CHRONIC ULCERATIVE STOMATITIS

Chronic ulcerative stomatitis (CUS) has recently been described as a n ew disease entity characterized by chronic ulceration of oral mucosa w hich responds to treatment with hydroxychloroquine. It has a particula r type of stratified epithelium-specific, antinuclear autoantibody as an immunological marker. Twelve cases have been reported in the litera ture. We present a 40-year-old woman with an Ii-year history of chroni c oral ulcerations. Other dermatological diseases, including oral lich en planus, pemphigus vulgaris and cicatricial pemphigoid, as well as b ullous lupus erythematosus, were excluded. The clinical diagnosis of C US was confirmed on the grounds of the immunological and ultrastructur al findings, The lesions initially responded to high doses of systemic corticosteroids but relapsed promptly after dose reduction. Dapsone w as ineffective. Hydroxychloroquine, given at a dosage of 200-400 mg/da y, led to a complete and long-lasting remission.