The lip in lupus erythematosus

Abstract

Lupus erythematosus (LE) frequently compromises the skin, lips and oral mucosa. There is a large body of medical and dental literature about the cutaneous and mucosal lesions of LE, but very little has been written specifically about labial lupus. The lip has a peculiar anatomical and histological architecture, and LE lesions at this site may have some distinct features. This article reviews the existing data and adds some new concepts to the issue of labial lupus in all of its presentations, comparing such lesions to the well-established characterization of cutaneous LE (in acute, subacute and chronic lesions), and highlighting some special clinical features that may enable a better diagnosis and differential diagnosis of lip diseases.

Oral Mucosal Lesions as Initial Presentation in Lupus Erythematosus Patient (A Case Report)

“…Intra oral examination showed a shallow erosive lesion of the labial mucosa adjacent to the vermilion border ( Figure 2); the lesions on the buccal mucosa were bilateral whitish macula surrounded by erythema with diffuse borders ( Figure 3 and 4); sloughing and keratotic papules on the lateral tongue (Figures 5). In addition, she had bad oral hygiene, sub and supra gingival calculus was accompanied by inflammation of the gingival margin, and radix 18,17,16,14,12,22,23,36,35,34.…”

“…Oral manifestations were symptomatic in cases of LE where 40% for SLE and 24% for cases of DLE [22]. The most common areas for oral mucosal lesions are the palate, the buccal mucosa (22.3%); lips (12.2%) especially the lower lip in the form of erythema, erosive, and crusta [6,16,23]. Clinical features of LE oral lesions vary widely with various terms used include oral discoid lesion, chronic plaque, lupus cheilitis, acute ulcer, ulcer oral, red ulcer, ulcerative plaques, pebbly red areas, honeycomb lesions, keratotic lesions, keratotic white plaques, purpura lesions and petechial diffuse palatal erythema [21].…”

Lichen Planus Affecting the Lips

“…Keratotic lesions can be confounded with exfoliative cheilitis, lichen simplex chronicus (persistent rubbing), actinic cheilitis, and discoid lupus erythematosus [2,19]. Erosive LP can simulate pemphigus vulgaris, acute lupus erythematosus, erythema multiforme 20, and herpes simplex.…”

“…c: Erythema multiforme: more marked edema, congestion, haemorragic crusts, and necrosis than would be expected in LP. d: Lupus erythematosus: a well-demarcated erythemato keratotic plaque that, contrarily from LP, typically spreads from the vermilion to the adjacent skin [19].…”

“…The ointment must be applied twice daily, but use may be increased to four times daily until remission or symptomatic relief [21][22][23][24][25][26]. There are a few reports about these drugs on labial LP [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”