Oral Mucosal Lesions, Immunologic Diseases

Immune-mediated diseases often involve the oral mucosa, frequently demonstrating the first visible sign of the disease process. Oral mucosal lesions related to immune dysfunction or presumed autoimmune etiologies may be symptomatic, seriously affecting quality of life, and serve as an associated comorbidity in high-risk patient populations. The clinical presentations of the lesions—including recurrent aphthous stomatitis, lichenoid lesions, and related conditions, systemic lupus erythematosus, vesiculobullous disease, erythema multiforme, and benign migratory glossitis—are often nonspecific, subtle, and ever-changing in appearance; typically, they require detailed evaluation of patient histories, histopathologic studies, and multidisciplinary consultation for definitive diagnosis. In otherwise asymptomatic patients, a detailed clinical examination allows an opportunity for early diagnosis and treatment. Patients may find treatments to provide unsatisfactory or inconsistent results but may also be content with simple, noninvasive therapies.