Strawberry Gingivitis – Challenges in the diagnosis of granulomatosis with polyangiitis on gingival specimens

Publication date: Available online 2 August 2019Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyAuthor(s): Bilal Msallem, Stefano Bassetti, Matthias S. Matter, Florian M. ThieringerAbstractStrawberry gingivitis is a rare oral manifestation of granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis). It manifests as a red-purple hyperplastic gingivitis that frequently goes unrecognized as a disease-specific symptom, especially if it is the primary and only manifestation of the disease. GPA is a systemic necrotizing granulomatous vasculitis that takes a fatal course without treatment. Oral health care providers, who are among the first to examine the oral cavity, should be familiar with its typical appearance, clinical course, diagnostic parameters and management.This paper highlights the challenges to early-stage diagnosis of initial multiple gingival enlargements since histological biopsies are often non-specific, which means that histology alone may not be sufficient to make a correct diagnosis of GPA from gingival specimens. Since strawberry gingivitis may be the first manifestation of GPA, awareness of it should be increased so that it can be diagnosed by its unique clinical appearance and additional related diagnostic parameters even if the histological gingival findings are non-specific.
Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology - Category: ENT & OMF Source Type: research