Stomatitis Case Study

Introduction
Stomatitis areata migrans (SAM) was first described by Cooke in 1955 1. It has been considered a more extensive involvement of the same process found in the geographic tongue. Geographic tongue is an interesting lesion of unknown etiology, although it has been related to emotional stress. Geographic tongue is also known as wandering rash of tongue, benign migratory glossitis, glossitis areata exfoliativa and erythema migrans. The condition consists usually of multiple areas of desquamation of the filiform papilae of the tongue in an irregular circinate pattern. The central portion of the lesion sometimes appears inflamed, while the border may be outlined by a thin, yellowish white line or band. Stomatitis areata migrans is known

The absence of the condition on the gingiva is both conspicuous and noteworthy 4,5,6. This case is rare and does not appear to have been previously documented either histologically or clinically (with photographs) very often in literature. Kuffer et al 7 described multiple lesions on the buccal mucosa, tongue, lip, and two examples on lower gingival tissues. In addition, this patient had a recurring ulcerative gingivitis. Stephen A. Rails, Gary R. Warnock in 1985 8 reported a 62-year-old male patient who had a varied medical history and oral lesions consistent with stomatitis areata migrans. The stomatitis areata migrans affected essentially all oral soft tissues, including the gingival tissues which were rarely involved. The gingival involvement was documented by clinical and histologic means. In our case the clinical appearance of the lesions remained consistent with SAM of the gingiva, with no concomitant dermatological problems or systemic diseases.
Management
Since the etiology was unknown the treatment is empirical.The patient was reassured as to the benign nature of the process. Heavy doses of vitamins have been used, but in general all types of treatment have been unsuccessful. A 10 -year study of patients with geographic tongue treated in a variety of ways concluded that treatment did not influence either the lesions or the subjective complaints of the patients 9.