AFTY (grech, aphtha sore) — small sites of a superficial necrosis of an epithelium of mucous membranes. There are hl. obr. on a mucous membrane of an oral cavity, is more rare — on mucous membranes of a nose, an eye, generative organs. AFTY are formed at herpetic and hron, recurrent stomatitis (tsvetn. fig. 5 — 9), Pospishill's aftoida, Bekhchet's syndrome, a big aphthosis of Touraine, a foot-and-mouth disease and herpangina.
An etiology and a pathogeny
the Causative agent of herpetic stomatitis — a virus of usual herpes (see. Herpes ); in emergence hron, recurrent stomatitis the great value is attached by allergies, and also to diseases went. - kish. path and liver; the etiology of other forms of stomatitis is not finalized. As afta — secondary cells of damage of mucous membranes, a pathogeny of AFT it is various depending on an etiology of a basic disease.
Development of AFT takes place the following stages: spot, bubble (tsvetn. fig. 3 and 4), afta.
Cytologic picture of development And. it is typical: at a stage of a bubble — ballooning and reticular dystrophy of an epithelium, at a stage of an afta — disintegration and a nonspecific inflammation, defect of an epithelium (fig.), a necrosis of fabric, under it considerable infiltration of a connective tissue basis cellular elements on the course of vessels.
A clinical picture
Size AFT — from a pin head to 5 mm in dia., form roundish or oval. Quantity And. depends on a form of a disease; so, at herpetic stomatitis (see) on a mucous membrane of a mouth at an easy current it is observed 1 — 5 And., at medium-weight — to 20, at heavy — can reach 100. Surface And. it is covered with an ochroleucous plaque; duration of their development at acute stomatitis — from 5 to 10 days, at chronic — up to 30 days. Heal And., without leaving on a mucous membrane of hems.
During the weakening of protective forces of an organism And. can, merge, forming extensive erosive surfaces.
Herpangina, or herpangina — the disease caused by Koksaki's viruses (see. Quinsy ); on a soft palate and handles there are pink specks size about a pin head which are consistently turning into papules, vesicles and roundish erosion on the hyperemic basis (tsvetn. fig. 2).
At to Pospishill's aftoida AFTY are localized not only on a mucous membrane of a mouth, but also on a mucous membrane of generative organs, on face skin, hands.
In a crust, time the disease meets seldom; apparently, represents one of the most severe forms of herpetic stomatitis.
At Bekhchet's syndrome afta appear at the same time on mucous membranes of a mouth, generative organs and eyes (see. Bekhcheta disease ).
Big aphthosis of Touraine on manifestations on a mucous membrane of an oral cavity it is similar to the above described diseases; however rash And. happens against the background of very serious general condition (multiple thrombosis of vessels of a retina, brain and its covers, intestines) to a high lethality.
And. on a mucous membrane of a mouth, a nose at a foot-and-mouth disease — see. Foot-and-mouth disease .
General treatment of a basic disease. Locally in all cases appoint the anesthetizing applications of 5% of an emulsion of anaesthesin on peach-kernel oil. In the first two days at herpetic stomatitis appoint antiviral drugs — 0,25% oxolinic ointment, interferon (solution), interferon ointment, etc.; in the next days and at afta of other etiology — the ointments containing antiseptic agents, antibiotics and corticosteroids. During healing And. — keratoplastichesky means (karotolin, oil of a dogrose, oil of a sea-buckthorn, etc.).
Afta of newborns
Afta of newborns (synonym: Bednar's afta, ulcera decubitalia palati) — the dekubitalny ulcers by the form reminding And., result from a bruise of a mucous membrane of the sky at careless wiping of a mouth of the newborn or owing to disturbance of an integrity of an epithelium a pacifier at artificial feeding (the epithelium of a mucous membrane of a mouth of the newborn does not orogovevat and is easily injured).
Newborns and babies on a mucous membrane of the sky in a transition range of a hard palate in soft more or less symmetrically from the centerline have ulcerations of rounded shape, small by the size, being located according to hamulus pterygoideus (tsvetn. fig. 1).
The same sores, but several big sizes, usually oblong shape, in certain cases arise also on the centerline of the sky.
Bednar's ulcers can become entrance gate of a septic infection.
In the started cases separate sores merge and form quite extensive wound surface in the form of a butterfly with deep crateriform deepening in the center. The surface of such ulcer rather often becomes covered by a fibrinous plaque, and then the disease reminds diphtheria of a pharynx.
Specification of the diagnosis requires a laboratory research of a smear.
At superficial damages of a sore disappear completely after an exception of the injuring factor; deep defeats begin to live with formation of a hem.
the Exception of the injuring factor. Locally — at deep defeat the surface of an ulcer is cleared solutions of enzymes (trypsin, chymotrypsin, chemical opsin, etc.) also cover with keratoplastichesky means (oil of a sea-buckthorn, a dogrose, Solutio oleosa of vitamin A, karotolin, etc.).
Extremely careful and only in case of need clarification of an oral cavity of the newborn from the got amniotic waters and separated patrimonial ways of mother; further — an explanation of mother that wiping of an oral cavity of the child is excessive. At artificial feeding it is necessary to watch that the pacifier was short, a surface its smooth.
Bibliography: Viral diseases of the person, under the editorship of A. F. Bilibin, page 302, M., 1967; Laboratory diagnosis of viral and rickettsial diseases, under the editorship of E. Flax-not that and N. Schmidt, the lane with English, page 622, M., 1974; Pashkov B. M. Damages of a mucous membrane of an oral cavity at skin and venereal diseases, M., 1963, bibliogr.; Rudnev of G. P. Antropozoonoza, page 206, M., 1970, bibliogr.; A. I. fishermen. Stomatitises, M., 1964, bibliogr.; Behcet H. Über rezidivierende aphthöse durch ein Virus verursachte Geschwüre am Mund, am Auge und an den Genitalien, Derm. Wschr., Bd 105, S. 1152, 1937; Touraine A. L’aphtose, Bull. Soc. frang. Derm. Syph., t. 48, p. 61, 1941; S with h u e r-m a η n H. Krankheiten der Mundschleimhaut und der Lippen, München — B., 1958.
A. newborns — Gavrilov K. P. Features of development and pathology of children of the period of a neonatality, page 90, M., 1951; Round A. F. Fiziologiya and pathology of newborn children, page 255, L., 1967; Shagan B. F. Bases of the doctrine about the newborn child, page 374, Frunze, 1966.
T. F. Vinogradova; A. F. Tour (ped.).