Challenges in the management of oral manifestations in a patient with limited systemic sclerosis

Background: Limited systemic sclerosis (SSc), or scleroderma, is characterized by widespread vasculopathy, excessive multiorgan fibrosis, and autoantibody. The early stages of SSc are challenging to diagnose because of their similarity to other autoimmune conditions. Inappropriate SSc treatment can...

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Main Authors: Yannie Febby Martina Lefaan, Riani Setiadhi
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2021-01-01
Series:Scientific Dental Journal
Subjects:
Online Access:http://www.scidentj.com/article.asp?issn=2580-6548;year=2021;volume=5;issue=3;spage=148;epage=154;aulast=Lefaan
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author Yannie Febby Martina Lefaan
Riani Setiadhi
author_facet Yannie Febby Martina Lefaan
Riani Setiadhi
author_sort Yannie Febby Martina Lefaan
collection DOAJ
description Background: Limited systemic sclerosis (SSc), or scleroderma, is characterized by widespread vasculopathy, excessive multiorgan fibrosis, and autoantibody. The early stages of SSc are challenging to diagnose because of their similarity to other autoimmune conditions. Inappropriate SSc treatment can increase the risk of disability, morbidity, and mortality. Different pathogenesis pathways incur various manifestations in the skin and the oral cavity. In this scenario, dentists play an essential role in managing oral SSc manifestations. Proper oral examination, diagnosis, and therapy help to increase the confidence and patient’s quality of life. Case Report: A 24-year-old female patient with SSc was referred from the Internal Medicine Department to the Oral Medicine Department because of lip soreness for 2 weeks, resulting in difficulty eating and opening the mouth. A complete anamnesis and clinical examination were done. The patient was diagnosed with an oral ulcer caused by SSc, cheilitis exfoliative, drug-induced pigmentation, xerostomia, and acute pseudomembranous candidiasis. The oral lesion in this patient was concluded as an oral ulcer caused by SSc because the patient had already stopped using methotrexate for 2 weeks before the ulceration appeared. The oral treatment included sodium chloride (NaCl 0.9%), vaseline album, hyaluronic acid mouthwash, and nystatin. Oral lesions had a significant improvement after 3 days of treatment. Conclusion: The SSc manifestation that appeared on the oral cavity of the patient as microstomia, tongue stiffness, and oral ulcer resulted in inadequate clinical examination, and diagnosis. Treatments for this oral SSc were challenging.
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spelling doaj.art-13b158ff578f400e80db6c1afd05fc302022-12-21T21:24:40ZengWolters Kluwer Medknow PublicationsScientific Dental Journal2580-65482541-321X2021-01-015314815410.4103/SDJ.SDJ_93_21Challenges in the management of oral manifestations in a patient with limited systemic sclerosisYannie Febby Martina LefaanRiani SetiadhiBackground: Limited systemic sclerosis (SSc), or scleroderma, is characterized by widespread vasculopathy, excessive multiorgan fibrosis, and autoantibody. The early stages of SSc are challenging to diagnose because of their similarity to other autoimmune conditions. Inappropriate SSc treatment can increase the risk of disability, morbidity, and mortality. Different pathogenesis pathways incur various manifestations in the skin and the oral cavity. In this scenario, dentists play an essential role in managing oral SSc manifestations. Proper oral examination, diagnosis, and therapy help to increase the confidence and patient’s quality of life. Case Report: A 24-year-old female patient with SSc was referred from the Internal Medicine Department to the Oral Medicine Department because of lip soreness for 2 weeks, resulting in difficulty eating and opening the mouth. A complete anamnesis and clinical examination were done. The patient was diagnosed with an oral ulcer caused by SSc, cheilitis exfoliative, drug-induced pigmentation, xerostomia, and acute pseudomembranous candidiasis. The oral lesion in this patient was concluded as an oral ulcer caused by SSc because the patient had already stopped using methotrexate for 2 weeks before the ulceration appeared. The oral treatment included sodium chloride (NaCl 0.9%), vaseline album, hyaluronic acid mouthwash, and nystatin. Oral lesions had a significant improvement after 3 days of treatment. Conclusion: The SSc manifestation that appeared on the oral cavity of the patient as microstomia, tongue stiffness, and oral ulcer resulted in inadequate clinical examination, and diagnosis. Treatments for this oral SSc were challenging.http://www.scidentj.com/article.asp?issn=2580-6548;year=2021;volume=5;issue=3;spage=148;epage=154;aulast=Lefaanfibrosislimited systemic sclerosismicrostomiasclerodermaxerostomia
spellingShingle Yannie Febby Martina Lefaan
Riani Setiadhi
Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
Scientific Dental Journal
fibrosis
limited systemic sclerosis
microstomia
scleroderma
xerostomia
title Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
title_full Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
title_fullStr Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
title_full_unstemmed Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
title_short Challenges in the management of oral manifestations in a patient with limited systemic sclerosis
title_sort challenges in the management of oral manifestations in a patient with limited systemic sclerosis
topic fibrosis
limited systemic sclerosis
microstomia
scleroderma
xerostomia
url http://www.scidentj.com/article.asp?issn=2580-6548;year=2021;volume=5;issue=3;spage=148;epage=154;aulast=Lefaan
work_keys_str_mv AT yanniefebbymartinalefaan challengesinthemanagementoforalmanifestationsinapatientwithlimitedsystemicsclerosis
AT rianisetiadhi challengesinthemanagementoforalmanifestationsinapatientwithlimitedsystemicsclerosis