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Cheema AW, Buckey JC, Holmgren EP. A Rare Presentation of Intraosseous Sarcoidosis of the Mandible Presenting as Peri-Implantitis: A Case Report and Literature Review. J Oral Maxillofac Surg 2021; 80:728-735.e2. [PMID: 34953770 DOI: 10.1016/j.joms.2021.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE We describe a rare case of intraosseous sarcoidosis initially presenting as peri-implantitis, perform a review and analysis of 27 cases of intraosseous sarcoidosis, and provide a clinical review of this condition. METHODS We searched the literature for patients presenting with intraosseous sarcoidosis of the jaw through June 2020 using key phrases. Additional papers were included via a search of references and citing papers. Data including patient demographic characteristics and diagnostic tests were manually extracted from the cases and then qualitatively coded by the authors. Descriptive statistical analysis was performed to elucidate general themes and characteristics. RESULTS A total of 27 cases, dating as early as 1943 and as recent as this case, were identified in the literature, including our case. The average age of these patients was 39 years old, with a range of 16 to 75 years. Eighteen (67%) cases were identified as female and nine (33%) as male. Fourteen cases were reported with localized mandibular involvement. Ten had maxillary disease; 3 cases were generalized to both regions. Nine cases presented anteriorly, 12 posteriorly, and 6 extended across both regions. Eight patients received surgical interventions, such as tooth extractions or lesion removal. Five patients received nonsurgical interventions, such as steroids. Ten patients received combination therapy, often involving surgical intervention and steroid therapy. CONCLUSION Our patient had an unusual presentation of intraosseous sarcoidosis mimicking peri-implantitis. To our knowledge, no case in the English literature describes a patient with sarcoidosis presenting with peri-implantitis. Based on the literature review and analysis of our patient's experience, sarcoidosis should be considered on the differential diagnosis for patients with persistent, nonhealing bony lesions in the maxillofacial region, particularly when patients have not been exposed to osteoclast inhibitory therapy or radiation. Pathologic analysis of bone and surrounding tissue in these scenarios is essential.
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Affiliation(s)
- Amal W Cheema
- Medical Student, Geisel School of Medicine at Dartmouth College
| | - Jay C Buckey
- Section Chief, Hyperbaric Medicine; Professor of Medicine, Geisel School of Medicine, Dartmouth
| | - Eric P Holmgren
- Assistant Professor, Geisel School of Medicine Dartmouth College and Department of Otolaryngology and Oral/Maxillofacial Surgery.
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2
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Alhassani AA, Al-Zahrani MS, Zawawi KH. Granulomatous diseases: Oral manifestations and recommendations. Saudi Dent J 2020; 32:219-223. [PMID: 32647468 PMCID: PMC7336012 DOI: 10.1016/j.sdentj.2019.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/25/2022] Open
Abstract
Granulomatous diseases may present with oral manifestations that are detectable by dental care providers. In certain cases, oral manifestations may precede systemic signs and symptoms. Dentists managing patients with these conditions may modify the dental treatment plan and possibly retain the support of other health professionals. This review gives an update on granulomatous diseases that can be faced by the dental practitioner.
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Affiliation(s)
- Ahmed A Alhassani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad S Al-Zahrani
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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3
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Strawberry gingivitis: Challenges in the diagnosis of granulomatosis with polyangiitis on gingival specimens. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:e202-e207. [DOI: 10.1016/j.oooo.2019.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/10/2019] [Accepted: 07/21/2019] [Indexed: 11/22/2022]
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4
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Radochová V, Radocha J, Laco J, Slezák R. Oral manifestation of sarcoidosis: A case report and review of the literature. J Indian Soc Periodontol 2017; 20:627-629. [PMID: 29238144 PMCID: PMC5713087 DOI: 10.4103/jisp.jisp_378_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Sarcoidosis is a common multisystemic granulomatous disease characterized by the formation of nonnecrotizing epithelioid granulomas in various body organs. The most commonly affected organs in the head-and-neck region include salivary glands and cervical lymph nodes. Involvement of the oral mucosa is very rare. The purpose of this report is to present an atypical oral manifestation of sarcoidosis with ulcerations of the buccal mucosa in a 59-year-old female.
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Affiliation(s)
- Vladimíra Radochová
- Department of Dentistry, Faculty of Medicine, University Hospital Hradec Králové, Charles University, Prague, Czech Republic
| | - Jakub Radocha
- Department of 4th Department of Internal Medicine - Haematology, Faculty of Medicine, University Hospital Hradec Králové, Charles University, Prague, Czech Republic
| | - Jan Laco
- The Fingerland Department of Pathology, Faculty of Medicine, University Hospital Hradec Králové, Charles University, Prague, Czech Republic
| | - Radovan Slezák
- Department of Dentistry, Faculty of Medicine, University Hospital Hradec Králové, Charles University, Prague, Czech Republic
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5
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Wilder EG, Frieder J, Sulhan S, Michel P, Cizenski JD, Wright JM, Menter MA. Spectrum of orocutaneous disease associations: Genodermatoses and inflammatory conditions. J Am Acad Dermatol 2017; 77:809-830. [PMID: 29029902 DOI: 10.1016/j.jaad.2017.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 12/18/2022]
Abstract
The oral cavity and cutaneous organ systems share a close embryologic origin. Therefore, there are numerous dermatologic conditions presenting with concomitant oral findings of which the dermatologist must be aware. The second article in this continuing medical education series reviews inflammatory orocutaneous conditions and a number of genodermatoses. It is essential for dermatologists to be familiar with oral cavity manifestations associated with dermatologic diseases for prompt diagnosis, management, and appropriate referral to stomatology and dentistry.
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Affiliation(s)
- Elizabeth G Wilder
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - Jillian Frieder
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - Suraj Sulhan
- Texas A&M Health Science Center College of Medicine, Bryan, Texas
| | - Pablo Michel
- Baylor Institute for Immunology Research, Dallas, Texas
| | - Jeffrey D Cizenski
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - John M Wright
- Texas A&M University College of Dentistry, Dallas, Texas
| | - M Alan Menter
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas.
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6
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Patil S, Maheshwari S. Prevalence of lip lesions in an Indian population. J Clin Exp Dent 2014; 6:e374-8. [PMID: 25593659 PMCID: PMC4282904 DOI: 10.4317/jced.51597] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 06/06/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Lip lesions are a frequent cause of consultation in dentistry, as they comprise a significant proportion of the oral lesions. The aim of the present study was to identify the different lip lesions and determine their prevalence in an Indian population. MATERIAL AND METHODS 5231 patients visiting a Department of Oral Medicine and Radiology were examined for the presence of different lip lesions during the period from October, 2011 to May, 2013. The statistical analysis was done using Chi-square test and p<0.05 was considered to be statistically significant. RESULTS The age of the patients ranged from 8-70 years with a mean age of 32.6 years. The prevalence of lip lesions was 18.8%. The most commonly diagnosed lesions were those due to infections, which affected 32.6% of the population, followed by mucocele (29.8%) and premalignant lesions and conditions which were observed in 20.6% of the population. Males were more commonly affected than females. CONCLUSIONS The relatively high prevalence of the lip lesions suggests dental practitioners and health care workers to educate the patients and create more awareness regarding them. The dentists should have adequate knowledge about the etiology, clinical features, diagnosis and management of the lip lesions. Key words: Lip, lesions, India, prevalence.
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Affiliation(s)
- Santosh Patil
- Dept of Oral Medicine and Radiology, Chattisgarh Dental College and Research Institute, Rajnandgaon (Chattisgarh). India
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7
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Güzel A, Köksal N, Aydın D, Aslan K, Gören F, Karagöz F. A rare clinical presentation of sarcoidosis; gingivitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:e280-2. [PMID: 24035119 DOI: 10.1016/j.oooo.2013.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 06/05/2013] [Accepted: 06/13/2013] [Indexed: 11/25/2022]
Abstract
Gingivitis due to sarcoidosis is a relatively rare condition. Gingivitis or isolated gingival involvement may be the first sign of systemic sarcoidosis. We report the case of a 37 year-old woman with isolated gingivitis due to sarcoidosis confirmed by biopsy. Following treatment with a systemic corticosteroid (prednisolone 40 mg/day), all clinical and radiologic findings were completely improved. In cases of chronic and intractable gingivitis, systemic sarcoidosis should be suspected. It should be confirmed with a biopsy, and the patient should be referred to a chest disease clinic to exclude other organ involvement.
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Affiliation(s)
- Aygül Güzel
- Assistant Professor, Department of Chest Disease, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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8
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Abstract
With new insights into the pathogenesis of specific granulomatous diseases, and with the advent of high-throughput genetic screening and availability of next-generation biological therapies, clinicians have several options at their disposal to help ensure accurate diagnosis and effective treatment. This article highlights some of the current knowledge about the more common granulomatous systemic diseases that may be encountered in clinical practice.
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Affiliation(s)
- Faizan Alawi
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Room 328B, Philadelphia, PA 19104-6002, USA.
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9
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Bouaziz A, Le Scanff J, Chapelon-Abric C, Varron L, Khenifer S, Gleizal A, Bentz MH, Barthel A, Valeyre D, Seve P. Oral involvement in sarcoidosis: report of 12 cases. QJM 2012; 105:755-67. [PMID: 22422021 DOI: 10.1093/qjmed/hcs042] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AIM To assess the clinical features, treatment and outcome of oral sarcoidosis and to determine whether oral involvement is associated with a particular clinical phenotype of sarcoidosis. DESIGN Multicentric retrospective study. METHODS Retrospective chart review. Each patient was matched with four controls. RESULTS Twelve patients (9 women, 3 men) were identified. Their median age at sarcoidosis diagnosis was 38 years. Oral involvement was the first clinical evidence of sarcoidosis in seven cases and was a relapse symptom in five cases. Clinical presentations were nodules (n = 7) or ulcers (n = 5) and were mostly solitary. The tongue was the commonest site affected (n = 4), followed by lips (n = 3), oral mucosa (n = 2), palate (n = 2) and gingiva (n = 1). Patients with oral sarcoidosis were significantly younger and had more frequent lacrimal or salivary glands and upper airway tract clinical involvement than the controls; increased angiotensin-converting enzyme was less frequent in oral sarcoidosis. Multiple treatments of oral sarcoidosis were used: no treatment (n = 3), surgery (n = 2), corticosteroids (n = 7), hydroxychloroquine (n = 3), methotrexate (n = 2), doxycycline (n = 1). Methotrexate was efficient in one patient, hydroxychloroquine showed benefit in only 1 out of 3 patients. Three patients presented oral relapses. After a mean follow-up of 6 years, 10 patients experienced a complete (n = 7) or partial (n = 3) remission of oral sarcoidosis; stability was observed in the remaining two cases. CONCLUSION Although oral manifestations of sarcoidosis are unusual, physicians should be aware that this specific localization is frequently the first manifestation of the disease. Treatment modalities range from observation in asymptomatic patients to immunosuppressants for severe involvement.
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Affiliation(s)
- A Bouaziz
- Department of Internal Medicine, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France
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10
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Zbar AP, Ben-Horin S, Beer-Gabel M, Eliakim R. Oral Crohn's disease: is it a separable disease from orofacial granulomatosis? A review. J Crohns Colitis 2012; 6:135-42. [PMID: 22325167 DOI: 10.1016/j.crohns.2011.07.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 02/08/2023]
Abstract
Symptomatic oral Crohn's disease is comparatively rare. The relationship between orofacial granulomatosis, (where there is granulomatous inflammation and ulceration of the mouth in the absence of gastrointestinal disease) and true oral Crohn's disease is discussed along with the plethora of clinical oral disease presentations associated with both disorders and the differential diagnosis of oral ulceration in patients presenting to a gastroenterological clinic. Specific oral syndromes are outlined including the association between oral manifestations in Crohn's disease and the pattern of intestinal disease and their relationship to other recorded extraintestinal manifestations. The histological and immunological features of oral biopsies are considered as well as the principles of management of symptomatic oral disease. At present, it is suggested that both orofacial granulomatosis and oral Crohn's disease appear to be distinct clinical disorders.
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Affiliation(s)
- Andrew P Zbar
- Department of Surgery and Transplantation, Chaim Sheba Medical Center, Tel-Aviv, Israel.
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11
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Braun T, Siedek V, Assmann G, Ihrler S, Kirchhoff S, Vielhauer V, de la Chaux R. Lymphknotensarkoidose der Submandibularisloge. HNO 2010; 58:371-3. [DOI: 10.1007/s00106-009-1947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Poate TWJ, Sharma R, Moutasim KA, Escudier MP, Warnakulasuriya S. Orofacial presentations of sarcoidosis – a case series and review of the literature. Br Dent J 2008; 205:437-42. [DOI: 10.1038/sj.bdj.2008.892] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2008] [Indexed: 11/10/2022]
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13
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Antunes KB, Miranda ÁM, Carvalho SRDS, Azevedo ALDR, Tatakis DN, Pires FR. Sarcoidosis Presenting as Gingival Erosion in a Patient Under Long-Term Clinical Control. J Periodontol 2008; 79:556-61. [DOI: 10.1902/jop.2008.070139] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Moretti AJ, Fiocchi MF, Flaitz CM. Sarcoidosis Affecting the Periodontium: A Long-Term Follow-Up Case. J Periodontol 2007; 78:2209-15. [DOI: 10.1902/jop.2007.070117] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Stewart C, Cohen D, Bhattacharyya I, Scheitler L, Riley S, Calamia K, Migliorati C, Baughman R, Langford P, Katz J. Oral manifestations of Wegener's granulomatosis: a report of three cases and a literature review. J Am Dent Assoc 2007; 138:338-48; quiz 396, 398. [PMID: 17332039 DOI: 10.14219/jada.archive.2007.0166] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hyperplastic granular gingivitis or "strawberry gingivitis" is a rare manifestation of Wegener's granulomatosis (WG), but it is nearly pathognomonic for this multisystem autoimmune vasculitis. The dentist may be the first health care professional to see patients with symptoms and findings of this condition. Early diagnosis and treatment is the most important factor in the management of this potentially fatal disease. METHODS The authors present three case reports that demonstrate the disease spectrum and conducted a literature review focused on current understanding of this disease. RESULTS The first patient had only the classic gingival manifestations of the disease. The second patient had simultaneous typical gingival lesions, as well as dermatologic findings. The third patient had an atypical oral presentation of aphthous ulcers and erythematous gingiva, as well as respiratory and genital involvement. Reaching a definitive diagnosis sometimes is challenging owing to the subtle onset of the disease and variable clinical and laboratory findings. CONCLUSION AND CLINICAL IMPLICATIONS Clinicians should be familiar with the broad variety of oral and systemic components of WG, as well as strategies to facilitate prompt disease recognition and to provide continued oral health care to these medically complex patients.
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Affiliation(s)
- Carol Stewart
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, University of Florida, College of Dentistry, Gainesville, FL 32610, USA.
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16
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Kasamatsu A, Kanazawa H, Watanabe T, Matsuzaki O. Oral Sarcoidosis: Report of a Case and Review of Literature. J Oral Maxillofac Surg 2007; 65:1256-9. [PMID: 17517319 DOI: 10.1016/j.joms.2005.09.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2005] [Accepted: 09/30/2005] [Indexed: 11/22/2022]
Affiliation(s)
- Atsushi Kasamatsu
- Division of Dentistry and Oral and Maxillofacial Surgery, Kimitsu Chuo Hospital, Chiba, Japan
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17
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Abstract
BACKGROUND Sarcoidosis is a multifactorial systemic inflammatory disorder of unknown origin characterized by many potential signs and symptoms, as well as by the presence of noncaseating granulomas in the organs involved. Sarcoidosis also may manifest in the oral and maxillofacial region. CASE DESCRIPTION The authors describe a patient with xerostomia, dysgeusia, oral burning, xerophthalmia and bilateral parotid enlargement. She was diagnosed as having systemic sarcoidosis on the basis of the histologic findings of a biopsy of the labial minor salivary gland, as well as subsequent diagnostic evalutons. CONCLUSION AND CLINICAL IMPLICATIONS Enlargement of major salivary glands may be the first sign of sarcoidosis in a patient with few other symptoms or clinical findings suggestive of the disease. This case emphasizes the importance of including sarcoidosis in the differential diagnosis of bilateral parotid swelling associated with xerostomia. It also highlights the dentist's potential role in the diagnosis and dental treatment of patients with systemic sarcoidosis.
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Affiliation(s)
- Mahnaz Fatahzadeh
- Department of Diagnostic Sciences, University of Medicine & Dentistry of New Jersey--New Jersey Dental School, Newark 07103, USA.
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18
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Abstract
Sarcoidosis is a common systemic granulomatous disease affecting multiple organs. Oral involvement is relatively rare and, to our knowledge, there have been only 64 cases reported in the English literature. Most cases of oral sarcoidosis present with mobility of the teeth due to rapid alveolar bone loss. Other oral manifestations include asymptomatic swelling of the involved mucosa, gingivitis and ulcers. Diagnosis of sarcoidosis is by exclusion as no specific test is available. Radiographic, biochemical and histological findings are non-specific, but helpful. All cases of sarcoidosis do not require treatment. Corticosteroids are the treatment of choice in patients requiring treatment. Other drugs such as chloroquine, methotrexate, infliximab and thalidomide are also used in the treatment of sarcoidosis. In most of the oral cases reported, systemic steroids and surgery were the preferred treatment.
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Affiliation(s)
- L Suresh
- Department of Oral Diagnostic Sciences, School of Dental Medicine, State University of New York at Buffalo, NY 14214, USA
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19
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Vairaktaris E, Vassiliou S, Yapijakis C, Papakosta V, Kavantzas N, Martis C, Patsouris E. Salivary gland manifestations of sarcoidosis: report of three cases. J Oral Maxillofac Surg 2005; 63:1016-21. [PMID: 16003631 DOI: 10.1016/j.joms.2005.03.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Roberts SD, Mirowski GW, Wilkes D, Teague SD, Knox KS. Sarcoidosis. Part I: pulmonary manifestations. J Am Acad Dermatol 2005; 51:448-51. [PMID: 15337989 DOI: 10.1016/j.jaad.2004.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Scott D Roberts
- Pulmonary Division at Indiana University School of Medicine, USA
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Abstract
Because of the relatively nonspecific clinical findings associated with a variety of granulomatous diseases, a microscopic diagnosis of granulomatous inflammation often presents a diagnostic dilemma for the clinician. The most common differential diagnosis includes foreign body reactions, infection, Crohn's disease, sarcoidosis, and orofacial granulomatosis. However, a variety of other conditions may be associated with granuloma formation. Often an extensive clinical, microscopic, and laboratory evaluation may be required to identify the source of the granulomatous inflammation. This article highlights the origin, clinical manifestations, current diagnostic modalities, and treatment of specific granulomatous diseases that may be encountered in clinical practice.
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Affiliation(s)
- Faizan Alawi
- Department of Pathology, School of Dental Medicine, University of Pennsylvania, 4010 Locust Street, Philadelphia, PA 19104, USA.
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22
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Grimaldi L, De Santis R, Brandi C, D'Aniello C. Mandibular intrabony lesion as first sign of sarcoidosis: case report. Int J Oral Maxillofac Surg 2004; 33:613-4. [PMID: 15308264 DOI: 10.1016/j.ijom.2003.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2003] [Indexed: 11/17/2022]
Abstract
A 33-year-old woman with intra-bony sarcoidosis of the mandible is reported. This presentation of sarcoidosis was the first sign of the disease in this patient, and was treated surgically because of an inaccurate biopsy report. Medical therapy was instituted once the diagnosis was made, and the disease was well controlled (including the mandibular localization) at 2 years follow-up.
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Affiliation(s)
- L Grimaldi
- Unit of Plastic Reconstructive Surgery, University Hospital of Siena, Siena, Italy.
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23
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Affiliation(s)
- Thomas R Lowry
- Wilford Hall Medical Center, Lackland AFB, TX 78236, USA.
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24
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Suresh L, Aguirre A, Buhite RJ, Radfar L. Intraosseous sarcoidosis of the jaws mimicking aggressive periodontitis: a case report and literature review. J Periodontol 2004; 75:478-82. [PMID: 15088887 DOI: 10.1902/jop.2004.75.3.478] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Sarcoidosis is a relatively common systemic granulomatous disease of unknown etiology. The skeletal system is affected in up to 39% of patients, but intraosseous sarcoidosis affecting the maxilla and mandible is rare. Only 20 cases have been reported previously in the English literature. This paper presents a case of generalized intraosseous sarcoidosis of the jaw bones that mimicked rapidly progressive periodontitis. METHODS A 46-year-old male patient presented with loose teeth for assessment of implants. He had been gradually losing his teeth since 1999. His past medical history was significant, with sarcoidosis diagnosed in 1998. A panoramic radiograph showed a bilateral cotton-wool appearance of the mandible. A soft tissue and bone biopsy was performed and sent for histological examination. RESULTS Microscopic examination of hematoxylin and eosin-stained sections revealed non-caseating granulomatous inflammation consistent with skeletal sarcoidosis. CONCLUSIONS Intraosseous sarcoidosis of the jaw bones is rare and presents commonly as progressive and rapid alveolar bone loss similar to periodontitis. Therefore, it is important for periodontists to be knowledgeable and able to diagnose this condition, as rapid alveolar bone loss may be the first sign of sarcoidosis.
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Affiliation(s)
- Lakshmanan Suresh
- Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, NY 14214, USA
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25
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Abstract
BACKGROUND The case outlined is a rare presentation of sarcoidosis intraorally associated with gingival ulceration. METHODS The diagnosis was made following a gingival biopsy. RESULTS The patient was subsequently referred to a physician for clinical management and the condition resolved without active treatment. CONCLUSIONS Sarcoidosis should be considered in the differential diagnosis of persistent swellings and ulceration of the oral mucosa. Intraoral sarcoid lesions are often the first indication of systemic involvement. It is important to make the diagnosis and monitor the condition as sarcoidosis is progressive if untreated in a small number of those affected.
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Affiliation(s)
- Conor Armstrong
- School of Dentistry, Royal Group of Hospitals, Belfast, Northern Ireland
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26
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Lindeboom JA, van den Akker HP. Sinusitis as the first indication of sarcoidosis an incidental finding in a patient with presumed 'odontogenic' sinusitis: case report. Br J Oral Maxillofac Surg 2000; 38:277-9. [PMID: 10922150 DOI: 10.1054/bjom.1999.0229] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Involvement of the paranasal sinuses and nose by sarcoidosis is uncommon, and has been reported in only 1-4% of patients with sarcoidosis. Clinical symptoms are nasal obstruction, epistaxis, nasal pain, discharge, anosmia or hyposmia, epiphora, and dyspnoea. We present a case of sarcoidosis in which sinusitis was the first clinical sign of the disease.
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Affiliation(s)
- J A Lindeboom
- Department of Oral and Maxillofacial Surgery, Academic Medical Center and Academic Center for Dentistry (ACTA), University of Amsterdam, Amsterdam, The Netherlands.
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27
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Batal H, Chou LL, Cottrell DA. Sarcoidosis: medical and dental implications. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1999; 88:386-90. [PMID: 10519742 DOI: 10.1016/s1079-2104(99)70049-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H Batal
- Boston University School of Dental Medicine, Department of Oral & Maxillofacial Surgery, MA 02118, USA
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Piattelli A, Favia GF, Di Alberti L. Oral ulceration as a presenting sign of unknown sarcoidosis mimicking a tumour: report of 2 cases. Oral Oncol 1998; 34:427-30. [PMID: 9861353 DOI: 10.1016/s1368-8375(98)00041-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Oral lesions seem to be rather infrequent in sarcoidosis, and only 43 cases have been described in the English literature. Clinically most oral lesions appear as non-tender well-circumscribed swellings or submucosal nodules. Superficial ulceration is unusual. The authors present two cases in which the first presenting symptom of an unknown sarcoidosis was the presence of an oral ulcerated lesion with indurated margins that could easily have been misdiagnosed for a squamous cell carcinoma. It must be stressed that in all ulcerated lesions of the oral cavity, squamous cell carcinoma must always be considered in the differential diagnosis.
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