Múltiplas manifestações orais em lúpus eritematoso cutâneo

Abstract

Lupus erythematosus is an autoimmune disease that can occur systemically or cutaneously. Chronic cutaneous lupus erythematosus (CCLE) is the chronic presentation of the disease and clinically presents as erythematous macules or papules and later as discoid plaques that scar and pigment the skin. It is subdivided into discoid LE (DLE), deep / panniculitis LE (PEL) and LE chilblain (CHLE). DLE is the most common and can be divided into localized, in which the lesions occur on the face, ears and scalp and in the disseminated form in which the lesions are above and below the neck. This disease can exhibit oral manifestations, and its identification and treatment are important. This report aims to present a clinical case of a patient with multiple oral manifestations of cutaneous lupus erythematosus, without simultaneous skin manifestations. On clinical examination, a lichenoid lesion was observed on the lower lip, on the hard palate an extensive, erythematous and asymptomatic area was observed, with white reticular lines and scaly gingivitis in the maxilla and mandible. There were lichenoid and pigmented areas in the cheek mucosa. An incisional biopsy was performed on the hard palate and histopathological an analysis revealed a fragment of the oral mucosa showing hyperkeratosis and focal degeneration of the basal layer. Additional tests were requested which ruled out systemic involvement. Finally, we highlight the diversity of oral manifestations in a patient with lupus and the importance of examining the mucosa, even in the absence of skin lesions.