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皮膚病與口腔疾病 (代謝疾病 (全身性疾病 (糖尿病
嘴巴有ketone味
oral candidasis
舌炎benign…
皮膚病與口腔疾病
代謝疾病
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lipid reticuloendotheliosis
lipid 堆積在不同細胞的lysosome 內
Gaucher disease最常見 lipid-engorged macrophage
Niemann -Pick disease 有 Sea blue histocyte
血小板缺乏 骨頭栓塞出現錐形燒瓶樣變形 肝脾腫大
amyloidosis 類澱粉沈積
有血管的地方都會, 角膜軟骨不會
顏色淡不紅 牙齦舌頭唾液腺腫大
有non-inflammatory deposition
congo red stain, apple green
systemic(primary, myeloma, hemodialysis, heredifamilial)
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荷爾蒙性
thyroid
過高(glycosaminoglycan堆積, 眼球突出 exophthalmos一定要吃藥)
假性過高(低血鈣Chvostek;s sign, pitting enamel hypoplasia)
低下(巨舌, 牙齒無法萌發, myxedema)
hyperparathyroid(central giant cell granuloma ,osteoclast)
primary:adenoma
secondary慢性腎臟病
stone(腎結石) bone(brown tumor, 上顎增生, loss of lamina dura, sub-periosteal resorption)
abdominal groans(十二指腸潰瘍) moans
巨人症:Gh high level, 肢端肥大症
McCune-Albright (咖啡歐雷 內分泌失調 , 下顎增生巨牙
全身性疾病
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Vit-D ricket
PHEX gene 性聯遺傳 男性
enlarged pulp髓腔變大, dentin 中clefting 從 pulp 延伸到 DEJ, non-vital pulp
Crohn;s disease
口腔到消化道
orofacial granulimatosis,紅斑, plaque mucogingivitis
pyostomatitis vegetans(snail track, 嗜酸性囚浸潤)
口腔皮膚
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white spongy nevus
雙側 皺摺光滑白斑 hyperkeratosis, acanthosis 無惡性轉變
Darier's disease= keratosis dyskeratosis follicularos, Dierier-white disease
鵝卵石狀白斑 cobblestone 點狀紅白班, UV 敏感 , centrla keratin plugging
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Ehler-Danlos syndrome
1.3.5 collagen mutation 皮膚彈性超級高 gorlin sign, rupture of aorta
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multiple hamartoma syndrome=Cowden PTEN
multiple facial tichlilemmommas, multiple oral papules, acral keratosis
牙齦 舌背 頰黏膜 很多小小巷粉圓的顆粒
皰疹性
脫屑性牙齦炎
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Lichen Planus扁平苔蘚
中年女性 頰黏膜舌頭牙齦
reticular type(Wickham's striae)Erosive type(潰瘍 疼痛) 過度角化 , rete ridge鋸齒狀
被破壞的 colloid , civatte, cytoid, hyaline bodies
基底膜下有一層T cell 聚集的 bandlike infilitrate
Erythema
Erythema Multiforme
皮膚口腔黏膜生殖器 toxic epidermal necrolysis 大槻沒水泡破皮
target lesion(bull's eye)
多種發炎細胞浸潤 過度敏感導致 可能因為吃藥或曾經患有HPV 嚴重的 Steve Johnson syndrome
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CREST syndrome 全身性纖維化
calcinisuis cutis 皮膚鈣化
Raynaud; phenomenon
esophageal phenomenon
sclerodactyly手指硬化
telangiectasia 血管不規則硬化造成血管擴張
systemic sclerosis
CT不正常堆積 , Raynaud's phenomenon, claw-like finger, microstomia, PDL變厚