Oral features of Wegener's granulomatosis
J. P. Handlers, J. Waterman, A. M. Abrams and R. J. Melrose
A review of the dental literature yielded ten cases of Wegener's
granulomatosis manifesting in the oral cavity, but only one was found in
the medical literature. The most common oral lesion is hyperplastic
gingiva, which is red to purple, with many petechiae. Tooth mobility, loss
of teeth, and failure of wounds to heal are also common manifestations. The
disease may remain localized in the oral cavity for unusually long periods
of time before multiorgan involvement occurs. Histologically, oral biopsy
tissue does not exhibit the characteristic features of vasculitis and
granulomas. There are, however, diagnostic histologic features that are
consistently present, including pseudoepitheliomatous hyperplasia,
epithelioid histiocytes, giant cells, and eosinophils. Failure to recognize
these diagnostic clinical and histologic features resulted in a 24-month
delay in the diagnosis and treatment of our patient.
