Page 50 - MDA SCATE 2024 Programme Book

ORAL PRESENTATION

ABSTRACTS

Persistent lip ulcer in an elderly diabetic patient as a presenting sign of
Abstract 2
plasma cell cheilitis: A case report and literature review

Awang Hasyim, N. A. & Ismail, S.
Unit of Oral Pathology and Oral Medicine, Department of Oral and
Maxillofacial Surgery, Hospital Sultan Abdul Halim, Sungai Petani, Malaysia.

Background: Plasma cell cheilitis (PCC) is a rare inflammatory disorder of
non-neoplastic plasma cell disease affecting the lip. Diagnosis of PCC can
be delayed as it is often mistaken for traumatic ulcer, actinic cheilitis, and
discoid lupus erythematosus. The objective of this study was to report a case
of PCC with emphasis in diagnostic work up and management of this rare
entity. A case of PCC seen in our Oral Medicine clinic is reported. A concise
review of the literature is also conducted.
Case Presentation: A 76-year-old male rubber tapper initially presented to
our Oral Medicine clinic with a chronic ulcer on the lip of more than two
months in duration. He had hypertension, diabetes mellitus, benign prostate
hyperplasia and was compliant to medication. Extraoral examination showed
an ulcer on the lower lip measuring 2 × 1 cm with well-defined border, soft
in consistency which is tender and bleeds upon manipulation. He was fully
edentulous and wears upper and lower complete denture for more than
20 years. Incisional biopsy reveals an ulcerated mucosa with subepithelial
dense band-like inflammatory cells of mainly plasma cells, lymphocytes,
and histiocytes. Collections of plasma cells are also observed in the deeper
connective tissue, particularly in perivascular arrangement. These findings
were consistent with a diagnosis of PCC. The patient was treated with
topical triamcinolone acetonide 0.1% three times daily and chlorhexidine
mouthwash. At 5-week follow-up, a complete resolution of the ulcer with
mild scar tissue is observed.
Conclusion: Diagnosis of PCC is challenging as this entity may mimic other
conditions in clinical and histopathological examination. The chronicity of
the lesion implies a plausible underlying immune mediated process, which
warrant a histopathological confirmation through biopsy. Our case displayed
substantial improvement and complete resolution of PCC with only topical
steroid application, which may not work in every case, hence contributes to
complexity of its management.

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