearance of the tongue; Cancerophobia may develop. Emotional stressful conditions contribute to a more severe course of the process. Desquamative glossitis, which occurs against the background of pathology of the gastrointestinal tract and other systemic diseases, can periodically worsen, which is often due to exacerbation of somatic diseases. Exacerbation of desquamative glossitis is accompanied by an increase in the intensity of desquamation of the epithelium of the mucous membrane of the tongue. Desquamative glossitis is combined with a folded tongue in approximately 50% of cases.

The disease lasts indefinitely, without causing concern to patients, sometimes disappears for a long time, then reappears in the same or other places. There are cases when desquamation occurs predominantly in the same place.

Diagnosis of Desquamative glossitis

Recognizing the disease does not present any particular difficulties, since its clinical symptoms are very characteristic.

Desquamative glossitis should be differentiated from:
- lichen planus;
- leukoplakia;
- plaques in secondary syphilis;
- hypovitaminosis B2, B6, B2;
- allergic stomatitis;
- candidiasis.

Histological changes are characterized by thinning of the epithelium and flattening of the filiform papillae in the area of ​​desquamation, parakeratosis and moderate hyperkeratosis in the epithelium of the areas surrounding the affected area. In the mucous layer itself there is slight swelling and inflammatory infiltrate.

Treatment of Desquamative glossitis

If there are no complaints or discomfort, treatment is not carried out. If a burning sensation or pain occurs, sanitation and rational oral hygiene and elimination of various irritants are recommended. Hygiene recommendations are especially relevant in the case of a combination of desquamative glossitis with a folded tongue, in which the anatomical features of the structure create favorable conditions for the proliferation of microflora in the folds, which can cause inflammation that causes pain.

If there is a burning sensation, pain, light antiseptic rinses, irrigations and oral baths with citral solution (25-30 drops of 1% citral solution in half a glass of water), applications of a 5-10% suspension of anesthesin in an oil solution of vitamin E, applications of keratoplastics (oil vitamin A solution, rosehip oil, carotoline, etc.).

Treatment with calcium pantothenate (0.1-0.2 g 3 times a day orally for a month) gives good results. In some patients, a positive effect is observed from the use of novocaine blockades in the area of ​​the lingual nerve (10 injections per course). In case of severe pain, it is advisable to prescribe local painkillers. Identification and treatment of concomitant diseases are mandatory.

This treatment is symptomatic, it is aimed at eliminating or reducing pain and reducing the frequency of relapses. However, there is still no means of completely eliminating relapses of the disease, especially in old age. Cancerophobia often develops. Prevention of such conditions can include individual conversations with patients and correct deontological tactics.

The prognosis for life of the disease is favorable; the possibility of malignancy of desquamative glossitis is excluded.

Forecast and prevention of desquamative glossitis

Desquamative glossitis does not pose a threat to the patient’s health; the likelihood of malignant lesions is excluded.

To prevent primary desquamative glossitis, it is necessary to eliminate traumatic factors (grinding fillings, fitting dentures), avoid smoking, drinking alcohol, and irritating foods. Prevention of secondary desquamative glossitis consists of treating the underlying diseases of which it is a manifestation.

Inflammation of the tongue, accompanied by keratinization and rejection of the papillae of the mucous membrane (desquamation), is called desquamative glossitis. The diagnosis is not difficult, since the tongue has characteristic appearance.

But in order to effectively treat a disease, it is necessary to identify its underlying cause. It was found that women and children are more susceptible to pathology. In adults, desquamative glossitis is rare.

What language changes characterize the disease?

The normal appearance of the tongue is pale pink in color and has a velvety surface on the back and edges. This is explained by the formation of numerous papillae from the cells of the mucous membrane. They are outgrowths, covered with stratified squamous epithelium, differ in shape, size and functional purpose. Vessels and sensitive nerve endings approach them.

Filiform papillae are the most numerous. They occupy the entire front surface of the tongue and the marginal part. The height of the protrusions of keratinizing cells is in the range of 0.6–2.5 mm (they are longer closer to the tip). Sloughing scales form on the surface of the cells. They give the tongue a whitish color. The process is ongoing.

In case of disorders, the rejection of keratinized cells is delayed, which is manifested by a white coating (doctors say “coated tongue”). Filiform papillae do not have taste buds and do not participate in determining the taste of food. Their main function is to sense touch and hold food on the tongue so that other papillae can make an assessment.

Desquamative glossitis is associated with dystrophic changes in the filiform papillae. The process of keratinization and epithelial rejection is disrupted. The appearance of the tongue is characteristic: against the background of the normal mucosa, foci of desquamation of various shapes and sizes appear. They resemble a geographical atlas or map. Thus, the name of the feature was formed - “geographical” language.

Causes of the disease

The search for the causes of desquamative glossitis is still ongoing. Most authors agree that dystrophic changes are caused by vascular disorders. There is a decrease in cell nutrition. Pathology can occur either primary (independent disease) or as a result of another disease (secondary).

The changes do not cover the entire shell, but individual areas; foci appear and disappear quickly, it seems that they migrate from one zone to another

Primary desquamative glossitis is caused by:

• injury to the tongue from the sharp edge of damaged teeth;
• in children, irregular eruption of baby teeth;
• uncomfortable prosthesis or filling;
• burn from hot food or chemicals.

Secondary glossitis appears due to hypersensitivity mucous membrane of the tongue to any dysfunction in the body, pathological processes. Desquamation of the epithelium is disrupted:

• for chronic diseases of the gastrointestinal tract;
• pathologies of the liver and gall bladder;
• poor nutritional quality, hunger;
• changes in the vitamin-mineral composition of tissues (with a lack of vitamins B 3, B 1, B 6, folic and pantothenic acid, disturbed iron balance);
• diseases of the blood and hematopoietic organs;
• autoimmune systemic pathology (lupus erythematosus, scleroderma, rheumatism);
• endocrine disorders and functional imbalance of hormones during pregnancy;
• autonomic disorder nervous system;
• chronic skin diseases (psoriasis, exudative diathesis).

Less commonly, cases of desquamative glossitis are found in acute infectious diseases (scarlet fever, influenza, typhoid fever), helminthic infestation in children with severe dysbiosis, as a negative effect medicines(antibiotics).

The baby's molar is growing in the second row, which creates problems for the tongue

Special attention is given a hereditary form if desquamative glossitis is detected in members of the same family.

Classification

Depending on the relief of the mucous membrane of the tongue and the degree of damage to the papillary layer, dentists distinguish 3 forms of desquamative glossitis. Superficial - a clear pattern of smooth bright red stripes and spots is visible on the tongue, with healthy mucous membranes around it. Patients experience mild burning and itching.

Hyperplastic - characterized by foci of compaction formed by hypertrophied filiform papillae, on the tongue there is a dense coating of gray-white or yellow. Patients experience a sensation of a foreign body in oral cavity, discomfort.

Lichenoid - foci of desquamation are characterized by migration, enlargement of fungiform papillae in the desquamation zone, they are surrounded by a cluster of filamentous forms. Every day the “geographical” picture changes. People feel a burning sensation. It is more common in dental prosthetics due to the increased sensitivity of the tongue mucosa to metals used in dentistry.

By morphological changes tissues with calculation of the keratinization index (percentage of keratinized epithelium), biochemical changes and immunological tests, the readiness of cells for apoptosis (the normal process of destruction of dying cells by tissue phagocytes), clinical types of desquamative glossitis are identified.

Microbial

Another name - dysbiotic (caused by changes in opportunistic flora) - is detected in individuals with infectious diseases of the respiratory and digestive systems. Morphology shows a decrease in the keratinization index by 20%, an increase in the number of cells ready for destruction by 5 times.

Bacteriological examinations from the oral cavity reveal pathogenic microorganisms ( Staphylococcus aureus, β-hemolytic streptococcus) and opportunistic pathogens (clostridia, staphylococci, corynebacteria). Immunological analysis indicates reduced level immunoglobulin A (IgA), which provides local immunity, and lysozyme activity in saliva.

Biochemical tests provide information about a decrease in the hormone norepinephrine. A study of blood flow using Doppler ultrasound shows a decrease in the volume of blood passing through the capillaries of the tongue by 20–30% of normal level.

Candida

Usually considered accompanying symptom inflammation of the oral cavity, pharynx, ears, intestinal dysbiosis. Plaque and areas of desquamation do not migrate, the epithelium grows in a hyperplastic type, blast forms of fungi and pseudomycelium are detected in it, exceeding the norm by almost 9 times.

Tissue morphology shows a 30% decrease in the keratinization index (this is attributed to the toxic effect of fungi), and a 1.5-fold increase in the number of epithelial cells prepared for lysis.
Immunologically, a 3-fold decrease in the level of immunoglobulin A, with a decrease in lysozyme activity, was proven.

Neurogenic

Glossitis of the neurogenic type is characterized by the presence of neurological symptoms or mental disorders in the patient. Typically a person is observed for:

• asthenoneurotic or hypochondriacal syndrome;
• neurasthenia;
• various phobias (fears).

Phobias in appearance healthy person are not advertised, but cause an unexpected reaction

In such patients, the content of norepinephrine in the blood is increased 7 times. A study of the blood flow of the tongue shows capillary spasms and foci of dystrophy. Confinement causes cancerophobia (fear of cancer) in patients. The keratinization index is reduced by half, and the mass of epithelial cells prepared for apoptosis is increased by 3 times. There is usually a decrease in saliva production.

Allergic

According to the name, the pathology accompanies chronic allergic diseases:

• hives;
• diathesis;
• vasomotor rhinitis;
• medicinal and food allergies;
• pronounced reaction to pollen of plants and flowers.

At the same time, the content of histamine in the oral cavity increases by 2 times. The keratinization index was slightly reduced. The number of cells ready for apoptosis is increased by 2 times.

Mixed

It is expressed in a combination of signs of candidiasis and allergic desquamative glossitis.

How does the disease manifest?

Symptoms of desquamative glossitis often occur without obvious causes. Less commonly, a person first experiences vague pain in the tongue (glossalgia) and numbness in the mouth. Almost 50% of patients have a combination with tongue folding. Not everyone has complaints. In most cases, the desquamative process is detected by chance at an appointment with a dentist or otolaryngologist.

Sometimes patients report discomfort, especially when eating; some have problems pronouncing words and impaired taste. The abnormal appearance of the tongue is usually a concern. First, small irregularly shaped areas appear on the surface, covered with a whitish-gray coating.

Penetration of infection into the deep layers can cause abscess formation, as seen in the photo

Then top layer swells and peels off, and in its place remains a smooth, bright spot of pink or red color. It stands out sharply against the background of the surrounding white and pink shade. The process of disappearance of epithelial cells begins from the periphery of the lesion. Due to this, the filiform papillae atrophy in the central part, the inflammatory zone is visible at the edges, and the lesion itself increases in size.

Recovery occurs in 2–3 days. Foci of desquamation are multiple in nature and are located on the back and sides of the tongue. The picture of the mucous membrane is constantly changing due to non-simultaneous transformations in different foci. The disease is long lasting, chronic course. A “geographical” pattern may temporarily disappear, then appear again in the same place or nearby.

Exacerbations are typical after suffering from stress, against the background of relapses of other chronic diseases.

It is important that the lesions lack normal mucosa. This means that infection penetrates through them much faster, a local reaction appears in the form of cracks, painful inflammation. Increase possible submandibular lymph nodes and general malaise.

How is diagnosis carried out?

Suspicion of the diagnosis arises after asking the patient about the sensations in the mouth and examining appearance language. For reliable confirmation, dentists use laboratory methods and the study of morphological structure, blood circulation, and local immunity. To establish the type of desquamative glossitis, the keratinization (keratinization) index is calculated. When sick, it decreases by 20–50%.

According to the morphological composition of cells, the mass of epithelial cells ready for apoptosis is important. Immunity is characterized by a drop in the level of serum IgA and salivary lysozyme. The content of norepinephrine in saliva is determined biochemically. Increased level indicates spastic contraction of capillaries and malnutrition of the papillae with cell degeneration.

Visual inspection is the first stage of diagnosis

Another important biochemical indicator is the level of histamine. Exceeding the norm indicates an allergic origin of glossitis. Bacteriological analysis the method of inoculating a smear from the surface of the tongue allows you to establish the cause or associated pathogenic flora. For precise definition use enzyme immunoassay, polymerase chain reaction technique.

Desquamative glossitis must be differentiated:

• with secondary changes in syphilis;
• lichen planus in the lichenoid form;
• flat form of leukoplakia;
• scleroderma;
• Addison-Beermer disease;
• exudative erythema;
• vitamin A deficiency;
• galvanosis.

If there are difficulties in diagnosis, the participation of specialists from different fields is necessary: ​​dentist, gastroenterologist, otolaryngologist, infectious disease specialist, dermatologist, neurologist, psychiatrist.

How is desquamative glossitis treated?

The treatment of desquamative glossitis must include general and local measures. Treatment of exacerbations of chronic diseases of the stomach and intestines, liver and gall bladder is carried out.

A gentle diet involves limiting fatty and fried foods, smoked foods, spicy seasonings and pickles, acidic foods. The diet should exclude fast food, canned food, hard crackers, and nuts.

Children may need a course of deworming with special drugs. Complexes of vitamins and minerals must be prescribed to eliminate hypovitaminosis, probiotics and prebiotics to restore the balance of intestinal microflora. May be needed antihistamines, soothing. To stimulate the immune system, immunomodulators are indicated (aloe, extract of lemongrass, lemongrass, transfer factor).

Rosehip oil enhances healing and has bactericidal properties

Local procedures begin with complete sanitation of teeth and replacement of irritating dentures. To relieve pain and burning sensations, the following are recommended:

• rinsing with antiseptic solutions (soda, Chlorhexidine, Furacilin);
• applying applications to the lesions with oil solutions of Retinol, rosehip, glycerin solution of Anesthesin Pyromecaine;
• if the pain does not disappear, do novocaine blockade lingual nerve.

Antibacterial and antifungal agents may be needed in therapy. Physiotherapeutic treatment using the methods of medicinal electrophoresis, ultraphonophoresis, and ultrasound therapy is effective.

Desquamative glossitis usually does not cause problems for patients and is safe for health. Virtually no transformation is observed in cancerous tumor language. To prevent this, you need to normalize your diet, give up smoking and alcohol, and promptly eliminate inconvenient factors of trauma after filling teeth or installing crowns.

The state of the tongue depends on general functioning digestive organs. Therefore, in addition to daily hygienic local procedures, patients with chronic diseases digestive tract patients must follow all the recommendations of the gastroenterologist and treat the underlying disease.