Plasma Cell Gingivitis Research Articles

Differential diagnosis and treatment protocols for desquamative gingivitis: A systematic review.

The occurrence of desquamation, shedding and erythema on marginal and attached gingiva is described as desquamative gingivitis (DG). Various autoimmune/dermatological disorders cause DG.The aim of the present systematic review was to gather information on all possible kinds of treatment for DG, based on specific DG diagnoses.The review was organized following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol. An electronic search was conducted in the PubMed, Scopus and Google Scholar databases, up to April 2022. Reviews, letters and studies with less than 2 participants were excluded.Fifteen publications matched the eligibility criteria: 6 case series; 5 clinical trials; 3 randomized clinical trials (RCTs), and 1 cohort study. A total of 330 patients were enrolled, mostly women (81.52%), with an average age of 57.6 years. Diagnostic characteristics corresponded to oral lichen planus (OLP) (n = 249), mucous membrane pemphigoid (MMP) (n = 30), pemphigus vulgaris (PV) (n = 19), plasma cell gingivitis (PCG) (n = 4), erythema multiforme (EM) (n = 1), and non-specified diseases (NSD) (n = 27). Oral lichen planus and MMP were eliminated using oral hygiene instructions with topical clobetasol and/or doxycycline monohydrate. Pemphigus vulgaris, PCG and EM were treated with topical clobetasol.To conclude, each DG case requires personalized treatment, depending on the diagnosis.

Challenges and solutions in plasma cell gingivitis: A clinical case analysis

Plasma cell gingivitis (PCG) is an uncommon benign gingival condition characterized by sharply defined erythematous and oedematous gingival lesions, often extending to the mucogingival junction. This hypersensitivity reaction presents as diffuse, papillary gingival inflammation, prone to bleeding upon minimal trauma. Histologically, PCG manifests as a dense infiltration of normal plasma cells within collagenous stroma, typically localized to the free and attached gingiva. The primary management approach involves identification and avoidance of the allergen source, alongside nonsurgical periodontal therapy. We report a 26-years-old female patient diagnosed clinically as plasma cell gingivitis and confirmed histologically. Surgical treatment along with pharmacological interventions resulted in complete resolution of symptoms. This case underscores the importance of comprehensive evaluation and tailored treatment approaches in managing plasma cell gingivitis.

Plasma cell gingivitis – An enigma

Plasma cell gingivitis (PCG) is a rare benign inflammatory disorder affecting the gingiva characterized by dense infiltration of plasma cells into the sub-epithelial connective tissue. It is considered a hypersensitivity reaction to various allergens; thus, the first step in management is to remove the causative factor. We are reporting a case of a 73-year-old male who presented with redness and swelling of upper gums, which bleeds easily on probing. The final diagnosis of PCG was confirmed by histology and immunochemistry. In this article, we report a rare case of PCG.

The "great imitator": IgG4-related disease of the oral cavity. Two case reports and scoping review.

This study aimed to review the lesser-known intraoral manifestations of immunoglobulin G4-related disease (IgG4-RD). In this paper we report an unprecedented case of oral IgG4-RD mimicking angiolymphoid hyperplasia with eosinophilia (ALHE), and another case presenting as plasma cell gingivitis. We then performed a scoping review of published cases of IgG4-RD involving the oral cavity. The following data were collected for each case: age, sex, intraoral site(s) involved, clinical appearance, imaging features, serum IgG4 values, histopathology, treatment, and follow-up duration. Fifty-one cases of oral IgG4-RD were published in literature. The hard palate and jaw bones were the two main locations reported, while the histological identification of a IgG4/IgG plasma cells ratio ≥40% was fundamental for diagnosis. Conversely, the pathological features of storiform fibrosis and obliterative phlebitis were not common. Future reports regarding oral IgG4-RD should report clear adherence to the recognized international diagnostic criteria of the disease.

Cheilitis: A Diagnostic Algorithm and Review of Underlying Etiologies.

Cheilitis, or inflammation of the lips, is a common reason for dermatologic consultation. The inflammation can include the vermillion lip, vermillion border, and surrounding skin, and can present with an acute or chronic course. There are many etiologies, including irritant and allergic contact dermatitis, atopic cheilitis, actinic cheilitis, infectious etiologies, nutritional deficiencies, drug-induced cheilitis, and rare etiologies, including granulomatous cheilitis, cheilitis glandularis, plasma cell cheilitis, lupus cheilitis, and exfoliative cheilitis. Distinguishing among the various etiologies of cheilitis is clinically difficult, as many causes may produce similar erythema and superficial desquamation of mucosal skin. In addition, patients report dryness, redness, irritation, burning, fissuring, and itch in many of the underlying causes. Thus, the specific etiology of cheilitis is often difficult to diagnose, requiring extensive testing and treatment trials. In this review, we summarize the various types of cheilitis, synthesizing novel cases, clinical presentations, histopathology, epidemiology, and advancements in diagnostic methods and therapeutics. We provide a diagnostic algorithm aimed to assist clinicians in the management of cheilitis.

Plasmoacanthoma of Lip-A Rare Case with Review of Literature.

Plasmoacanthoma is an extremely rare benign verrucous lesion, with few cases reported in the literature, and it often goes misdiagnosed. An attempt was made to discuss the features and compare them to reduce the diagnostic dilemma in cases of plasmoacanthoma, which mimics squamous cell carcinoma, both for the clinician and pathologist. Written informed consent was obtained from the patient for the case report. Institutional ethical clearance was obtained. A review of the literature was conducted after a PubMed search with the keyword "Plasmoacanthoma" on September 20, 2023. Nine articles were obtained, out of which two were not available. One was excluded since it was on plasma cell cheilitis. Five articles, all of which were in the English language, with a diagnosis of plasmoacanthoma were retrieved for the study. A 70-year-old female presented with an ulcer-exophytic lesion involving the lower lip, mimicking a typical squamous cell carcinoma, for which an edge biopsy of the lesion was taken to confirm. Histopathology revealed it to be plasma cell mucositis. The patient was put on the medical line of management with corticosteroids as per guidelines, with no response. A wedge excision was later done as the patient was not responding to medical therapy, and the final histopathology came out to be "plasmoacanthoma". Due to their close resemblance to malignant lesions and histologically mimicking plasma cell mucositis, such lesions often get misdiagnosed, leading to inadequate management. Various sources of literature related to plasmoacanthoma were compared, and the features and histological findings were tabulated so that if any cases were similar to the present case reports, then we could have other differential diagnoses and work accordingly. Plasmoacanthoma may be present in any age group, and the clinical features may be similar to those of squamous cell carcinoma. PCM and plasmoacanthoma are clinically and histologically mimicking conditions that should be confirmed by excisional biopsy on histopathological examination rather than incisional biopsy to avoid pathological adversity, as seen in our case. IHC with kappa and lambda light chains will help identify clonal plasma cells seen in plasmoacanthoma.

Homeopathic management of plasma cell cheilitis

Homeopathic management of plasma cell cheilitis

Plasma Cell Cheilitis Showing Excellent Response to Systemic Steroids.

Plasma Cell Cheilitis Showing Excellent Response to Systemic Steroids.

Increased frequency of oral plasma cell mucositis/plasma cell gingivitis after the COVID-19 pandemic: a 23-year retrospective analysis and review of diagnostic challenges relating to this condition

Oral plasma cell mucositis (PCM) or localized plasma cell gingivitis (PCG) is an idiopathic inflammatory condition often associated with hypersensitivity reactions. This study aimed to evaluate the frequency and features of PCM/PCG in a large biopsy service over a time period of more than 20 years. The biopsy archives at University of Florida College of Dentistry were searched from 2000 through the first quarter of 2023 for cases of oral PCM or PCG. Case data were aggregated and analyzed. A total of 107 cases were included. Between 2000 and 2019, PCM/PCG was diagnosed in 0.03% of all biopsy cases. Starting in 2020 through 2023, the percentage of biopsies diagnosed as PCM/PCG increased threefold to 0.10% of all biopsy cases, and the mean patient age increased by 3 years. There were no statistically significant differences between cases diagnosed from 2000 to 2019 and those from 2020 to 2023 regarding age, sex, location, or histology. A significant increase in PCM/PCG was identified in this study at one institution coinciding with the start of the COVID-19 pandemic. Further investigation is recommended to determine if this is a widespread phenomenon and identify possible etiologic mechanisms.

The scientometric characteristics of cheilitis researched by multidisciplinary specialists: A comparative study

Background/purposeCheilitis is a relatively common lip disease with many etiologies and causes including concomitant mucocutaneous or systemic diseases, which needs multidisciplinary communication. The purpose of this study was to compare the scientometric characteristics of cheilitis publications by multidisciplinary specialists. Materials and methodsAll the papers on cheilitis were comprehensively retrieved from the Scopus database, and divided into three groups (dermatologists, stomatologists, and other scholars). ResultsThere were 478 and 241 papers on cheilitis published by dermatologists and stomatologists, respectively. The total citation count was 5838 and the h index was 36 for cheilitis publications by dermatologists, and the total count was 2983 and the h index was 27 for cheilitis publications by stomatologists. Interestingly, we observed that dermatologists preferentially concerned contact cheilitis/dermatitis and plasma cell cheilitis, while stomatologists preferentially concerned cheilitis-related lip neoplasms including squamous cell carcinoma, dysplasia, and precancerous conditions. The most common disorder researched by both dermatologists and stomatologists was actinic cheilitis. The keywords such as patch test, cosmetic, edema, drug efficacy, toothpaste, lipstick, allergens, and granulomatous inflammation were common in dermatologists' publications; while the keywords such as protein expression, metabolism, risk factor, prevalence, malignant transformation, and carcinogenesis were common in stomatologists’ publications. ConclusionThis study for the first time reported the scientometric characteristics of cheilitis as an interdisciplinary disease researched by specialists. It highlights that cheilitis-related specialists through reciprocal collaboration and communication will improve the patients’ outcomes.

PLASMA CELL GINGIVITIS TRIGGERED BY TOOTHPASTE

Plasma cell gingivitis is a rare benign condition characterized by the inflammatory infiltration of plasma cells, secondary to a hypersensitivity reaction to allergens found in oral hygiene products. This study aimed to present the case of a 48-year-old female, who was admitted to our clinic complaining of an intense gingival discomfort for the past six months, with the onset of symptoms occurring after using a new toothpaste. Clinical examination revealed generalized gingival erythema and edema. An incisional biopsy was performed, which, through direct immunofluorescence, revealed connective tissue densely permeated by interstitial lymphoplasmohistiocytic inflammatory cells, a condition that must be distinguished from other autoimmune diseases. The diagnosis of plasma cell gingivitis was concluded with a detailed history, differential diagnoses, and histopathology. The elimination of the etiologic factor, namely the toothpaste, and the use of topical corticosteroids improved both the lesions and the symptoms. Plasma cell gingivitis is a rare benign condition characterized by the inflammatory infiltration of plasma cells, secondary to a hypersensitivity reaction to allergens found in oral hygiene products. This study aimed to present the case of a 48-year-old female, who was admitted to our clinic complaining of an intense gingival discomfort for the past six months, with the onset of symptoms occurring after using a new toothpaste. Clinical examination revealed generalized gingival erythema and edema. An incisional biopsy was performed, which, through direct immunofluorescence, revealed connective tissue densely permeated by interstitial lymphoplasmohistiocytic inflammatory cells, a condition that must be distinguished from other autoimmune diseases. The diagnosis of plasma cell gingivitis was concluded with a detailed history, differential diagnoses, and histopathology. The elimination of the etiologic factor, namely the toothpaste, and the use of topical corticosteroids improved both the lesions and the symptoms.

Plasma Cell Gingivitis and Its Mimics.

Plasma cell gingivitis (PCG) is an inflammatory condition that affects the gingival mucosa of the oral cavity. It is characterized by polyclonal dense plasma cell infiltrate in the connective tissue. Lesions do not respond to prophylactic treatment. Etiology is most likely hypersensitivity to certain antigens (eg, toothpastes, oral rinses, chewing gums, spices). Differential diagnosis of PCG includes reactive, granulomatous, and neoplastic lesions. The diagnostic workup is based on patient's history and the clinicopathologic correlation to rule out mimics of PCG. Dermatologic patch test may be indicated in chronic conditions to identify the allergen.

“Plasma cell gingivitis” encompasses multiple entities: a retrospective series of 37 cases

“Plasma cell gingivitis” encompasses multiple entities: a retrospective series of 37 cases

ATYPICAL PLASMA CELL GINGIVOSTOMATITIS: A RARE CASE REPORT

ATYPICAL PLASMA CELL GINGIVOSTOMATITIS: A RARE CASE REPORT

Plasma cells in oral lesion: A clue to diagnosis or a diagnostic dilemma.

Plasma cells can just represent a part of host inflammatory response or form the cornerstone of diagnosis such as IgG4-related disease (IgG4RD) and plasma cell dyscrasias and sometimes create a diagnostic dilemma. The study aims to discuss a series of plasma cell lesions which we encountered in the oral cavity, discuss the diagnostic conundrum of plasma cell lesions. We also propose a working classification for their interpretation. All plasma cell lesions affecting the oral and maxillofacial region were retrieved from the archives of the Department of Oral and Maxillofacial Pathology. The cases were analyzed on the basis of histomorphology and immunohistochemical markers along with clinical, imaging and laboratory findings. Thirteen (0.64%) of 2026 oral lesions were diagnosed with plasma cell lesions. Out of 13 cases, 9 were plasma cell gingivitis, 2 IgG4-RD, 1 plasma cell myeloma and 1 plasmablastic lymphoma. Representative case from each category is discussed along with one case of well-differentiated squamous cell carcinoma (WDSCC) masquerading as plasma cell dyscrasias. We discuss the practical difficulties faced during the diagnosis of these oral plasma cell entities along with a working classification and propose an efficient diagnostic scheme for the correct characterization of these lesions.

Dermoscopic findings in a case of plasma cell cheilitis

Dermoscopic findings in a case of plasma cell cheilitis

LOWER LIP MELANOACANTHOMA MICROSCOPICALLY PRESENTING PLASMA CELL CHEILITIS–LIKE FEATURES

Oral melanoacanthoma is an uncommon benign pigmented lesion, microscopically presenting hyperplasia of spinous keratinocytes and dendritic melanocytes. Its pathogenesis remains uncertain, although the clinical behavior suggests a reactive origin. Oral melanoacanthoma affects mainly young adults and Blacks, with a strong female predilection. The most common oral sites are the buccal mucosa, lip, palate, and gingiva. Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown etiology that affects the lips. The clinical presentation of PCC is variable, sometimes simulating malignancy, and microscopically characterized by a dense plasma cell infiltrate. Here, we present a 59-year-old Black male patient presenting blackish-colored lesions, associated with a reddish erosive area, on the lower lip, 1.5 years ago. Microscopy revealed melanoacanthoma associated with intense lymphoplasmacytic infiltrate, such as observed in PCC. If the current case represents a microscopic spectrum of melanoacanthoma or simultaneous presence of melanoacanthoma and PCC remains open to debate, however, we favor the former.

Unusual presentation of maxillary plasma cell gingivitis mistakenly treated as aggressive periodontitis. (A case report).

IntroductionA rare benign inflammatory condition of gingiva of unknown etiology, characterized by diffuse and massive infiltration of plasma cells into the sub-epithelial gingival tissue. Plasma Cell Gingivitis (PCG) is characterized by macular lesions that are bright red, velvety, sharply circumscribed, and flat to slightly elevated.Presentation of caseFemale patient 38 years old, complain of mobility of upper right 7 with dull pain and swelling related to it. She also mentioned that the upper wisdom molar at the same side was extracted a year before due to the same reason. Extraction of upper right 7 and excisional biopsy of surrounding soft tissue swelling and by laboratory investigation and analysis to the biopsy we found that the lesion is gingival plasmacytosis. Microscopic examination revealed marked squamous hyperplasia with focal ulceration and diffuse dense subepithelial plasmacytic infiltrate consistent with PCG. At higher magnification, plasma cells were seen without cellular atypia. The individual plasma cells had eccentric round nuclei with cartwheel chromatin patterns and abundant cytoplasm.DiscussionIn the current report, the surgical team performed complete scaling and root planning to remove the associated plaque to decrease any chance of recurrence or plaque induced exacerbation. The patient was instructed to change her habits to avoid the possibility of exacerbation by unknown allergen. The lesion was excised by enblock removal to decrease recurrence possibility.ConclusionPlasma cell gingivitis needs radical management and a thorough diagnosis should be done to rule out and differentiate it from the malignant type of plasma cell tumors like multiple myeloma.

Melanoacanthoma, Plasma Cell Cheilitis and Langerhans Cell Hyperplasia on the Lower Lip: An Unusual Association and Immunohistochemical Analysis.

Oral melanoacanthoma is an uncommon reactive lesion, characterized by basal and prickle cell keratinocyte proliferation surrounded by pigment-laden dendritic melanocytes. Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown aetiology, microscopically presenting a dense plasma cell infiltrate. Most PCC cases affect the lower lip. Langerhans cell hyperplasia (LCHyp), a non-neoplastic counterpart of the LC proliferations, has been reported in association with chronic inflammatory skin diseases. Here, we present an unusual association of melanoacanthoma, PCC and LCHyp on the lower lip in a 59-old-year male, expanding the clinicopathological spectrum of these uncommon lesions. The dendritic melanocytes were highlighted by Fontana-Masson stain and HMB-45, whereas S100, CD1a and CD207 evidenced numerous LCs. MUM1/IRF4, EMA, and CD138 highlighted sheets of polyclonal plasma cells, with an IgG4+/IgG+ ratio of 24%. FTA-ABS test for syphilis was negative.

Clinicopathological and immunohistochemical analysis of plasma cell gingivitis- A retrospective study.

This study aims to describe the demographics and clinicopathological characteristics of the cases of plasma cell gingivitis (PCG) reported in our institute, supported by a review of pertinent literature. Further, we investigated the role of the cluster of differentiation CD138, Ki67, CD56, and CD117 immunoexpression in the differential diagnosis of PCG from plasma cell dyscrasias. All histopathologically confirmed cases of PCG, whose relevant details could be obtained, were included in this study. They were subjected to panel of immunohistochemical markers to exclude plasma cell malignancies. Further, published English literature for PCG since 1970-2020 was reviewed. Nine histopathologically confirmed cases of PCG, were retrieved from the archives of our department. The cases comprised 3 males and 6 females with their ages ranging between 14 and 82 years. The plasma cells exhibited equivocal reactivity for kappa and lambda; and immunonegativity for CD56, CD117 with low Ki67 proliferation index. Published literature in English showed 43 cases of PCG were predominantly female; the diffuse involvement of maxilla and mandible was a common finding. In addition to kappa lambda reactivity, an immunoprofile of CD138, Ki67, CD56, and CD117 may be used as a diagnostic adjunct to exclude malignant plasma cell lesions in confusing cases.