Abstract
Sjögren’s syndrome (SS) is commonly associated with other autoimmune diseases, representing a cluster of autoimmunity. A 59-year-old black female patient was referred with severe dry mouth for clinical evaluation of SS. Her medical history included systemic sclerosis, rheumatoid arthritis, and dermatomyositis. Extraoral evaluation showed marked features of systemic sclerosis, including microstomy, nose deformity, and paucity of wrinkles. Intraoral assessment revealed severe hyposalivation, with scarce and foamy saliva and depapillated tongue. Salivary glands scintigraphy showed lack of capture and elimination of the tracer, bilaterally. Sialometry results were negative and Schirmer test was intensely reduced; lip biopsy was compatible with focal lymphocytic sialoadenitis, rendering the diagnosis of SS. Systemic treatment was not modified and local measures were introduced to control the oral symptoms, with limited benefit. The patient has been kept in close follow-up for months because of the high risk of extraglandular involvement.
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