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Case Reports
. 2023 Mar 11;23(1):143.
doi: 10.1186/s12903-023-02851-0.

Oral epithelial dysplasia and aphthous ulceration in a patient with ulcerative colitis: a case report

Kai Sun  1   2   3   4   5 , Rong-Hui Xia  6   7   8   9   10
Affiliations
Case Reports

Oral epithelial dysplasia and aphthous ulceration in a patient with ulcerative colitis: a case report

Kai Sun et al. BMC Oral Health. .

Abstract

Background: Ulcerative colitis is a chronic inflammatory disease with apparent extraintestinal manifestations, including in the oral cavity. Oral epithelial dysplasia, an exclusive histopathological diagnosis that is used to predict malignant transformation, has never been reported with ulcerative colitis. Herein, we report a case with ulcerative colitis that was diagnosed via extraintestinal manifestations of oral epithelial dysplasia and aphthous ulceration.

Case presentation: A 52-year-old male suffering from ulcerative colitis came to our hospital complaining of pain on his tongue with a history of 1 week. Clinical examination revealed multiple painful oval ulcers on the ventral surfaces of the tongue. Histopathological examination indicated ulcerative lesion and mild dysplasia in the adjacent epithelium. Direct immunofluorescence demonstrated negative staining along the junction of the epithelium and lamina propria. Immunohistochemical staining with Ki-67, p16, p53 and podoplanin was used to rule out the reactive cellular atypia to inflammation and ulceration of the mucosa. A diagnosis of aphthous ulceration and oral epithelial dysplasia was made. The patient was treated with mouthwash (composed of lidocaine, gentamicin and dexamethasone) and triamcinolone acetonide oral ointment. Oral ulceration healed after one week of treatment. At the 12-month follow-up, minor scarring was observed on the right ventral surface of the tongue, and the patient felt no discomfort in the oral mucosa.

Conclusion: Oral epithelial dysplasia might also occur in patients with ulcerative colitis despite the low incidence, which should broaden the understanding of oral manifestations of ulcerative colitis.

Keywords: Aphthous ulceration; Case report; Oral epithelial dysplasia; Ulcerative colitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Clinical manifestations of oral mucosa before and after treatment. (A) – (B) Aphthous ulceration before biopsy and treatment; A right ventral surface of the tongue, blue arrows indicate the oral ulcers and yellow arrow indicates the region of biopsy; B left ventral surface of the tongue. (C) – (D) Oral manifestations at one-year follow-up; C right ventral surface of the tongue and D left ventral surface of the tongue
Fig. 2
Fig. 2
Histopathological examination of the oral lesion. (A) – (B) Hematoxylin and eosin, 200 × ; A an ulcerative lesion with chronic inflammation. B the epithelium displayed mild dysplasia. (C)—(G) Direct immunofluorescence; C C3; D fibrinogen; E IgA; F IgM; and G IgG; Ig, immunoglobulin. Scale bar: 100 μm
Fig. 3
Fig. 3
Immunohistochemical staining of the oral lesion. A Ki-67. B P16. C P53. D Podoplanin. Scale bar: 100 μm
See this image and copyright information in PMC

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