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

Lupus erythematosus (LE) is a chronic inflammatory disease caused by interference of the immune system. There are several criteria to establish a diagnosis of this disease including oral mucosal lesions. Oral mucosa lesions are an important part because they can be the initial presentation of LE. The objective of this case report was to describe oral mucosal lesions as initial presentation of LE disease without involvement of other organs. A 47-year-old female came to the Oral Medicine Clinic at RSUPN Cipto Mangunkusumo Jakarta with complaints of a five-month history of soreness on her inner cheek, tongue and severe crusted lips without fever. Patient had been taken drug containing paracetamol and caffeine every day since 2 years ago without any doctor's prescription. Clinical finding seen were erosion and blackish brown crusted on the lips; macular and irregular ulcer, surrounded by reddish color with diffuse borders on the buccal mucosa; sloughing and keratotic papules on the tongue. The working diagnosis on the first visit is Oral Lichen Planus. At the next visit, after clinical evaluation and referral to the Immunological Allergy Department were done, the patient was diagnosed of LE. Topical dexamethasone was prescribed and the patient are required for follow up each one week. The patient given advice to follow Immunological Allergy Department's treatment plan. Oral mucosal lesions may be the initial appearance of LE patient. Early diagnosis is important for LE comprehensive treatment, so that the morbidity can be reduced and survival rate can be increased.