STRAWBERRY GUMS - A CLINICOPATHOLOGICAL MANIFESTATION DIAGNOSTIC OF WEGENERS GRANULOMATOSIS

Aims-To highlight an uncommon but characteristic gingival lesion assoc iated with Wegener's granulomatosis, emphasising the presence of pseud oepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells; and the paucity of the currently accepted histopathological cri teria of Wegener's granulomatosis-namely necrosis, vasculitis, and gra nulomata. Methods-The histopathological features of a gingival biopsy specimen from a case of Wegener's granulomatosis limited to the upper aerodigestive tract in a 36 year old woman were compared with those of 14 similar reported cases. Results-Pseudoepitheliomatous hyperplasia, microabscesses, and multinucleate giant cells were recorded as presen t in almost all cases of gingival Wegener's granulomatosis. Necrosis, vasculitis, and granuloma formation were present in only a few cases. Conclusions-The combination of pseudoepitheliomatous hyperplasia, micr oabscesses, and multinucleate giant cells in a gingival biopsy specime n from erythematous, swollen gums, clinically resembling over-ripe str awberries, in a patient with a severe systemic upset, is so typical of Wegener's granulomatosis as to be virtually diagnostic. Recognition o f this characteristic lesion may aid early diagnosis and treatment in cases where other diagnostic variables are absent.