Uremic stomatitis mimicking oral squamous cell carcinoma associated with local and systemic factor

https://doi.org/10.22146/majkedgiind.84627

Faiznur Ridho(1*), Novia Tri Hasanah(2), Tenny Setiani Dewi(3)

(1) Oral Medicine Specialist Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
(2) Oral Medicine Specialist Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
(3) Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Bandung, West Java, Indonesia
(*) Corresponding Author

Abstract


Uremic stomatitis is one of the oral manifestations of chronic kidney disease. This disease is caused due to increased levels of urea in the blood circulation. Patients will complain sore lesions accompanied by a characteristic ammonia breath odor. The clinical manifestation of uremic stomatitis is not only influenced by high levels of urea in the blood but also related to local factors, the oral anatomy and parafunction habits. This study aimed to  present  a case report of clinical features of uremic stomatitis that mimicking oral squamous cell carcinoma. A 51 year old woman was referred from the department of internal medicine to the department of oral medicine at Hasan Sadikin Hospital, Bandung. The patient complained of pain in the tongue and also when swallowing. The clinical manifestation shows an ulcerated lesion on the right lateral of the tongue and a slightly raised hyperkeratotic area on the floor of the mouth. The treatment is using 0.12% chlorhexidine digluconate mouthwash three times a day and followed by applying a thin layer of vaseline on the upper and lower lips, as well as instructions and education on maintaining oral and tongue hygiene. Controls were carried out on the second and fourteenth day. The patient complaints are decreasing until disappear. The patient's masticatory function is getting better. Local and systemic factors have effect on the clinical manifestation of uremic stomatitis. A clinician must be able to carry out examinations, establish diagnosis and appropriate management so that patients receive appropriate treatment.


Keywords


chlorhexidine; chronic renal failure; uremic stomatitis

Full Text:

1. Faiznur Ridho


References

1. Glick M, Greenberg MS, Lockhart PB, Challacombe SJ. Burket’s Oral Medicine Thirteenth Edition. USA: Wiley Blackwell; 2021.


2. Kuravatti S, David MP. Oral manifestations of chronic kidney disease-an overview. Int J
Contemp Med Res. 2016; 3(4): 1149-1152.

3. Hasselfeld K, Van Ingen J, Chandler G, Williams L, Osborne C, Blanchette E. White
tongue because of uremic stomatitis as a sign of advanced kidney disease. Pediatrics. 2022;
150(4): e2021056023. doi: 10.1542/peds.2021-056023

4. Lazos JP, Piemonte ED, Lanfranchi HE, Brunotto MN. Characterization of chronic
mechanical irritation in oral cancer. Int J Dent. 2017; 2017; 6784526.
doi: 10.1155/2017/6784526

5. Chamoli A, Gosavi AS, Shirwadkar UP, Wangdale K V., Behera SK, Kurrey NK, et al. Overview of oral cavity squamous cell carcinoma: risk factors, mechanisms, and diagnostics. Oral Oncol. 2021; 121: 105451. doi: 10.1016/j.oraloncology.2021.105451

6. Irani S. New insights into oral cancer—risk factors and prevention: a review of literature.
Int J Prev Med. 2020; 11: 202. doi: 10.4103/ijpvm.IJPVM_403_18

7. Suga T, Tu TTH, Takenoshita M, Mikuzuki L, Umezaki Y, Shimamoto H, et al. Case report:
hidden oral squamous cell carcinoma in oral somatic symptom disorder. Front Psychiatry.
2021; 12:651871. doi: 10.3389/fpsyt.2021.651871

8. Yano H, Kinjo M. Uraemic stomatitis. BMJ Case Rep. 2019; 12(10): e231948.
doi: 10.1136/bcr-2019-231948

9. Mini M, Prasad TS, Thomas V. Uremic stomatitis: report of two cases. Oral Maxillofac
Pathol J. 2015; 6(2): 636–638. doi: 10.5005/jp-journals-10037-1055

10. He L, Wei Q, Liu J, Yi M, Liu Y, Liu H, et al. AKI on CKD: heightened injury, suppressed
repair, and the underlying mechanisms. Kidney Int. 2017; 92(5): 1071–1083.
doi: 10.1016/j.kint.2017.06.030

11. Yuan Q, Tang B, Zhang C. Signaling pathways of chronic kidney diseases, implications for
therapeutics. Signal Transduct Target Ther. 2022; 7(1): 182. doi: 10.1038/s41392-022-01036-5

12. Podkowińska A, Formanowicz D. Chronic kidney disease as oxidative stress-and
inflammatory-mediated cardiovascular disease. Antioxidants (Basel). 2020; 9(8):
1–54. doi: 10.3390/antiox9080752

13. Joshi C, Shukla P. Plasma cell gingivitis. 2015; 19(2): 221–223. doi: 10.4103/0972-124X.145830

14. Gilligan G, Piemonte E, Lazos J, Simancas MC, Panico R, Warnakulasuriya S. Oral squamous
cell carcinoma arising from chronic traumatic ulcers. Clin Oral Investig. 2023; 27(1): 193–
201. doi: 10.1007/s00784-022-04710-8

15. Siu A, Landon K, Ramos DM. Differential diagnosis and management of oral ulcers.
Semin Cutan Med Surg. 2015; 34(4): 171–177. doi: 10.12788/j.sder.2015.0170

16. Nalin AS, Mary J, Leukose T, Sreedhar S, Padiath S. Traumatic ulcer – mimicking
squamous cell carcinoma. J Dent Med Sci. 2016; 15(3): 83–86.

17. Mukkanwar RN, Palaskar S, Pawar R, Shah DR. Clear cell variant of oral squamous cell carcinoma: case report and review. Autops Case Rep. 2022; 12: 1–8. doi: 10.4322/acr.2021.388


18. Alarfaj AA, AlHayek AR, Alghanim R, Al-Jazan NA. Self-Induced traumatic macroglossia:
case report and literature review. Case Rep Otolaryngol. 2019; 2019: 1–4. doi:
10.1155/2019/6040354

19. Zhang JF, Nickerson K, Piryani R, Farooq O. Macroglossia associated with clobazam
administration: a case report and literature review. Front Neurol. 2022; 13: 1–5.
doi: 10.3389/fneur.2022.900763

20. Regezi JA, Sciubba JJ, Jordan RCK. Oral Pathology: Clinical Pathologic Correlations
Seventh Edition. Elsevier; 2017.

21. Kumar SB. Chlorhexidine mouthwash-a review. J Pharm Sci Res. 2017; 9(9): 1450–1452.

22. Dande R, Gadbail AR, Sarode S, Gadbail MPM, Gondivkar SM, Gawande M, et al. Oral manifestations in diabetic and nondiabetic chronic renal failure patients receiving hemodialysis. J Contemp Dent Pract. 2018; 19(4): 398–403.

23. Manchanda Y, Das S, Sarda A, Biswas P. Controversies in the management of cutaneous adverse drug reactions. Indian J Dermatol. 2018; 63(2): 125–130.

24. Bauters T, Van Schandevyl G, Laureys G. Safety in the use of vaseline during oxygen
therapy: the pharmacist’s perspective. Int J Clin Pharm. 2016; 38(5): 1032–1034.
doi: 10.1007/s11096-016-0365-7

25. Siregar FD, Hidayat W. The role of vitamin d on the wound healing process: a case series.
Int Med Case Rep J. 2023; 16: 227–232. doi: 10.2147/IMCRJ.S402005



DOI: https://doi.org/10.22146/majkedgiind.84627

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