In systemic lupus erythematosus sle, many geneticsusceptibility factors, environmental triggers, antigenantibody ab responses, bcell and tcell interactions, and. Mucosal involvement is commonly seen in patients with lupus. Many of these conditions have excellent fulllength medscape. Systemic lupus erythematosus is chronic inflammatory multisystem disease of unknown etiology.
Lupus erythematosusits oral manifestations report of a case donald w. In 23% of patients with sle, cutaneous involvement is the initial manifestation. Oral manifestations of sle are frequently encountered and may. Systemic lupus erythematosus sle is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. Prevalence of oral involvement in patients with le is uncertain but may vary from 9 to 45% in patients with systemic disease and from 3 to 20% in patients with chronic. Systemic lupus erythematosus lupus is a chronic longlasting autoimmune disease that can affect many parts of the body. Skin and oral manifestations in juvenileonset systemic.
Systemic lupus erythematosus sle, is the most common type of lupus. Pdf oral manifestation of systemic lupus erythematosus. For a general discussion, and for links to other system specific manifestations, please refer to the article on systemic lupus erythematosus. Systemic lupus erythematosus sle clinical presentation. Despite this, there has been little done to further characterize them. Autoimmune diseases and their manifestations on oral. Lupus erythematosus european association of oral medicine. Oral ulceration may be found in patients with lupus erythematosus, pemphi gus vulgaris, or crohn disease. Mucocutaneous manifestations in juvenileonset systemic. Systemic lupus erythematosus sle, or lupus, is an autoimmune disease in which a persons immune system attacks various organs or cells of the body, causing damage and dysfunction. Systemic lupus erythematosus sle is a serious multisystem disease with variety of cutaneous and oral manifestations.
Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli cated and challenging disease to diagnose and treat. These mucocutaneous lesions, as defined by the american college of rheumatology acr in 1997, include. Systemic lupus erythematosus cns manifestations dr daniel j bell and dr rohit sharma et al. It is not intended to provide details about the diagnosis and management of these conditions. Mucocutaneous manifestations in juvenileonset systemic lupus. Oral manifestations of lupus erythematosus sciencedirect. Ab0659 oral manifestations, oral health status, and. Jul 17, 2016 oral manifestations 2050% of cases of dle, slightly more frequently in sle oral mucosa may be involved prior to skin manifestation or later or even in its absence oral lesions of sle and dle are similar in nature except in sle there is more severity of hyperemia, edema and extension of the lesions tendency for bleeding.
Oral manifestations of discoid lupus erythematosus are referred as oral discoid lesions and they occur in about 20% of patients. Background the mouth buccal cavity is the reservoir for the chewing and mixing of food with saliva. Ab0659 oral manifestations, oral health status, and salivary. Lupus is an autoimmune disease or a disease that starts because of an abnormal functioning of your immune system.
Autoimmune disease, lupus erythematosus, periodontal disease introduction systemic lupus erythematosus sle is a systemic, chronic inflammatory condition with. Clinical and histopathological study of oral manifestations and immunohistochemical profile of the inflammatory infiltrate background. Th e figure 1 natural history of systemic lupus erythematosus. A pilot study mohammedhammoudeh,1 ahmedalmomani,2 husamsarakbi,1 premchandra,3 andsamerhammoudeh 4 departmentofmedicine,hamadmedicalcoporaion,p. Oral manifestations of sle are frequently encountered. Histopathology of oral lesions of discoid lupus erythematosus. Oral manifestations of systemic diseases slideshare. Its diversity of clinical features is matched by the complexity of the factors genetic, hormonal, and environmental that cause it, and the array of autoantibodies with which it is associated. The study is entitled mucocutaneous manifestations in juvenileonset systemic lupus erythematosus. Systemic lupus erythematosus is a multisystem autoimmune disease characterized by general autoantibody production and a wide range of mucocutaneous, renal, neuropsychiatric, cardiovascular, infectious, and hematologic manifestations. Lupus erythematosus is a serious autoimmune disease, which can cause oral mucosal lesions, manifesting as white striae and erythematous, atrophic and hyperkeratotic areas, as well as erosions and ulcerations. Impact of systemic lupus erythematosus on oral healthrelated. Seek medical care for lupus if you have rapid swelling of one of your extremities. It is more common in african americans and people of american indian and asian descent than in.
Additional oral manifestations of lupus erythematosus may. Oral symptoms in systemic lupus erythematosus sle patients are often unexplored and affect the healthrelated quality of life. L upus erythematosus is a dystrophic condition characterized by degenera tion of collagenous connective tissue. Systemic lupus erythematosus sle is a severe and chronic. Oral manifestations of patients with lupus erythematosus. The majority of patients were female 88% and had a diagnosis of discoid lupus erythematosus 62%. This post evaluates the evaluation and management of the lupus patient in the ed.
We studied 10 patients with american college of rheumatology acr criteria for a diagnosis of sle who had oral lesions of lupus six prospectively. These mucocutaneous lesions, as defined by the american college of rheumatology acr in 1997, include malar rash, discoid rash, photosensitivity and oral ulcers. In a study of 25 oral biopsy specimens of lesions of chronic discoid lupus erythematosus, a characteristic and diagnostic histopathological pattern was confirmed, which consisted of parakeratosis, hydropic degeneration of stratum germinativum, collagen degeneration, and a lymphocytic infiltration in a perivascular orientation. The disease has two forms chronic dis coid type and an acute, fatal, systemic type. A combination of traditional and nontraditional risk factors, including dyslipidemia and to a varying degree, hypertension, diabetes, and smoking, inflammation, antiphospholipid antibodies apls, and lipid oxidation, contribute. Squamous cell carcinoma arising within oral lupoid plaques has been described, emphasizing the importance of identifying and treating oral lupus. This case report presents a clinical profile of a patient with sle along with different oral lesions. It is an autoimmune disease where bodys immune system antibodies in this case referred to as autoantibodies mistakenly attacks its own tissues, causing multiorgan inflammation and diverse clinical manifestations with domination of peripheral symmetric polyarthritis of small and.
Central nervous system manifestations of systemic lupus erythematosus cns lupus describe a wide variety of neuropsychiatric manifestations that are secondary to systemic lupus erythematosus sle in the central nervous system cns. Background systemic lupus erythematosus sle is a multisystem autoimmune disease associated with significant morbidity and mortality 1. Study procedures took place between november 2014 and april 2016. Systemic lupus erythematosus sle is an autoimmune disease of uncertain aetiology that can affect multiple organ systems. Oral discoid lesions most commonly occur on the labial mucosa, vermillion border and buccal mucosa. A pilot study mohammedhammoudeh,1 ahmedalmomani,2 husamsarakbi,1 premchandra,3 andsamerhammoudeh 4. Lupus erythematosus le is a multifactorial autoimmune disease, which may affect the oral mucosa in either its cutaneous and systemic forms, with varied prevalence. Tarek sheta lecturer of internal medicine mansoura faculty of medicine 2. Impact of systemic lupus erythematosus on oral health.
In some populations sle incidence is highest in women of reproductive age, while in others the highest agespecific incidence rates in women are seen after age 40 years. Lupus erythematosus le is an autoimmune disease which may be seen in one of two well recognized forms, systemic lupus erythematosus sle and discoid lupus erythematosus dle both of which may have oral manifestations. Oral manifestations of lupus journal of the american academy of. Differential diagnosis given the protean manifestations of systemic lupus erythematosus sle, the differential diagnosis is correspondingly broad. They are included in both classification criteria and disease activity indices. A study conducted in venezuela on 90 systemic and cutaneous lupus erythematosus patients reported that 11% had oral lesions including oral ulcerations, erythema, and white plaque. It is an auto immune disease, where the patient develops auto antibodies to many of their cells and cell components and tissues. Half of the patients had positive oral findings, 26% had no oral examination documented, and 24% had documented normal oral examinations. Lupus nephritis report of a case article pdf available in general dentistry 561. Disease severity is wide ranging, with most suffering milder. Similar oral mucosal lesions are seen in dle and sle. Oral manifestations of lupus erythematosus report of two. Autoimmune diseases and their manifestations on oral cavity ncbi. Select the best treatment for patients with simple and complex manifestations of systemic lupus erythematosus sle including lupus nephritis ln support your treatment decisions on the basis of evidence appreciate the risks and sideeffect profiles of commonly used medications for sle.
A study conducted in saudi arabia on 46 sle patients reported mucocutaneous involvement including oral ulcers in 72% and discoid lupus in % of the sample 18. Reseacharicle oral manifestations of systemic lupus erythematosus patients in qatar. Oral manifestation of systemic lupus erythematosus. Patients diagnosed with juvenileonset systemic lupus erythematosus jsle often have skin and oral lesions as part of their presentation. The disease causes uncontrolled activation of the immune system with widespread inflammation manifested by vague and varied symptoms. Oral ulcers ou are a common manifestation of systemic lupus erythematosus sle. Lupus erythematosus le is an autoimmune disease of unknown cause. Systemic lupus erythematosus sle is a severe autoimmune disease in which the bodys own immune system overreacts and attacks healthy joints and organs. We undertook a retrospective singlecentre study looking at oral findings in patients attending our multidisciplinary lupus clinic between. This work was undertaken to evaluate the disease specific features associated with ou in sle. Oral manifestation of systemic lupus erythematosus international.
Previously, a diagnosis of an oral discoid lesion oral dle was generally accepted if discoid skin lesions were present. Oral lesions in systemic lupus erythematosus journal of the. The purpose of this pilot study was to assess the prevalence of oral manifestations among systemic lupus erythematosus sle patients in qatar, in order to warrant future studies that would investigate each one of these manifestations with detail and further scrutiny. Systemic lupus erythematosus larissa lisnevskaia, grainne murphy, david isenberg systemic lupus erythematosus is a remarkable and challenging disorder.
Oral manifestations of autoimmune disease are frequently the primary sign of. Our findings suggest that oral pathology is common in this. Sometimes, these signs can be misdiagnosed as other oral diseases such as lichen planus. Sle is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. Oral ulceration may be found in patients with lupus erythematosus, pemphigus vulgaris, or crohn disease. Objectives to detemine prevalence of oral manifestations, oral health status, and salivary changes in iraqi sle patients.
What is the etiology of systemic lupus erythematosus sle. The disease is more prevalent in women, with a female. The typical lesion comprises a central erythematous mucosa surrounded by a slightly elvated white border. Katarzyna gilekseibert, md abstract systemic lupus erythematosus sle is a chronic, compli. Oral manifestations of systemic disease 24 general dentistry novemberdecember 2017 or absent, and the oral mucosa may be dry, red, and wrinkled. Oral manifestations of systemic lupus erythematosus patients. In a study of 25 oral biopsy specimens of lesions of chronic discoid lupus erythematosus, a characteristic and diagnostic histopathological pattern was confirmed, which consisted of parakeratosis, hydropic degeneration of stratum germinativum, collagen degeneration, and a lymphocytic infiltration.
This can be obtained thanks to specific knowledge of oral manifestations of autoimmune diseases. Jun 12, 2016 oral manifestations of systemic diseases 1. Abstract systemic lupus erythematosus sle is a chronic disease with farreaching systemic implications. Hence, in the present study we present a case of a 70yearold female suffering from sle with oral manifestations. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. Oral manifestations of systemic lupus erythematosus. Although it is primarily initiated by bacteria, the host immune response plays a significant role in its development. Oral lesions of lupus erythematosus show an array of clinical aspects and most affected sites are lips and buccal mucosa 1, 2. This article presents a case of a sle patient with oral manifestations. Apr 21, 2020 in systemic lupus erythematosus sle, many geneticsusceptibility factors, environmental triggers, antigenantibody ab responses, bcell and tcell interactions, and immune clearance processes. Its effect on oral health is the development of symptoms such as acute sudden onset with short period of duration or chronic lingers for a very long period of time soft tissue lesions. Systemic lupus erythematosusoral manifestations and.
More than 90% of cases of sle occur in women, frequently starting at childbearing age. Systemic lupus erythematosusoral manifestations and adverse. This article highlights methods torecognize and manage the oral manifestations of this systemic disease. Bullous systemic lupus erythematosus bsle is a rare subset of systemic lupus erythematosus sle associated with autoimmunity to type vii collagen. Skin and oral manifestations in juvenileonset systemic lupus. Sicca symptoms are frequent in sle which may be related to concomitant occurrence of sjogrens syndrome ss 2. Lupus erythematosus its oral manifestations report of a case donald w. The hallmark feature in sle is chronic inflammation. Autoimmune diseases and their manifestations on oral cavity. Oral manifestations 2050% of cases of dle, slightly more frequently in sle oral mucosa may be involved prior to skin manifestation or later or even in its absence oral lesions of sle and dle are similar in nature except in sle there is more severity of. Belimumab is a newer therapy which is licensed for addon therapy in adults with active. Additional oral manifestations of lupus erythematosus may include honeycomb plaques silvery white, scarred plaques. These may occur without involvement of skin lesions or before the skin lesions develop.
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