SLE Oral Manifestations — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementSLE Oral ManifestationsORE Part 1

A patient with systemic lupus erythematosus (SLE) presents for dental treatment. She takes hydroxychloroquine and prednisolone. Which oral manifestation is she most likely to exhibit?

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Correct answer: D — Oral ulceration

Oral ulceration is the most common oral manifestation of SLE, present in approximately 30% of patients (systematic review; prevalence range 7–45% depending on population). These ulcers are typically painless, pale yellow with grayish-white appearance, and most often affect the hard palate, buccal mucosa, and lips. They correlate with disease activity and are included in some classification criteria for SLE. Gingival overgrowth, melanotic pigmentation, dental fluorosis, and supernumerary teeth are not associated with SLE and serve as effective distractors. Hydroxychloroquine and prednisolone may increase secondary oral candidiasis risk, but oral ulceration remains the primary characteristic lesion.

Reference: Du F, et al. Prevalence of oral mucosal lesions in patients with systemic Lupus Erythematosus: a systematic review and meta-analysis. BMC Oral Health. 2023 Dec 21;23(1):1030. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10734171/