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Consultant in Oral Medicine, Oral Medicine Department, Guy's Hospital, King's College London Dental Institute at Guy's and St Thomas' Hospital, London, UK
Sarcoidosis is a multisystem, non-caseating, chronic, granulomatous disease affecting any organ. In the head and neck region, salivary glands and lymph nodes are most commonly involved. Oral manifestations are rare but these lesions, occasionally haemorrhagic, may be the first sign of systemic disease. It is important to recognize the oral manifestations of sarcoidosis and to be aware of potential secondary disease-driven processes, such as thrombocytopenia. The purpose of this paper is to present a previously undiagnosed case of sarcoidosis, initially presenting with oral manifestations, including mucosal bleeding, and to review the current literature on oral sarcoidosis.
CPD/Clinical Relevance: Oral lesions can be the first sign of undiagnosed systemic sarcoidosis.
Article
Sarcoidosis is a classic non-caseating, multisystem, chronic, granulomatous disease affecting any organ. In the head and neck region, salivary glands and lymph nodes are most commonly involved. Oral manifestations are rare but have been reported in the literature.1,2,3,4,5,6 A new case of oral sarcoidosis with disease-driven thrombocytopenia is presented.
A 39-year-old female was referred to the Acute Dental Care Department by her dentist, with a 4-day history of spontaneous gingival bleeding. At the time of her consultation she also complained of lethargy, malaise, poor appetite resulting in 12.5 kg of unintentional weight loss and a persistent cough, which were undiagnosed and consequently not treated.
Examination revealed a swollen lower lip with petechial haemorrhages, spontaneous gingival bleeding and nodular areas with soft tissue hyperplasia in the lower labial gingivae (Figure 1). Several purpurae were present in the mouth, particularly on the left buccal mucosa, along with surrounding ecchymosis (Figure 2). No skin lesions were noted but the patient described pruritic petechial rashes on the legs which had resolved spontaneously.
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