Analysis of Non-infective Oral Mucosal Lesions with Possible Autoimmune Aetiology: A 3-year Review in a Nigerian Population

Abstract

This study aims to highlight the diagnostic challenges and the difficulties often encountered during treatment and follow up of patients with possible immune mediated oral mucosal lesions in a Nigerian population. This was a 3-year retrospective review of clinical records of 12,179 patients seen in Oral Medicine and Oral Diagnosis Clinics, University of Benin Teaching Hospital, Benin City, Nigeria. There were 24 (0.2%) patients with possible immune mediated oral mucosal lesions in the study period. The mucosae of the lip (n=7, 29.2%), buccal (n=5, 20.8%) and tongue (n=4, 16.7%) were the commonest oral sites for the lesions. Most patients presented within a week of onset of the lesion (n=6, 25.0%). Oral mucosa sores (n=10, 41.7%) and painful mouth (n=4, 16.7%) were the most frequent symptom, and oral ulcers (n=13, 54.2%) and erythematous mucosal (n=12, 50.0%) were the commonest signs. The lesions were mostly recurrent aphthous ulcer (n=10, 43.5%), allergic stomatitis (n=6, 25.0%), and erythema multiforme (n=5, 20.8%). The patients were treated mainly with prednisolone (n=8, 33.3%), anti-histamine (n=8, 33.3%) and warm saline mouth rinse (n=7, 29.2%). Satisfactory healing was observed within 2 weeks of therapy for 6 (25.0%) patients; four of these cases were females with minor RAU (16.7%) [p=0.039]. This study suggests a rarity of autoimmune disease of oral mucosal. The lesions consist predominantly of RAU and an emerging trend of allergic stomatitis due to herbal toothpaste was observed. This study emphasizes the need for routine immunological tests in the diagnosis of suspected autoimmune oral mucosal lesions.

Key words: Autoimmune disease, oral mucosal, diagnostic challenge, treatment outcome.