Management of Patients with Oral Lesions Associated Systemic Lupus Erythematous (SLE) Nephritis: A Case Report

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease involving multi-organ such as mucocutaneous, musculoskeletal, and blood vessels with varied extraoral and intraoral clinical manifestations that require treatment from many medical specialists including dentists. The purpose of writing a case report is to describe how to manage oral lesions in patients with SLE Nephritis.
 Case report: A female 17 years old patient was referred to the oral medicine department of Dr. Hasan Sadikin General Hospital from the pediatrics department and was diagnosed with SLE nephritis due to complaints of ulcers on almost the entire oral mucosa. Extraoral examination revealed a moon face, malar rash, and erythematous rash on the palms of the hands. Intraoral examination revealed multiple ulcers, on labial mucosa, buccal mucosa, lateral right of the tongue, palate, and white plaque on the dorsum of the tongue. The therapy provided was non-pharmacological and pharmacological. Non-pharmacological therapies include oral hygiene instruction and communication, information, education. Pharmacological therapy is a solution containing sucralfate and prednisone which is gargled for one minute, then followed by nystatin oral suspension drug that discards after one minute, then followed by chlorhexidine digluconate 0,12% mouthwash, gargle for one minute, as an antiseptic (each drug is applied in 0,5 – 1 hours). The patient has received a systemic corticosteroid drug (methylprednisolone), but the treatment of oral lesions requires additional topical corticosteroids to accelerate the healing process because of its direct effect on the mucosa.
 Conclusion: The management of oral lesions using topical corticosteroids in patients with SLE nephritis can help accelerate the healing process.
 Keywords: Management, Oral Lesions, SLE nephritis