ORAL ULCERS DUE TO SELF-INJURY IN PEDIATRIC PATIENTS: Case Presentation and Literature Review.

Traumatic oral ulcers are common pathologies in pediatric patients and are sometimes self-inflicted due to frequently unconscious self-aggressive behavior. In these cases, it is important to refer the patient to a psychologist to identify causes and provide treatment for pain and inflammation. We present the case of a 9-year-old girl who came to the oral medicine clinic at the UNPHU School of Dentistry, accompanied by her father, for lingual ulcers that had previously been evaluated by different specialists without resolution. The father mentioned a biopsy, diagnosing an ulcerated telangiectatic granuloma without the need for treatment. The patient was initially uncooperative but eventually allowed for evaluation in confidence, revealing two irregular ulcerative lesions with raised borders, one measuring 1.5 cm with a necrotic base and hemorrhagic areas at the tip of the tongue, and the other measuring 4 mm on the left lateral border. It was observed that the patient exhibited oral movements suggestive of chronic sucking or biting, which the father confirmed she did constantly. The diagnosis of self-inflicted traumatic oral ulcers was established. Emphasis was placed on controlling the habit, psychological assessment, and the need for topical anti-inflammatory treatment (mixture: 15 ml of milk of magnesia and 4 mg of dexamethasone) applied three times a day for two weeks, along with oral antihistamines. At the first follow-up, there was a significant reduction in the larger lesion, and complete remission of the other lesion was observed. The treatment was extended, and complete healing was observed after one month, leading to the patient's discharge. As of the present date, there have been no new lesions.

创伤性口腔溃疡是儿科患者常见的病理状态，有时由于频繁的无意识自我攻击行为而自我造成。在这些情况下，将患者转诊至心理医生以识别病因并提供针对疼痛和炎症的治疗至关重要。本文介绍了一位9岁女孩的病例，她由其父亲陪同来到UNPHU医学院口腔医学诊所，此前她所患的舌溃疡已由多位专科医生评估但未得到解决。父亲提及活检，诊断为溃疡性毛细血管扩张性肉芽肿，无需治疗。患者最初不配合，但最终在信心中同意评估，揭示出两个不规则溃疡性病变，边缘隆起，一个直径1.5厘米，基底坏死并有舌尖出血区域，另一个位于左侧舌缘，直径4毫米。观察到患者表现出提示慢性吮吸或咬合的口腔运动，其父证实她确实经常这样做。诊断为自我造成的创伤性口腔溃疡。重点在于控制这一习惯、进行心理评估以及局部抗炎治疗的需要（混合物：15毫升氧化镁乳剂和4毫克地塞米松），每日三次，持续两周，同时口服抗组胺药。在首次随访时，较大的病变明显减小，另一个病变完全缓解。治疗被延长，一个月后观察到患者完全愈合，遂出院。截至目前，未出现新的病变。