Sarcoidosis presenting as gingival erosion in a patient under long-term clinical control.
BACKGROUND
Sarcoidosis is an inflammatory granulomatous systemic disease that rarely affects the oral cavity. Gingival involvement has been reported in only a very limited number of cases, occasionally as the first manifestation of the disease. This article reports a case of sarcoidosis affecting the gingiva and alveolar mucosa in a patient previously treated for the systemic disease and considered under long-term clinical control.


METHODS
A 57-year-old white female presented with a chief complaint of gingival pain in the maxillary right area lasting 3 years. Clinical examination revealed an erythematous, ill-defined erosive macule on the buccal aspect of the maxillary right gingiva extending from the canine to the third molar. The medical history included a diagnosis of sarcoidosis 16 years prior to presentation, which was considered to be under clinical control for the last 11 years. An incisional biopsy was obtained.


RESULTS
Histopathology indicated the presence of an intense chronic inflammatory infiltrate and focal areas with non-caseating granulomas. Periodic acid-Schiff and Grocott's stains were negative for microorganisms, and the diagnosis was compatible with sarcoidosis. Systemic evaluation showed no involvement of other areas and organs, and the patient was managed with topical steroid therapy using silicone trays in conjunction with conventional periodontal therapy and oral hygiene instructions. Complete response was achieved after 6 months, and the patient remains in clinical follow-up.


CONCLUSIONS
Although sarcoidosis is a systemic disease that rarely affects the gingiva, the possibility of gingival involvement as the sole manifestation of the disease should be considered in the differential diagnosis of gingival lesions.
Antunes
Karinne B
KB
Department of Stomatology, School of Dentistry, Estácio de Sá University, Avenida Alfredo Baltazar da Silveira 580, Rio de Janeiro, RJ, Brazil.
Miranda
Aguida M M A
AM
Carvalho
Sônia R da S
SR
Azevedo
André L da R
AL
Tatakis
Dimitris N
DN
Pires
Fábio R
FR
D000287:Administration, Topical; D002990:Clobetasol / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004890:Erythema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005882:Gingival Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D019226:Oral Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*
D005938:Glucocorticoids; D002990:Clobetasol