Oral lesions as a clinical sign of systemic lupus erythematosus

Eliza Kristina M. Munthe, Irna Sufiawati

= http://dx.doi.org/10.20473/j.djmkg.v51.i3.p147-152
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Background: Oral lesions represent one of the most important clinical symptoms of systemic lupus erythematosus (SLE), an autoimmune disease with a high degree of clinical variability rendering it difficult to arrive at a prompt and accurate diagnosis. There are many unknown causes and multiple organ systems involved, with the result that permanent organ damage may occur before treatment commences. Purpose: The purpose of this case report is to discuss the importance of recognizing the lesions related to SLE which may help dentists to make an early diagnosis. Case: A 17-year-old female patient was referred by the Internal Medicine Department with a suspected case of SLE. Prior to admittance to the hospital, the patient was diagnosed with tuberculosis. A subsequent extraoral examination revealed ulceration with a blackish crust on the upper lip. An intraoral examination showed similar ulceration covered with a blackish crust on the labial mucosa accompanied by central erythema in the hard palate. Blood tests indicated decreased levels of hemoglobin, hematocrit and platelets, but increased levels of leukocytes. A diagnosis of oral lesions associated with SLE and angioedema was formulated. Case management: The patient was given 1% hydrocortisone and vaseline album for extraoral lesions, while 0.2% chlorhexidine gluconate and 0.1% triamcinolone acetonide was used to treat intraoral lesions. An improvement in the oral lesions manifested itself after two weeks of treatment. Conclusion: Early detection of oral lesions plays a significant role in diagnosing SLE. It is important for the dentist to recognize the presentation of diseases that may be preceded by oral lesions. A multidisciplinary approach and appropriate referrals are necessary to ensure comprehensive medical and dental management of patients with SLE.


Early detection; oral lesions; systemic lupus erythematosus

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Sebastiani GD, Prevete I, Iuliano A, Minisola G. The importance of an early diagnosis in systemic lupus erythematosus. Isr Med Assoc J. 2016; 18(3–4): 212–5.

Choi J, Kim ST, Craft J. The pathogenesis of systemic lupus erythematosus-an update. Curr Opin Immunol. 2012; 24(6): 651–7.

Bertsias G, Cervera R, Boumpas DT. Systemic lupus erythematosus: pathogenesis and clinical features. In: Textbook on Rheumatic Diseases. 2nd ed. Zurich: Eular; 2015. p. 476–505.

Fortuna G, Brennan MT. Systemic lupus erythematosus: epidemiology, pathophysiology, manifestations, and management. Dent Clin North Am. 2013; 57(4): 631–55.

Ben-menachem E. Systemic lupus erythematosus: a review for anesthesiologists. Anesth Analg. 2010; 111(3): 665–76.

Maidhof W, Hilas O. Lupus: an overview of the disease and management options. P T. 2012; 37(4): 240–9.

Kuhn A, Bonsmann G, Anders H-J, Herzer P, Tenbrock K, Schneider M. The diagnosis and treatment of systemic lupus erythematosus. Dtsch Aerzteblatt Online. 2015; 112(25): 423–32.

Rivas-larrauri F, Yamazaki-nakashimada MA. Systemic lupus erythematosus: Is it one disease? Reumatol clínica. 2016; 12(5): 274–81.

Barbhaiya M, Costenbader KH. Environmental exposures and the development of systemic lupus erythematosus. Curr Opin Rheumatol. 2016; 28(5): 497–505.

Mackern-Oberti JP, Llanos C, Riedel CA, Bueno SM, Kalergis AM. Contribution of dendritic cells to the autoimmune pathology of systemic lupus erythematosus. Immunology. 2015; 146(4): 497–507.

Wesley SJ. Oral manifestations of Systemic Lupus Erythematosus : A Case report. Int J Dent Clin. 2014; 6(2): 35–6.

Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P. Cutaneous manifestations of systemic lupus erythematosus. Autoimmune Dis. 2012; 2012: 1–15.

Khatibi M, Shakoorpour AH, Jahromi ZM, Ahmadzadeh A. The prevalence of oral mucosal lesions and related factors in 188 patients with systemic lupus erythematosus. Lupus. 2012; 21(12): 1312–5.

Chiewchengchol D, Murphy R, Edwards SW, Beresford MW. Mucocutaneous manifestations in juvenile-onset systemic lupus erythematosus: a review of literature. Pediatr Rheumatol Online J. 2015; 13: 1–9.

Rodsaward P, Prueksrisakul T, Deekajorndech T, Edwards SW, Beresford MW, Chiewchengchol D. Oral ulcers in juvenile-onset systemic lupus erythematosus: a review of the literature. Am J Clin Dermatol. 2017; 18(6): 755–62.

Nico MMS, Bologna SB, Lourenco S V. The lip in lupus erythematosus. Clin Exp Dermatol. 2014; 39(5): 563–9.

Khan A, Shah MH, Nauman M, Hakim I, Shahid G, Niaz P, Sethi H, Aziz S, Arabdin M. Clinical manifestations of patients with systemic lupus erythematosus (SLE) in Khyber Pakhtunkhwa. J Pak Med Assoc. 2017; 67(8): 1180–5.

Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD. Manifestations of systemic lupus erythematosus. Mædica. 2011; 6(4): 330–6.

Bashal F. Hematological disorders in patients with systemic lupus erythematosus. Open Rheumatol J. 2013; 7: 87–95.

Ranginwala AM, Chalishazar MM, Panja P, Buddhdev KP, Kale HM. Oral discoid lupus erythematosus: a study of twenty-one cases. J Oral Maxillofac Pathol. 2012; 16(3): 368–73.

Tsokos GC. Systemic lupus erythematosus. N Engl J Med. 2011; 365(22): 2110–21.

Nico MMS, Romiti R, Lourenço S V. Oral lesions in four cases of subacute cutaneous lupus erythematosus. Acta Derm Venereol. 2011; 91(4): 436–9.

Penn-Barwell JG, Murray CK, Wenke JC. Comparison of the antimicrobial effect of chlorhexidine and saline for irrigating a contaminated open fracture model. J Orthop Trauma. 2012; 26(12): 728–32.

Nobee A, Vaillant AJ, Akpaka PE, Poon-king P. Systemic lupus erythematosus (SLE): a 360 degree review. Am J Clin Med Res. 2015; 3(4): 60–3.


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