ORAL LESIONS IN LICHEN PLANUS AND SYSTEMIC LUPUS ERYTHEMATOSUS

Introduction: Lichen planus/lupus erythematosus overlap syndrome is rarely seen in the clinic and has the characteristic clinical manifestations, histopathology, and immunopathology of lichen planus (LP) and lupus erythematosus (LE). This is the first reported case of bullous lichen planus (BLP)/systemic lupus erythematosus (SLE) overlap syndrome with hair loss as the first symptom.Case Presentation: A 48-year-old female presented with alopecia for half a year, and skin lesions accompanied by itching on her face, trunk, and limbs for 3 months. She had a history suggestive of photosensitivity. Laboratory tests and histopathology were performed for diagnosis. Histopathologic features of the upper arm and back of the hand were consistent with BLP, whereas the scalp lesion indicated LE. Laboratory examination indicated positive for antinuclear antibody (ANA) (1:160), leukopenia, increased urinary protein, decreased C3/C4, and normal BP180. The patient was given glucocorticoid combined with acitretin and immunosuppressive therapy after a definite diagnosis of BLP/SLE overlap syndrome. The lesions of the patient disappeared and some hair had regrown during the two years of follow-up.Conclusion: This is the first reported case of BLP/SLE overlap syndrome which responded well to glucocorticoids, retinoids, and immunosuppressive drugs. Multiple biopsies from characteristic lesions will guide doctors to avoid misdiagnoses and delayed treatment.

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The prevalence of oral mucosal lesions and related factors in systemic lupus erythematosus patients

Arthritis Research & Therapy ◽

10.1186/s13075-021-02614-8 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Mayssoun Kudsi ◽

Louei Darjazini Nahas ◽

Rama Alsawah ◽

Ahmad Hamsho ◽

Abdullah Omar

Keyword(s):

Systemic Lupus Erythematosus ◽

Clinical Examination ◽

Lupus Erythematosus ◽

Oral Lesions ◽

Systemic Lupus ◽

Related Factors ◽

Wide Range ◽

Significant Difference ◽

Oral Mucosal Lesions ◽

Mucosal Lesions

Abstract Background Systemic lupus erythematosus (SLE) is a chronic inflammatory multi systematic disease of unknown aetiology. SLE has a wide range of symptoms. The most common symptoms are joint pain, skin rash and fever. Oral lesions in SLE manifest in a variety of forms, such as oral mucosal ulceration, mouth burns, xerostomia and salivary gland diseases, temporomandibular joint disease, periodontal disease, dysgeusia, white lesions, oedema, bleeding and petechiae. Objective This study was conducted to evaluate the prevalence of oral mucosal lesions and their related factors in patients with SLE, giving the lack of comprehensive statistical data in Syria and the differences between reported prevalence. Patients and methods A cross-sectional study was performed in the Al-Mouassat University Hospital in Damascus. Patients were evaluated appropriating observation, clinical examination, completing questionnaires, studying patient’s medical records and paraclinical laboratory tests if required. Four types of oral lesions were evaluated: ulcer, erythema, white plaque and spots. The diagnosis of these lesions was made according to observation and clinical examination, and the location of each lesion was also recorded. Data were analysed using SPSS version 16.0. Result In this study, 42 (70% %) out of 60 patients (38 women and 4 men) had oral lesions, while 18 (30%) had none. The most common areas for the lesions were the buccal mucosa (26.1%) and the lips (14.2%). Of the 42 patients with oral lesions, 12 (27.6%) showed ulcers. There was a significant relationship between the following factors and oral lesions: oral hygiene status, the duration of the disease involvement, frequency of pregnancies, the amount of daily use of corticosteroids without significant difference between dosage groups, and medications used for SLE treatment other than corticosteroids (p < 0.008) without mentioned names or dosages. Conversely, age, sex, cigarette smoking and medications other than those used for SLE treatment were not significantly related to the presence of oral lesions (p value was greater than 0.05 in all subjects).

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Oral lesions in systemic lupus erythematosus

Journal of the American Academy of Dermatology ◽

10.1016/0190-9622(92)70204-s ◽

1992 ◽

Vol 27 (3) ◽

pp. 389-394 ◽

Cited By ~ 25

Author(s):

Joseph L. Jorizzo ◽

P. Lee Salisbury ◽

Roy S. Rogers III ◽

Stuart M. Goldsmith ◽

Gina G. Shar ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Oral Lesions ◽

Systemic Lupus

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Oral lesions as a clinical sign of systemic lupus erythematosus

Dental Journal (Majalah Kedokteran Gigi) ◽

10.20473/j.djmkg.v51.i3.p147-152 ◽

2018 ◽

Vol 51 (3) ◽

pp. 147

Author(s):

Eliza Kristina M. Munthe ◽

Irna Sufiawati

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Clinical Symptoms ◽

Organ Damage ◽

Multiple Organ ◽

Suspected Case ◽

Oral Lesions ◽

Systemic Lupus ◽

Organ Systems ◽

High Degree

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.

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Synchronous presentation of systemic lupus erythematosus and oral reticular lichen planus

JAAD Case Reports ◽

10.1016/j.jdcr.2017.08.008 ◽

2018 ◽

Vol 4 (2) ◽

pp. 135-137 ◽

Cited By ~ 1

Author(s):

Amber Kiyani ◽

Nabiya Shahroz

Keyword(s):

Systemic Lupus Erythematosus ◽

Lichen Planus ◽

Lupus Erythematosus ◽

Systemic Lupus

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Coexistence of Late-Onset Systemic Lupus Erythematosus With Focal Segmental Glomerulosclerosis and Lichen Planus: A Case Report

Archives of Rheumatology ◽

10.5606/archrheumatol.2017.6109 ◽

2017 ◽

Vol 32 (2) ◽

pp. 162-166 ◽

Cited By ~ 1

Author(s):

Betül Sargın

Keyword(s):

Systemic Lupus Erythematosus ◽

Case Report ◽

Focal Segmental Glomerulosclerosis ◽

Lichen Planus ◽

Lupus Erythematosus ◽

Late Onset ◽

Systemic Lupus ◽

Segmental Glomerulosclerosis ◽

Onset Systemic Lupus Erythematosus

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Dental Implant Rehabilitation in Patients Suffering from Mucocutaneous Diseases: A Systematic Review and Meta-Analysis

The Open Dentistry Journal ◽

10.2174/1874210601812010873 ◽

2018 ◽

Vol 12 (1) ◽

pp. 873-883 ◽

Cited By ~ 1

Author(s):

Parichehr Zarean ◽

Paridokht Zarean ◽

Negar Kanounisabet ◽

Ahmad Moghareabed ◽

Mansour Rismanchian ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Systemic Lupus Erythematosus ◽

Lichen Planus ◽

Lupus Erythematosus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Pemphigus Vulgaris ◽

Systemic Lupus ◽

Oral Lichen

Objective: Dental implantations are widely used for oral rehabilitation of edentulous patients. Despite high success rate, there are some risk factors that have been associated with failures. Oral mucocutaneous diseases are one of these risk factors for implant insertion due to the immunosuppressive therapy. There are limited studies that have dealt with the subject of dental implantology in oral mucosal disorders mainly with patients with oral lichenplanus, pemphigoid, pemphigus vulgaris, and systemic lupus erythematosus. In order to assess the result of implantations in such patients, we have reviewed the studies. Materials and Methods: We searched PubMed, Science Direct, and Cochrane databases for articles published from Jan 2000 to Dec 2017, using key search word “dental implants”, “oral lichen planus”, “pemphigoid”, “pemphigus vulgaris” and ”systemic lupus erythematosus”. Results: The random effects analysis result shows overall failure rates of 22% in patients with oral lichen planus. A systematic review revealed some failures that are not definitely related to these diseases. Conclusion: Due to the lack of adequate studies, a meta-analysis was only possible for oral lichen planus. Presently, there is no definite guideline regarding the placement of implant in patients suffering from mucocutaneous diseases; nevertheless, we should always consider that these patients are specific cases and need more attention in the first step of treatment and follow-ups. So there is a need to further clinical studies in order to evaluate more risk factors accurately and make a definitive conclusion.

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