Also known as systemic lupus erythematosus (SLE), lupus is a systemic autoimmune disease that shows an increased activity of B lymphocytes as well as abnormally functioning T cells. These are white blood cells that are responsible for adaptive immunity, meaning they help the body learn how to defend itself from various diseases. Lupus is the most common connective tissue disorder.

How does lupus clinically appear?

Women are affected by lupus 8 times more than men, which is common among autoimmune disorders. Lupus can cause symptoms such as fever, weight loss, arthritis, and fatigue. The classic triad of symptoms associated with lupus are erythema (reddening), kidney dysfunction, and arthritis.

The classic feature is an erythematous rash known as a malar rash. This rash is seen on the face and is shaped like a butterfly (commonly called a butterfly rash).

How does lupus affect dentistry?

Oral lesions are present in 5-25% of patients with SLE. These lesions appear on the palate, buccal mucosa, and the gingiva, and may resemble lichen planus. If a patient with SLE presents with these oral lesions, then lichen planus may be removed from the differential diagnosis.

The most important aspect of SLE is the possibility of kidney failure, and patients with SLE should be regularly seeing a physician. The majority of SLE patients will have a characteristic known as Libman-Sacks endocarditis, which causes inflammatory vegetations on the heart valves of those affected.

To summarize:

• SLE is an autoimmune disease that presents with a malar rash, kidney disfunction, and arthritis
• Oral lesions do occur with SLE, but are rare
• Kidney failure can occur in patients with SLE

References:

(n.d.) Oral and Maxillofacial Pathology: Red Lesions. Dr. Al Pourian. A.T. Still Missouri School of Dentistry and Oral Health

2017. Immunology Semester 1 Handout. Dr. Priscilla Phillips. A.T. Still Missouri School of Dentistry and Oral Health