Red gums as primary manifestations of skin diseases

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Background: Red gums, as a manifestation of chronic mucocutaneous diseases, is an infrequent oral complaint and are commonly due to plaque-induced gingival diseases in which a microbial biofilm and bad oral hygiene may precipitate gingivitis. Patients and Methods: This is descriptive, case-series study was conducted during the period from October 2019 to October 2020. Ten patients were presented primarily with red gums without an apparent identifiable cause. A full clinical history and examination were done. Laboratory investigations and biopsy were performed selectively. Results: Ten patients during the period of one year were included in this work. Two (20%) males and eight (80%) females were complaining of red gums. Their age on presentation ranged from 7 to 55 years, with a mean of 39.6 ? 12.4 years. Oral burning and discomfort with a bad odor were recorded in all patients, and this was moderate to severe, thus interfering with the process of consuming food. Also, gum bleeding after brushing or when minimally traumatized was a complaint in all patients. This study revealed that pemphigus vulgaris was the main diagnosis behind red gums in seven (70%) patients, followed by lichen planus in two (20%) patients, and viral reactionary gingival hyperplasia in one (10%) pediatric patient. Minimal skin involvement was observed in seven (70%) patients, with some patients unaware of its presence and it being discovered accidentally. Conclusion: Red gums are a common manifestation of chronic orodental conditions, yet could be part of systemic diseases and oral manifestations of primary cutaneous diseases. The current study highlighted that pemphigus vulgaris and lichen planus may initially and/or primarily present themselves as red gums, possibly delaying the proper diagnosis for months or even years. Hence, dermatologists and oral physicians should be aware of this clinical finding.