|THROUGH THE LENS
|Year : 2020 | Volume
| Issue : 5 | Page : 874-875
Plasma cell gingivitis
Sweta Subhadarshani1, Jayati Sarangi2, Savita Yadav3
1 Department of Dermatology, University of Alabama at Birmingham, Birmingham, USA
2 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
|Date of Submission||04-Aug-2019|
|Date of Decision||13-Jan-2020|
|Date of Acceptance||03-Jul-2020|
|Date of Web Publication||19-Sep-2020|
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Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Subhadarshani S, Sarangi J, Yadav S. Plasma cell gingivitis. Indian Dermatol Online J 2020;11:874-5
A 24-year-old woman presented to the dermatology clinic with complaints of painful swollen bleeding gums for past 4 months. She had been using herbal toothpaste for 5 years but had stopped brushing for past 2 weeks due to discomfort. She denied history of use of lozenges, prior drug intake, dental implants. Her past medical and family history were unremarkable. On examination, there was presence of pinkish erythematous friable gingival hyperplasia, which bled easily on probing [Figure 1]. Her oral hygiene was unsatisfactory. Rest of the local, general physical, and systemic examination were within normal limits. Gingival biopsy revealed acanthotic epithelium with numerous plasma cells and lymphocytes in the subepithelium [Figure 2]a and b]. A diagnosis of plasma cell gingivitis was made based on clinicopathological correlation.
|Figure 2: (a) Mucosal Biopsy from gingiva shows acanthotic epithelium with numerous plasma cells and lymphocytes in the subepithelium (H&E 4×) (b) Higher magnification showing plasma cells (arrow) (H&E 40×)|
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Plasma cell gingivitis is a rare condition which presents as diffuse reddening and edematous swelling of the gingiva with a sharp demarcation along the mucogingival border. It is characterized by diffuse and massive infiltration of plasma cells into the subepithelial connective tissue and may be associated with similar involvement of rest of the oral mucosa., Plasma cell mucositis may clinically mimic acute leukemia and histologically imitate multiple myeloma and extramedullary plasmacytoma. Hence, these should be ruled out with hematological screening (bone marrow aspiration cytology and peripheral blood smear) in addition to histopathological examinations. We could not do these investigations as our patient was lost to follow-up.
The etiology of this bizarre condition is still not properly understood, although hypersensitivity reaction to allergens may play a role. Although several medical and surgical modalities have been tried, including corticosteroids (topical, intralesional, and systemic), antibiotics, destruction of the tissue (liquid nitrogen, Carbon dioxide laser and electrocoagulation), excision of the tissue, and radiation therapy, no treatment has been found to be consistently effective.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Janam P, Nayar BR, Mohan R, Suchitra A. Plasma cell gingivitis associated with cheilitis: A diagnostic dilemma!. J Indian Soc Periodontol 2012;16:115-9.
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Solomon LW, Wein RO, Rosenwald I, Laver N. Plasma cell mucositis of the oral cavity: Report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:853-60.
[Figure 1], [Figure 2]