title: Oral involvement in sarcoidosis: report of 12 cases.
abstract: OBJECTIVE
  To assess the clinical features, treatment and outcome of oral sarcoidosis and to determine whether oral involvement is associated with a particular clinical phenotype of sarcoidosis.
  
  
  METHODS
  Multicentric retrospective study.
  
  
  METHODS
  Retrospective chart review. Each patient was matched with four controls.
  
  
  RESULTS
  Twelve patients (9 women, 3 men) were identified. Their median age at sarcoidosis diagnosis was 38 years. Oral involvement was the first clinical evidence of sarcoidosis in seven cases and was a relapse symptom in five cases. Clinical presentations were nodules (n = 7) or ulcers (n = 5) and were mostly solitary. The tongue was the commonest site affected (n = 4), followed by lips (n = 3), oral mucosa (n = 2), palate (n = 2) and gingiva (n = 1). Patients with oral sarcoidosis were significantly younger and had more frequent lacrimal or salivary glands and upper airway tract clinical involvement than the controls; increased angiotensin-converting enzyme was less frequent in oral sarcoidosis. Multiple treatments of oral sarcoidosis were used: no treatment (n = 3), surgery (n = 2), corticosteroids (n = 7), hydroxychloroquine (n = 3), methotrexate (n = 2), doxycycline (n = 1). Methotrexate was efficient in one patient, hydroxychloroquine showed benefit in only 1 out of 3 patients. Three patients presented oral relapses. After a mean follow-up of 6 years, 10 patients experienced a complete (n = 7) or partial (n = 3) remission of oral sarcoidosis; stability was observed in the remaining two cases.
  
  
  CONCLUSIONS
  Although oral manifestations of sarcoidosis are unusual, physicians should be aware that this specific localization is frequently the first manifestation of the disease. Treatment modalities range from observation in asymptomatic patients to immunosuppressants for severe involvement.
authors.affiliation: Department of Internal Medicine, Hôpital de la Croix-Rousse, 69317 Lyon Cedex 04, France.
authors.forename: A
authors.initials: A
authors.lastname: Bouaziz
authors.forename: J
authors.initials: J
authors.lastname: Le Scanff
authors.forename: C
authors.initials: C
authors.lastname: Chapelon-Abric
authors.forename: L
authors.initials: L
authors.lastname: Varron
authors.forename: S
authors.initials: S
authors.lastname: Khenifer
authors.forename: A
authors.initials: A
authors.lastname: Gleizal
authors.forename: M-H
authors.initials: MH
authors.lastname: Bentz
authors.forename: A
authors.initials: A
authors.lastname: Barthel
authors.forename: D
authors.initials: D
authors.lastname: Valeyre
authors.forename: P
authors.initials: P
authors.lastname: Seve
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000473:pathology / Q000628:therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones