Lupus Erythematosus
Etiology: Autoimmune disease with a type III hypersensitivity reaction. The immune system attacks it's own normal cells and causes inflammation. Triggers include sunlight, stress, hormones, cigarettes, certain medications, and viruses. Symptoms include painful and swollen joints, muscle pain, unexplained fever, red rashes, on the face chest, chest pain on deep breathing, loss of hair, swelling or edema in the legs and around the eyes, mouth ulcers, swollen glands, and extreme fatigue.
Transmission: Autoimmune disease and it is not contagious however females are affected more than males.
Characteristics: Weight loss, arthritis, skin lesions, and a classic rash over the nose and molar region,. Oral lesions present as white lesions that radiate around a erythematous and possibly ulcerated center. The lips, vermilion border, and buccal mucosa are usually involved. It can be associated with endothelial damage to the heart with increased incidence of infective endocarditis. Other features include photosensitivity, giant cell arteritis, celiac disease, primary biliary cirrhosis, facial and parotid swelling, and potential malignant changes. Seizures may occur.
Dental implications: Be aware if patient is prone to seizures. Careful and non-traumatic maintenance appointments 2 to 3 times a year are optimal for maintaining the tissue. Patient education regarding dental products, brushing and oral dental care is crucial.The gingiva the may be desquamative and the general description of soreness is how patients feel. Oropharyngeal mucosa, the larynx, and the epiglottis may be affected. Patients complain about xerostomia. If corticosteroids are involved for treatment candida infections may occur.
Treatment: Topical and intralesional corticosteroids. Hydroxychloroquine, acts as an anti-inflammatory agent, antibiotic prophylactic may prevent bacterial endocarditis, topical corticosteroids and systemic steroids are used to treat oral lesions. Antimalarial drugs, gold salts, NSAIDS, and cyclosporine have been used in the treatment of lupus.
Prognosis: It is a chronic and progressive disease. Renal failure is the most common cause of death.
Citation: DeLong, Burkhart, (2019). General and Oral Pathology for the Dental Hygienist. pgs 296-298