CROHNS-DISEASE MASQUERADING AS APHTHOUS ULCERS

Although intraoral involvement in Crohn's disease (CD) is observed in only approximately 9% of cases, oral inflammation precedes intestinal symptoms of CD in about 60% of these patients. We describe a 20-year-o ld male with recurrent, painful, intraoral lesions who presented no ot her signs of systemic disease apart from severe loss of body weight. F rom the routinely screened serological parameters only the erythrocyte sedimentation rate and the acute phase reactants were elevated. A bio psy from the vestibular mucosa revealed a dense mononuclear infiltrate and, focally, small noncaseating granulomas suggestive of CD, Gastroi ntestinal endoscopy was performed showing mucosal involvement reaching from the esophagus to the descending colon, The diagnosis of active C D was confirmed by histopathology of intestinal biopsy specimens. As o ral lesions are sometimes treated without a definite diagnosis, we emp hasize the need to search for underlying systemic illness in the diffe rential diagnosis of recurrent inflammatory lesions of the oral cavity .