Strawberry gums: a clinicopathological manifestation diagnostic of Wegener's granulomatosis?
OBJECTIVE
To highlight an uncommon but characteristic gingival lesion associated with Wegener's granulomatosis, emphasising the presence of pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells; and the paucity of the currently accepted histopathological criteria of Wegener's granulomatosis--namely necrosis, vasculitis, and granulomata.


METHODS
The histopathological features of a gingival biopsy specimen from a case of Wegener's granulomatosis limited to the upper aerodigestive tract in a 36 year old woman were compared with those of 14 similar reported cases.


RESULTS
Pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells were recorded as present in almost all cases of gingival Wegener's granulomatosis. Necrosis, vasculitis, and granuloma formation were present in only a few cases.


CONCLUSIONS
The combination of pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells in a gingival biopsy specimen from erythematous, swollen gums, clinically resembling over-ripe strawberries, in a patient with a severe systemic upset, is so typical of Wegener's granulomatosis as to be virtually diagnostic. Recognition of this characteristic lesion may aid early diagnosis and treatment in cases where other diagnostic variables are absent.
Napier
S S
SS
Department of Dental Surgery and Pathology, Royal Victoria Hospital, Queen's University, Belfast.
Allen
J A
JA
Irwin
C R
CR
McCluskey
D R
DR
D000038:Abscess / Q000473:pathology; D000328:Adult; D005260:Female; D015726:Giant Cells / Q000473:pathology; D005881:Gingiva / Q000473:pathology*; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia