Abstract:

Systemic lupus erythematous (SLE) is an autoimmune collagen-vascular disease involving mucocutaneous and musculoskeletal systems as well as blood vessels that is characterized by diverse clinical manifestations, making it necessary to use a comprehensive multidisciplinary approach. Oral manifestations of SLE include oral ulcer, discoid lesions, oral lichen planus-like-lesion, oral candidiasis, and xerostomia. This study reports two cases of 19-year-old and 41-year-old female patients visiting the Oral Medicine Department Dr. Hasan Sadikin General Hospital in October 2016. These patients were referred by the Internal Medicine Department with SLE diagnosis, involving hematological, musculoskeletal and mucocutaneous systems. Extraoral examination revealed moon face in the first patient and malar rash and lips exfoliations in the second  patient. Intraoral examination revealed oral ulcers on buccal and labial mucosa as well palate in both patients. Both patients were given methyl prednisolone, calcium, and folic acid by the Internal Medicine Department. Oral ulcers were treated with prednisone mouthwash, nystatin oral suspension, and vitamin B12. The oral ulcer on palate was considered very difficult to resolve so that topical corticosteroid was required. Prednisone mouthwash was chosen as drug of choice due to its efficacy on oral mucosa and its ability to minimize the systemic adverse effects which were resolved in 6 week after starting treatment. Comprehensive multidisciplinary approach associated with oral manifestation of SLE has significant effects in decreasing disease severity and improving the quality of life in patients with SLE.

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