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Abstract: A 30-year-old male patient presented to our hospital with recurrent small intraoral blisters for six months. The patient’s intraoral mucosa was pale and scattered blisters were visible, and the diagnosis of oral aspergillosis was made after the completion of relevant examinations in the outpatient clinic. The patient was treated with glucocorticoids and hydrogen peroxide solution. After treatment, the herpes disappeared, the oral mucosa regained its flatness and redness, and the patient was satisfied with the reduction of symptoms.
Basic information】Male, 30 years old
Disease Type】Oral aspergillosis
Hospital】The First Hospital of China Medical University
Date of consultation】January 2022
Treatment plan】Medication (dexamethasone tablets + hydrogen peroxide solution)
Treatment Period】Follow up after 2 weeks, follow up for discomfort
Results】Herpes sores disappeared, oral mucosa regained flatness and redness, and symptoms were reduced
I. Initial consultation
In January 2022, a 30-year-old male patient came to our department with recurrent small intraoral herpes for six months. Upon questioning the medical history, the patient denied systemic diseases, and the patient and his family denied the history of travel to high school risk areas and the history of close contact with related personnel, and there were no recent fever, malaise, diarrhea, dry cough and respiratory symptoms such as nasal congestion, runny nose and sore throat. The patient reported that he had been chewing betel nut for the past 2 years and that small blisters often appeared in his mouth starting six months ago, which could subside on their own, with no abnormalities in other areas. Clinical examination revealed that the patient’s mouth opening was limited to degree I. The mucosa of both cheeks was pale and soft to palpation, and fibrous striae could be palpated in the left cheek near the corner of the mouth; the mucosa of the soft palate area was pale with plate-like changes, and 2-3 small blisters were seen scattered on the surface, without congestion and erosion. After completing relevant examinations to assess the condition, the patient was initially diagnosed as having oral aspergillosis based on the clinical manifestations and ancillary examinations.
II. Treatment process
I told the patient to take oral dexamethasone tablets for anti-inflammation and suppression of immune response, and to gargle with hydrogen peroxide solution to reduce local inflammatory damage and pain in the oral mucosa. In addition, I told the patient to avoid spicy and irritating food, to stop smoking and drinking, to enhance nutrition, to eat more fresh vegetables, fruits and protein-rich food, and to follow up promptly if there is any discomfort or adverse reaction.
Third, the effect of treatment
After medication and life intervention, local anti-inflammation and pain relief, immune response was relieved, symptoms were reduced, pain gradually disappeared, blisters became smaller and gradually disappeared, ruptured surface gradually became smaller, redness and swelling subsided. At the follow-up two weeks after the initial consultation, no new blisters were seen, the white spots on the mucosa of the ruptured surface had disappeared, and the oral mucosa had regained its flatness and redness, so the treatment effect was remarkable. The use of glucocorticoids did not show any obvious side effects, and the dosage was gradually reduced according to the condition.
IV. Precautions
After seeing the relief of the patient’s oral aspergillosis symptoms, I felt very relieved and instructed the patient to pay attention to the following points.
1. No betel nut chewing, no stimulating food, no smoking, no alcohol, no spicy and barbecued fried food. Such as: chili, onion, ginger, garlic, leek, mutton, dog meat and other raw hair stimulating food.
2, avoid long-term application of broad-spectrum antibiotics and immunosuppressants.
3, maintain a regular routine, ensure adequate sleep, avoid strain and stay up late, and keep a happy mood in daily life.
4.When taking glucocorticoids, observe whether there are any adverse drug reactions, such as increased food intake, elevated blood pressure, elevated blood sugar, mental excitement, gastrointestinal bleeding, etc. If there are any of the above situations, you should communicate with your doctor in time.
V. Personal insight
Oral aspergillosis is an autoimmune disease that can occur not only in the oral mucosa but also in the mucosal tissues of various organs, causing long blisters to appear on the mucosa, which can break down and can form larger pieces of lesions. In this case, the patient often eats betel nut, which can cause the oral mucosa to be stimulated, making it easy for pemphigus to appear in the mouth. It is important to regulate the rhythm of life and work, eat a balanced diet, eat less spicy and other stimulating foods, avoid eating rough or repeatedly chewed food, and pay attention to dietary health.