Track

Case Reports

Abstract

A 55 year-old woman with suspected systemic lupus erythematosus (SLE) on hydroxychloroquine presented to the dermatology clinic for evaluation of a recurring ulcer on the bottom inner mucosal lip. The ulcer had been waxing and waning for over 3 years. She was previously given magic mouthwash and vitamin B supplementation without benefit. A punch biopsy was performed, which revealed granulation tissue and a mixed dermal inflammatory infiltrate, non-specific findings consistent with aphthous stomatitis. Pathogenic microorganisms were not seen on PAS, Gram, and AFB stains.  It was noted that dermal CD123+ plasmacytoid dendritic cells were increased, which suggest this patient’s aphthous ulcer is an oral manifestation of this patient’s SLE. The presence of increased CD123+ plasmacytoid dendritic cells in this patient’s biopsy helped confirm her connective tissue diagnosis, which will likely aid further management of this systemic inflammatory condition.