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ELSABAGH SCORING SYSTEM FOR ASSESSING SEVERITY AND TREATMENT IMPROVEMENT IN MULTIPLE ORAL LICHEN PLANUS Permatasanti, Ayu; Hapid, M. Hasan; Hidayat, Wahyu
Dentino: Jurnal Kedokteran Gigi Vol 9, No 1 (2024)
Publisher : FKG ULM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/dentino.v9i1.18866

Abstract

Introduction: Lichen planus (LP) is a mucocutaneous, chronic, autoimmune disease, with various clinical manifestations, often involving the oral mucosa, and commonly occurs in adults 30-60 years old.  Among the various scoring systems for oral lichen planus, the Elsabagh scoring system is valid, accurate, relatively easier to teach, relatively faster to master, and does not require complex calculations.Objective: This paper aimed to report and evaluate the successful therapy given based on using the Elsabagh scoring system in oral lichen planus. Case: A 53-years-old woman came to the Department of Oral Medicine with a main complaint of pain in the upper gums and lower right left a year ago. The pain got worse when eating highly spiced and spicy foods. She felt pain when brushing her teeth. Extra oral examination revealed multiple white plaques on the vermilion border. Intra-oral examination revealed erosive, erythema, accompanied by white plaques mesh-like shaped, irregular, and painful, on the upper labial, right and left buccal mucosa, posterior teeth of the mandible that extend into the mucobuccal fold, and gingiva, palate, and posterior gingiva of the right and left maxillae. Amalgam fillings were found on teeth 37 and 46 with plaque and calculus. Based on clinical features, the patient was diagnosed with Multiple Oral Lichen Planus of Erosive and Reticular type. Case management: The patient received topical and systemic corticosteroids, mouthwashes, and supplements. She was advised to stop eating highly spiced and spicy foods, replace amalgam filling with tooth-colored filling, scaling, and replace removable dentures with permanent dentures. The evaluation result using the Elsabagh scoring system showed an improvement from the value of 8 on the initial visit to 3 on the last visit. There was an improvement in the patient's condition after treatment based on evaluation using the Elsabagh scoring system in this case. The Elsabagh scoring system can correlate disease severity with subjective symptoms, allowing comparisons between the initial evaluation of lesions and treatment efficacy or disease progression in oral lichen planus. Keywords: Autoimmune, Elsabagh Scoring System, Oral Lichen Planus
Finding the pathognomonic clinical features, do we still need supporting examinations?: two case reports Fetriani, Ulfa; Permatasanti, Ayu; Wahyuni, Indah Suasani
Padjadjaran Journal of Dentistry Vol 37, No 1 (2025): March 2025
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/pjd.vol37no1.60580

Abstract

Introduction: Pathognomonic symptoms often allow for the extablishment of a clinical diagnosis without laboratory-supporting examinations. This article discusses two cases of oral mucosal disease presenting with typical symptoms and pathognomonic clinical features. Through anamnesis, history taking, and physical examination led to the clinical diagnosis of primary herpetic gingivostomatitis and pseudomembranous oral candidiasis. Case report: The first case involved a 30-year-old woman with primary herpetic gingivostomatitis, characterized by multiple ulcers in the oral cavity and lips. The second case was that of a 4-year-old girl with pseudomembranous oral candidiasis, characterized by wipeable whitish plaques on the oral mucosa, which left an erythematous area. Antiviral therapy was given to the herpetic gingivostomatitis patient, while the patient wih pseudomembranous candidiasis received antifungal treatment. Significant clinical improvement was observed within 1-2 weeks following adequate treatment. Supporting examinations were not performed due to the pathognomonic clinical features. Conclusion: Primary herpetic gingivostomatitis and acute pseudomembranous candidiasis exhibit pathognomonic clinical features that are typical and generally sufficient for clinical diagnosis without laboratory-supporting confirmation.  If clinical diagnosis-based treatment results in improvement, supporting examination may not be necessary. Therefore, strict supervision from a doctor is mandatory in this situation.