Crohn Disease Oral Manifestations — ORE Part 1 MCQ

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ModerateOral MedicineCrohn Disease Oral ManifestationsORE Part 1

A 40-year-old patient with established Crohn disease attends with oral lesions. Which finding is most characteristic of oral Crohn disease?

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Correct answer: A — Buccal cobblestoning with linear vestibular ulcers

Explanation lettering: D = shown as B · B = shown as D

A is correct. Oral Crohn disease has specific granulomatous-pattern lesions, particularly cobblestoning of the buccal mucosa and deep linear ulceration or fissuring in the oral vestibule. This combination is substantially more characteristic than isolated aphthous ulceration. Aphthous ulcers can occur in Crohn disease, but they are non-specific and are seen commonly in patients without inflammatory bowel disease. Bilateral reticular white striae suggest oral lichen planus. A velvety red patch is erythroplakia and requires assessment for epithelial dysplasia or malignancy rather than being attributed to Crohn disease. Migratory tongue patches describe geographic tongue, a benign condition unrelated to Crohn disease.

Reference: Lankarani KB, Sivandzadeh GR, Hassanpour S. Oral manifestations of inflammatory bowel disease: the neglected piece of the puzzle. European Journal of Gastroenterology & Hepatology. 2020. https://pubmed.ncbi.nlm.nih.gov/32183532/