IndexCase ReportDiscussionReferencesLupus is a chronic autoimmune disease that damages any part of the body such as the skin, joints or any part inside the body. Autoimmune disease means that our immune response is unable to differentiate foreign invaders and healthy body tissue. Therefore the body creates autoantibodies that will attack the body's healthy tissues. Most of those affected are women, as 9 out of 10 people with lupus are women. It commonly develops in women between the ages of 15 and 45. It can be difficult to distinguish lupus from other diseases because it can mimic many other diseases, and symptoms often develop slowly because no pattern can be detected. It can also come and go. Early diagnosis is always the best way to reduce the progression and severity of the disease. Lupus can be caused by some factors such as genes, environment, hormones. It is not scientifically proven that genes cause lupus, but the incidence of lupus in a family member gives the idea that genes contribute to lupus disease. Lupus can also be triggered by certain environmental factors such as UV rays from the sun, antibiotic drugs such as penicillin, sulfa drugs that make a person more sensitive to the sun, an infection, injury, or even a cold or viral illness. As for hormones, sexual hormones may play a role in the development of lupus, especially estrogen. This hormone is produced by both men and women, but production is high in women, which may indicate the severity of lupus. Lupus is classified into three different types: Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Systemic lupus erythematosus (SLE), long referred to as lupus. It is a systemic disorder, meaning it can affect many types of organs or parts of the body. A person with SLE may have mild to severe symptoms. Discoid lupus erythematosus affecting only the skin. A person will have a red, raised rash on the face, scalp, or elsewhere. Those areas will become thick and scaly. Drug-induced lupus which refers to lupus caused by the use of medications. Symptoms usually disappear after stopping the drug. Case Report A 70 year old female was reported to the Department of Periodontology, Adesh Institute of Dental Sciences & Research with the chief complaints of dry mouth, fever and generalized redness of gums with associated burning sensation in the lips. gum for a month that had started spontaneously. He also complained of bleeding gums for the past month while brushing his teeth and eating. Her medical history revealed that she was diagnosed with systemic lupus erythematosus approximately 10 years ago. His vital signs were monitored and were normal. Clinical examination revealed a depigmented malar rash on the face. Laboratory examination showed a leukocyte count of 2300 (neutrophils 30%, lymphocytes 45%, monocytes 25%), elevated ESR and normal urinalysis. Intraoral examination revealed the presence of erythematous marginal attached gingiva and interdental papilla in the anterior maxillary and mandibular region. Nikolsky's sign was positive. Generalized bleeding on probing was positive; however, no involvement of periodontal pockets or furcations was observed. The clinical diagnosis was established by incisional biopsy, performed under local anesthesia. Histological examination reveals findings consistent with SLE. Therefore the management of this patient in the periodontal department is being scaled down as much as possiblegently as possible and advising you to maintain oral hygiene. She was prescribed a soft-bristled toothbrush with Triamcinolone acteonide oral paste and chlorhexhidine mouthwash. A 68-year-old male presented with a complaint of non-healing mouth ulcers for 6 months associated with pain and burning sensation. Gradual onset associated with erythema and burning sensation followed by blisters that rupture within 2-3 days led to aulceration of the region. There was no fever or prodromal malaise. Initially, lesions were noted on the dorsum of the tongue followed by involvement of the palate and the buccal and labial mucosa associated with swallowing difficulties. Two months later, he noticed similar lesions on his skin, predominantly in the trunk and scalp regions, which healed within 7 to 14 days. The patient is undergoing skin examination and is currently taking topical corticosteroids and anti-candidal mouthwashes. The skin lesion has shown signs of healing but the intraoral lesion is persistent. Medical history revealed that the patient has been suffering from diabetes for 14 years and is under treatment. Family history is not significant. The patient was poorly nourished and weak with signs of pallor. Examination of the trunk revealed multiple, well-defined, approximately round erosive lesions, approximately 1x2 cm in size. Examination of the head and neck showed distinct erosive lesions on the cheek, nose, and scalp measuring approximately 0.5 x 1 cm in diameter. Scalp lesions that cause scarring. Bilateral submandibular lymph nodes are palpable, single in number, tender, firm, mobile, and measured 1 cm in diameter. Intraoral examination revealed limited and painful mouth opening with multiple, discrete superficial ulcerations along the upper and lower buccal mucosa, labial mucosa, soft palate, and vestibule. . Diffuse and irregular ulcers covered by a pseudomembranous layer were observed. On palpation, the ulcers are painful and bleed upon slight provocation. Multiple fibrotic bands are felt along the buccal mucosa bilaterally and circumorally. The tongue appears to be depapillated, with areas of fissures and erythema. Hard tissue examination revealed poor periodontal health, with generalized mobility and tooth attrition. Histopathological section was obtained from incisional biopsy of a skin lesion that revealed epidermal hyperkeratosis and focal keratotic obstruction. Mild atrophy of the stratum malphigii and mild degeneration of the basal layer may also be observed. This suggests DLE as the dermis showed mild edema and few scattered aggregates of mononuclear chronic inflammatory cells in the form of lymphocytes and plasma cells. The treatment administered to this patient during the first visit included topical antibiotics and analgesics along with multivitamins, an antioxidant and protein supplement was administered for the skin lesions, and topical corticosteroids were administered. Follow-up was carried out after 5 days. A 19-year-old male patient, working as a farmer, presented with the chief complaint of a painful ulcer on the lower lip dating back 6 months. The nature of the pain was insidious at onset, localized from throbbing to stinging, of moderate intensity, and aggravated by food intake or trauma to that region. The ulcers were initially small in size and gradually progressed to their current size with the incidence of white serous discharge. The lymph nodes were not palpable. A systematic evaluation was carried out and no significant evidence was provided. The patient had a class 3 facial profile with lower lip protuberance. Two distinct oval shaped ulcers measuring 1cm x 1cm with regular thin edgeserythematous marginal area. The presence of striae radiating from the erythema area was found. Considering the oral manifestation, a provisional diagnosis was made for the mixed white and red lesions. The differential diagnosis made was actinic keratosis DLE and erythema multiforme minor. The treatment administered was systemic and topical corticosteroid therapy for a duration of 21 days. The patient was advised to cover his mouth with a soft cloth while in the fields. It is reiterated that the diagnosis is DLE based on the clinical presentation, nature of the lesion and response to treatment. Discussion Systemic lupus erythematosus is an autoimmune disease that presents with many cutaneous and oral manifestations. As mentioned above, the disease attacks whenever the body produces numerous autoantibodies of its cells and cellular and tissue components. Hormone and sex play a vital role in SLE as it is more common in women and is always related to the production of estrogen and progesterone levels. SLE often does not appear at all. Clinically, lupus is a disease with an unpredictable course that involves flare-ups and remissions, where the longer it progresses, the greater the damage it does to the body. Common symptoms that may occur in a person with SLE are extreme tiredness, headache, fever. , swelling of the joints, anemia, chest pain when breathing deeply, butterfly-shaped rash on the cheek and nose, sensitivity to the sun or light, hair loss, abnormal blood clotting, and mouth and nose ulcers. Mucosal involvement as in SLE patients is common. It typically presents as a well-demarcated erythema or erosion with central white papules surrounded by white radiating striae. A study was conducted examining oral findings in patients attending the multidisciplinary lupus clinic between January 2015 and April 2016. The results show that the majority of patients were female (88%) and diagnosed with DLE (62%). , 26% had SLE. Half of the patients had positive oral findings, 26% had no documented oral exam, and 24% had a documented oral exam. The most common site for oral findings is the palate. Then on the labial mucosa, on the buccal mucosa, on the gingiva and on the alveolar ridge. Oral manifestations compatible with lupus were erosion or ulcers (5 cases), erythema in 4 cases, and white plaque in 4 cases. In this cohort study, it is common to find oral pathology, and it is mandatory to perform oral examination to identify oral lupus and provide treatment. Fabri et al revealed that treatment of periodontal disease is useful in controlling disease activity in SLE patients with immunosuppressive therapy. A recent study also stated that periodontal treatment may be helpful in reducing the symptoms of SLE. SLE is a type of lupus erythematosus that is usually limited to the skin and has minimal systemic involvement. Lesions usually present as erythematous, edematous, scaly papules that spread centrifugally and coalesce into plaques. The lifting of the scales produces the appearance of a carpet, then revealing dilated pilosebaceous orifices occupied by horny plugs. Healing of a lesion occurs centrally, producing atrophy, scarring, telangiectasias and pigmentary changes. Cicatricial alopecia is a significant finding. Mucosal findings usually affect approximately 24% of patients with DLE and present as chronic plaques or lichen planus-like oral lesions, ulcerations, cheilitis, and plaque-like palatal lesions. Please note: this is just a sample. Get a customized paper from our expert writers now.Patients.38