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Orale submuköse Fibrose bei einer 31-jährigen Inderin

Erster Fallbericht aus Deutschland

Oral submucous fibrosis in a 31-year-old Indian women

First case report from Germany

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Zusammenfassung

Hintergrund

Die orale submuköse Fibrose (OSF) ist ein chronisches Krankheitsbild mit Fibrosierung des subepithelialen Bindegewebes der Mundhöhle und angrenzender Strukturen. Die OSF wird den oralen Präkanzerosen zugeordnet. Die Ursache ist das Kauen von Betel (Areca catechu L., Piper betle, Kalziumhydroxid, Tabak), vor allem aber von industriell hergestellten Produkten wie Pan Masala und Gutka, die in Südasien verbreitet sind. Das Leitsymptom der OSF ist die zum Teil extreme Einschränkung der Mundöffnung.

Fallbericht

Eine seit 1997 in Deutschland lebende 31-jährige Inderin stellte sich wegen zunehmender Mundöffnungseinschränkung vor. Sie gab an, seit dem 17. Lebensjahr Pan Masala und Gutka zu kauen. Die Anamnese, der klinische und histologische Befund ermöglichten die eindeutige Diagnose einer OSF.

Diskussion

Therapeutische Maßnahmen, sowohl konservativer als auch chirurgischer Art, führen bis heute zu keinen zufrieden stellenden Langzeitergebnissen. Da die OSF bereits bei Kindern und Jugendlichen auftreten kann, sollte das primäre Ziel sein, die Mundöffnungseinschränkung aufzuhalten oder zu verbessern. Chirurgische Maßnahmen sollten nicht zu früh erfolgen, da häufig Mehrfacheingriffe notwendig werden. Aufgrund einer zunehmenden Zahl von Migranten aus Südasien ist in Zukunft auch mit einer zunehmenden Zahl von Patienten mit OSF zu rechnen, da die arecanusshaltigen Produkte auch in Deutschland erhältlich sind.

Abstract

Background

Oral submucous fibrosis (OSF) is a chronic disease characterized by subepithelial collagen deposition with formation of bands involving the oral cavity and adjacent structures. Oral submucous fibrosis is a precancerous condition. It is caused by chewing of betel quid (Areca catechu L., Piper betle, lime and tobacco) and ready-made products like pan masala and gutka which also contain areca nut. These products are available all over South Asia. The hallmark of OSF is extremely restricted mouth opening.

Case report

A 31-year-old Indian woman who has lived in Germany since 1997 presented herself because of limitation of mouth opening. She reported that she has chewed pan masala and gutka since she was 17 years of age. History, clinical and histological findings clearly pointed to the diagnosis of OSF.

Discussion

Conservative as well as surgical interventions for OSF have not resulted in adequate long-term results. Since OSF may occur in children and young adults, the primary aim should be to avoid progression of the disease, initially by physiotherapy. Surgical interventions should not be applied at an early stage of the disease because recurrences and further surgical interventions are often necessary. Due to the increasing numbers of migrants from South Asia more cases of OSF will probably also be observed in Germany, where areca nut-containing products are also available.

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Literatur

  1. Babu S, Sesikeran B, Bhat RV (1996) Oral fibrosis among teenagers chewing tobacco, areca nut, and pan masala. Lancet 348: 692

    Article  Google Scholar 

  2. Canniff JP, Harvey W, Harris M (1986) Oral submucous fibrosis: its pathogenesis and management. Br Dent J 160: 429–434

    Article  PubMed  Google Scholar 

  3. El Naggar AK, Reichart PA (2005) Proliferative verrucous leukoplakia and precancerous conditions. In: Barnes L, Eveson JW, Reichart PA, Sidransky D (eds) World Health Organization classification of tumours. Pathology and genetic. Head and neck tumours. IARC, Lyon, pp 180–181

  4. Farrand P, Rowe RM, Johnston A, Murdoch H (2001) Prevalence, age of onset and demographic relationship of different areca nut habits among children in Tower Hamlets, London. Br Dent J 190: 150–154

    Article  PubMed  Google Scholar 

  5. Gupta PC, Sinor PN, Bhonsle RB, Pawar VS, Mehta HC (1998) Oral submucous fibrosis in India: a new epidemic? Natl Med J India 11: 113–116

    PubMed  Google Scholar 

  6. Haque MF, Meghji S, Nazir R, Harris M (2001) Interferon gamma (IFN-γ) may reverse oral submucous fibrosis. J Oral Pathol Med 30: 12–21

    Article  PubMed  Google Scholar 

  7. Hazare VK, Goel RR, Gupta PC (1998) Oral submucous fibrosis, areca nut and pan masala use: a case-control study. Natl Med J India 11: 299

    Google Scholar 

  8. Johnson NW, Maher R, Trivedi C, Warnakulasuriya S (1997) The clinical condition and pathology of oral submucous fibrosis. Oral Dis 3: 278–279

    Google Scholar 

  9. Kakar PK (1985) Oral submucous fibrosis: treatment with hyalase. J Laryngol Otol 99: 57–62

    PubMed  Google Scholar 

  10. Krishnapa A (1965) Oral submucous fibrosis. Dent J Malaysia Singapore 7: 32–39

    Google Scholar 

  11. Lai DR, Chen HR, Lin LM; Huang YL, Tsai CC (1995) Clinical evaluation of different treatment methods for oral submucous fibrosis. A 10-year experience with 150 cases. Oral Pathol Med 24: 402–406

    Google Scholar 

  12. Maher R, Aga P, Johnson NW, Sankaranarayanan R, Warnakulasuriya S (1997) Evaluation of multiple micronutrient supplementation in the management of oral submucous fibrosis in Karachi, Pakistan. Nutr Cancer 27: 41–47

    PubMed  Google Scholar 

  13. Merchant AT, Haider SM, Fikree FF (1997) Increased severity of oral submucous fibrosis in young Pakistani men. Br J Oral Maxillofac Surg 35: 284–287

    Article  PubMed  Google Scholar 

  14. Mokal NJ, Raje RS, Ranade SV, Rajendra Prasad JS (2005) Release of oral submucous fibrosis and reconstruction using superficial temporal fascia flap and split skin graft — a new technique. Br J Plast Surg 58: 1055–1060

    Article  PubMed  Google Scholar 

  15. Murti PR, Bhonsle RB, Pindborg JJ, Daftary DK, Gupta PC, Mehta FS (1985) Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dent Oral Epidemiol 13: 340–341

    PubMed  Google Scholar 

  16. Murti PR, Bhonsle RB, Gupta PC et al. (1995) Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing. J Oral Pathol Med 24: 145–152

    PubMed  Google Scholar 

  17. Nair U, Bartsch H, Nair J (2004) Alert for an epidemic of oral cancer due to use of the betel quid substitute gutka and pan masala: a review of agents and causative mechanisms. Mutagenesis 19: 251–262

    Article  PubMed  Google Scholar 

  18. Pillai R, Balaram P, Reddiar KS (1992) Pathogenesis of oral submucous fibrosis. Cancer 69: 2011–2020

    PubMed  Google Scholar 

  19. Pizzo G, Scardina GA, Messina P (2003) Effects of a nonsurgical exercise program of the decreased mouth opening in patients with systemic scleroderma. Clin Oral Invest 7: 175–178

    Article  Google Scholar 

  20. Reichart PA, Mohr U, Srisuwan S, Geerlings H, Theetranont C, Kangwanpong T (1987) Precancerous and other oral mucosal lesions related to chewing, smoking and drinking habits in Thailand. Community Dent Oral Epidemiol 15: 152–160

    PubMed  Google Scholar 

  21. Reichart PA, Schmidtberg W, Scheifele C (1996) Betel chewer’s mucosa in elderly Cambodian women. J Oral Pathol Med 25: 367–370

    PubMed  Google Scholar 

  22. Reichart PA, Khonghkhunthian P, Scheifele C, Lohsuwan P (1999) Thai dental student’s knowledge about the betel quid chewing habit in Thailand. Eur J Dent Educ 3: 126–132

    PubMed  Google Scholar 

  23. Reichart PA, Philipsen HP (2005) Betel and Miang. Vanishing Thai habits. White Lotus, Bangkok, Thailand

  24. Shah B, Lewis MAO, Bedi R (2001) Oral submucous fibrosis in a 11-year-old Bangladeshi girl living in the United Kingdom. Br Dent J 191: 130–132

    Article  PubMed  Google Scholar 

  25. Shiau YY, Kwan HW (1979) Submucous fibrosis in Taiwan. Oral Surg Oral Med Oral Pathol 47: 453–457

    Article  PubMed  Google Scholar 

  26. Sinor PN, Gupta PC, Murti PR, Bhonsle RB, Daftary DK, Mehta FS, Pindborg JJ (1990) A case-control study of oral submucous fibrosis with special reference to the etiologic role of areca nut. J Oral Pathol Med 19: 94–98

    PubMed  Google Scholar 

  27. Warnakulasuriya S (1987) Semi-quantitative clinical description of oral submucous fibrosis. Ann Dent 46: 18–21

    PubMed  Google Scholar 

  28. Warnakulasuriya S (2002) Areca nut use following migration and its consequences. Addict Biol 7: 127–132

    Article  PubMed  Google Scholar 

  29. World Health Organization (2004) International Agency For Research On Cancer: IARC. Monographs on the evaluation of carcinogenic risks to humans, Vol 85. Betel quid and areca-nut chewing and some areca-nut-derived nitrosamines. Lyon, France

    Google Scholar 

  30. www.berlin.de (Berliner Senat: Integration und Migration in Berlin. Zahlen, Fakten, Daten)

  31. www.destatis.de (Statistisches Bundesamt)

  32. www.isoplan.de (Statistik zu Migranten in Deutschland)

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Authors and Affiliations

  1. Zentrum für Zahnmedizin, Charité, Campus Virchow-Klinikum, Universitätsmedizin Berlin

    P. A. Reichart

  2. Guadalmina Alta, San Pedro de Alcántara, Spanien

    H. P. Philipsen

  3. Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin

    P. A. Reichart

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  2. H. P. Philipsen
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Correspondence to P. A. Reichart.

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Reichart, P.A., Philipsen, H.P. Orale submuköse Fibrose bei einer 31-jährigen Inderin. Mund Kiefer GesichtsChir 10, 192–196 (2006). https://doi.org/10.1007/s10006-006-0671-7

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