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

• Published in: BMC oral health Vol. 23; no. 1; pp. 143 - 6
• Main Authors: Sun, Kai, Xia, Rong-Hui
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11-03-2023; BioMed Central; BMC
• Subjects: Analysis; Anemia; Aphthous ulceration; Biomarkers; Biopsy; Care and treatment; Case Report; Case reports; Chronic Disease; Colitis, Ulcerative; Dexamethasone; Diagnosis; Dosage and administration; Dysplasia; Epithelium; Epithelium - pathology; Gentamicin; Hemoglobin; Humans; Hyperplasia - pathology; Immunofluorescence; Immunoglobulins; Inflammation; Inflammatory bowel disease; Inflammatory bowel diseases; Lamina propria; Lidocaine; Male; Middle Aged; Mucosa; Oral cavity; Oral diseases; Oral epithelial dysplasia; Pain; Patients; Surveillance; Tongue; Triamcinolone; Triamcinolone acetonide; Tumor proteins; Ulcerative colitis; Ulcers; China; Oral epithelial dysplasia; Case report; Aphthous ulceration; Ulcerative colitis
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-023-02851-0

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.
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.
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.