Browsing by Author "Mulder-van Staden, Sune"

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    Oral medicine case book: epidermolysis bullosa acquisita
    (South African Dental Journal, 2018) Negi, Marwa Milad; Mulder-van Staden, Sune; Holmes, Haly; Jeftha, Anthea
    A 49-year-old female was referred from the Dermatology department to the Oral Medicine Department at the University of the Western Cape (UWC), Oral Health Center, Tygerberg campus. The patient complained of a sore mouth and difficulty In brushing her teeth. She had been diagnosed with epidermolysis bullosa acquisita (classical type) 12 years ago and was being managed by her Dermatologist with topical and systemic steroids (Dovate® ointment and 10mg prednisone daily). The extra oral examination revealed extensive sloughing of the skin of the hands, chest and back. The hands showed atrophic scarring, skin fragility and nail loss on numerous fingers, which also demonstrated restricted movement (Figures 1,2). The patient had malted mouth opening because of scarring related to repeated episodes of ulceration (Figure 3) and poor oral hygiene. Her gingiva was Inflamed (Figure 4). The middle to anterior dorsal surface of her tongue was atrophic, smooth and erythematous, while the posterior dorsal tongue had white yellowish plaques (Figure 5). The orthopantomogram demonstrated multiple carious teeth with generalised, severe horizontal boneless (Figure 6). An appointment was scheduled for a scaling as well as extraction of root remnants and teeth with a hopeless prognosis. The patient was booked for a follow-up at the Oral Medicine and Periodontology Department two weeks later, but failed to return for her appointment.