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Oral lupus erythematosus - Oral Mucosal Lesion
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Oral lupus erythematosus - Oral Mucosal Lesion

Contributors: Belinda Tan MD, PhD, Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc
Other Resources UpToDate PubMed


Lupus erythematosus is a chronic inflammatory autoimmune disease that can manifest cutaneously, orally, and systemically. Risk factors for developing cutaneous lesions include sex (3:1 female-to-male ratio, especially during childbearing years) and race/ethnicity, with Black patients demonstrating a higher incidence compared with White patients. Cutaneous lupus erythematosus may be acute, subacute, or chronic (also known as discoid). Sex and race/ethnicity are also risk factors for developing systemic lupus erythematosus (SLE), with a 6:1 female-to-male ratio, and with Black women demonstrating a fourfold higher incidence compared with White women. Individuals of childbearing potential are most commonly affected. Lupus erythematosus can also be drug induced.

Oral mucosal lesions can occur in both cutaneous and systemic forms of lupus erythematosus. The lips, gingiva, tongue, and palatal and buccal mucosa are the most commonly involved sites.

For a more in-depth discussion of the subtypes of cutaneous lupus erythematosus and of SLE, see Discoid lupus erythematosus, Subacute cutaneous lupus erythematosus, and Systemic lupus erythematosus. See also Drug-induced lupus erythematosus.


L93.2 – Other local lupus erythematosus

403495008 – Discoid lupus erythematosus of oral mucosa

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The oral lesions of lupus erythematosus could be confused with other superficial oral ulcerative conditions such as Oral lichen planus, hypersensitivity reactions, or even Aphthous stomatitis. However, the oral lesions of lupus erythematosus almost never occur without concomitant skin lesions or systemic involvement. 

Because patients with SLE may have been treated with immunosuppressive therapy for years, patients should be evaluated for erythroplakia, erythro-leukoplakia, and squamous cell carcinoma.

Differential diagnosis of oral lesions:
  • Erosive Oral lichen planus
  • Mucous membrane pemphigoid 
  • Pemphigus vulgaris
  • Oral erythroplakia – usually unilateral
  • Oral squamous cell carcinoma – usually unilateral
If patients have dry eyes or dry mouth, they should be evaluated for concomitant Sjögren syndrome.

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Last Updated:08/16/2021
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Oral lupus erythematosus - Oral Mucosal Lesion
A medical illustration showing key findings of Oral lupus erythematosus : Oral ulcers, Mouth pain, Oral burning sensation
Clinical image of Oral lupus erythematosus - imageId=4347200. Click to open in gallery.  caption: 'Whitish and reddish prlaques on the labial mucosa.'
Whitish and reddish prlaques on the labial mucosa.
Copyright © 2024 VisualDx®. All rights reserved.