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Case Studies — Lichenoid Mucositis
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Lichenoid Mucositis: Case Study #1
Patient: 45-Year-Old Female
Diagnosis: Lichenoid Mucositis
Location: Left Retromolar Trigone
Morphology: ???
History of Present Illness
The patient is a 45-year-old female presenting with a few months’ history of gum irritation from the left retromolar trigone. Currently, she denies any oral functional limitation and any history of oral trauma. She also denies any other cutaneous condition. The patient reports medically stable. She denies any smoking, alcohol, and allergy history.
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Examination
On examination, there was no facial asymmetry. No lymphadenopathy was identified in the head and neck regions. Range of motion of TMJ was within normal limits. Intra-oral examination revealed a moist oral environment. General erythema with white striation was found on the left lower buccal vestibule/ retromolar. A diffuse pigmented macule was also found on the left lower posterior edentulous ridge area. The left tonsil showed abscess formation. PA from referring office reviewed no obvious radiographic abnormality.
Clinical Impressions
The patients mucosal changes could well represent lichenoid mucositis, secondary to juxtaposed amalgam tattoo.
Treatment Plan & Follow-Up
Upon consensus, incisional biopsies were performed under local anesthesia. Pathology confirmed lichenoid mucositis. Quantitative cytology showed typical findings. Due to the asymptomatic nature of the condition, no active medical management was suggested. However, it is recommended that the patient have the lesion site monitored every six-to-nine months, in conjunction with her continual dental/hygiene care. Complete excision of Ag tattoo might be considered if the clinical lesion progresses.
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Slides (Click on Thumbnails):
Case Study #1: Presentation under White Light and Fluorescence
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