[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-420343-105":59,"doc-detail-420343-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","a-rare-case-of-extensive-oral-involvement-in-bullous-systemic-lupus-erythematosus-diagnostic-and-therapeutic-challenges","A Rare Case of Extensive Oral Involvement in Bullous Systemic Lupus Erythematosus - Diagnostic and Therapeutic Challenges","","Bullous systemic lupus erythematosus (BSLE) is a rare autoantibody-mediated subepidermal blistering disease affecting fewer than 5% of systemic lupus erythematosus (SLE) patients. Although oral involvement is usually mild, the case describes exceptionally extensive oral lesions as the predominant manifestation and outlines major diagnostic and therapeutic challenges. A 29-year-old woman presented with severe, diffuse oral ulcerations, VAS pain 8/10, fever, and dysphagia after no new medication or food exposure. Examination showed widespread erythematous bullae and erosions plus non-scrapable white plaques. Histopathology confirmed BSLE via subepidermal separation with predominant neutrophilic infiltration; management used topical agents and systemic high-dose methylprednisolone plus cyclosporine, achieving complete oral resolution within four weeks.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-rare-case-of-extensive-oral-involvement-in-bullous-systemic-lupus-erythematosus-diagnostic-and-therapeutic-challenges/420343/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-rare-case-of-extensive-oral-involvement-in-bullous-systemic-lupus-erythematosus-diagnostic-and-therapeutic-challenges/420343.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What makes oral involvement in bullous systemic lupus erythematosus (BSLE) unusual in this case?","Question",{"text":113,"@type":114},"Oral involvement is typically mild in BSLE, but this report highlights dominant and extensive oral lesions as the predominant manifestation, which is exceptionally uncommon.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the diagnosis of BSLE confirmed when direct immunofluorescence (DIF) was not available?",{"text":118,"@type":114},"Diagnosis was supported by histopathology showing subepidermal separation with predominant neutrophilic infiltration, which helped confirm BSLE and differentiate it from other vesiculobullous disorders.",{"name":120,"@type":111,"acceptedAnswer":121},"What treatment approach led to complete resolution, and how quickly did the oral lesions heal?",{"text":122,"@type":114},"A multimodal regimen was used, combining topical therapy with systemic high-dose intravenous methylprednisolone and oral cyclosporine under dermatology supervision. All oral lesions resolved completely within four weeks.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},420343,1790719364,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","International Medical Case Reports Journal  \n Open Access Full Text Article  \nC ASE REPORT  \nA Rare Case of Extensive Oral Involvement in Bullous Systemic Lupus Erythematosus:  \nDiagnostic and Therapeutic Challenges  \nTiara Resmi 1 , Oki Suwarsa 2 , Irna Sufiawati 3  \n1Oral Medicine Residency Programme, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia; 3Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia  \nCorrespondence: Irna Sufiawati, Department of Oral Medicine, Faculty of Dentistry, Universitas Padjadjaran, Jalan Sekeloa Selatan I, Bandung, 40132, Indonesia, [Email irna.sufiawati@unpad.ac.id](Email irna.sufiawati@unpad.ac.id)  \n\n| Abstract: Bullous systemic lupus erythematosus (BSLE) is a rare autoantibody-mediated subepidermal blistering disease that affects fewer than 5% of systemic lupus erythematosus (SLE) patients. While oral involvement is generally mild, extensive oral lesions as the predominant manifestation are exceptionally uncommon and present significant diagnostic and therapeutic challenges. This report describes a unique case of BSLE with dominant and extensive oral involvement, a presentation rarely documented in the literature. A 29-year-old female presented to the Oral Medicine Clinic with severe, diffuse oral ulcerations of one week’s duration (VAS pain score 8/10), which impaired swallowing and were accompanied by fever, without any history of new medication or food exposure. A 29-year-old female presented to the Oral Medicine Clinic with severe diffuse oral ulcerations for one week (VAS pain score 8/10) that impaired swallowing and were accompanied by fever, without any history of new medications or food exposure. Clinical examination identified widespread erythematous bullae and erosions across the oral mucosa, as well as non-scrapable white plaqueson the dorsum and lateral tongue. Histopathological analysis revealed subepidermal separation with predominant neutrophilic infiltration, confirming BSLE and distinguishing it from other vesiculobullous disorders in the absence of direct immunofluorescence (DIF) testing. Management consisted of a multimodal approach, including topical therapy (dexamethasone ointment, antiseptic rinses, saline compresses, and protective emollients) and systemic therapy with high-dose intravenous methylprednisolone and oral cyclosporine, supported by antibiotics and analgesics under dermatology supervision. Notably, all oral lesions resolved completely within four weeks without the need for more aggressive systemic treatment. This case highlights the diagnostic value of a multidisciplinary, clinicopathological approach in confirming BSLE with dominant oral involvement, even when advanced immunofluorescence testing is unavailable, and demonstrates the effectiveness of a tailored, minimally invasive therapeutic strategy that achieved complete healing without the need for aggressive systemic therapy.\u003Cbr>Keywords: bullous systemic lupus erythematosus, oral ulcerations, autoimmune blistering disease, non-communicable diseases, case report |\n| --- |\n| Background\u003Cbr>Lupus erythematosus is a chronic autoimmune disease characterized by a broad spectrum of clinical manifestations, ranging from cutaneous lesions to multi-organ systemic involvement.1 Bullous systemic lupus erythematosus (BSLE) is a rare subepidermal blistering disease caused by autoantibodies against type VII collagen,2 affecting fewer than 5% of systemic lupus erythematosus (SLE) .3 The estimated prevalence of BSLE ranges from 0. 19% to 0.41% in SLE patients, with a higher predilection in women, consistent with the epidemiology of SLE.4,5 BSLE is particularly uncommon as an initial or isolated manifestation.6\u003Cbr>Clinically, BSLE may present with vesicles, bullae, erosions, and ulcers on the skin and mucous membranes, including the oral cavity, which can","cbCaiv2xFJUEZqeO","https://ap.wps.com/l/cbCaiv2xFJUEZqeO","pdf",992449,"English","# Case report\n## Background\n## Clinical presentation\n## Diagnosis\n## Treatment and outcome\n# Received, accepted, and published information","[{\"question\":\"What makes oral involvement in bullous systemic lupus erythematosus (BSLE) unusual in this case?\",\"answer\":\"Oral involvement is typically mild in BSLE, but this report highlights dominant and extensive oral lesions as the predominant manifestation, which is exceptionally uncommon.\"},{\"question\":\"How was the diagnosis of BSLE confirmed when direct immunofluorescence (DIF) was not available?\",\"answer\":\"Diagnosis was supported by histopathology showing subepidermal separation with predominant neutrophilic infiltration, which helped confirm BSLE and differentiate it from other vesiculobullous disorders.\"},{\"question\":\"What treatment approach led to complete resolution, and how quickly did the oral lesions heal?\",\"answer\":\"A multimodal regimen was used, combining topical therapy with systemic high-dose intravenous methylprednisolone and oral cyclosporine under dermatology supervision. All oral lesions resolved completely within four weeks.\"}]","A Rare Case of Extensive Oral Involvement in Bullous Systemic Lupus Erythematosus - Diagnostic and Therapeutic Challenges | PDF",1790620544,18]