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Necrotizing stomatitis in the developed world.

J A G Buchanan1, M Cedro, A Mirdin

  • 1Unit of Oral Medicine, Division of Maxillofacial Medical Diagnostic and Surgical Sciences, Eastman Dental Hospital, UCLH NHS Foundation Trust and UCL Eastman Dental Institute, London, UK. j.buchanan@eastman.ucl.ac.uk

Clinical and Experimental Dermatology
|May 10, 2006
PubMed
Summary

This case study highlights necrotizing stomatitis in a malnourished adult with hypothyroidism. Early diagnosis and treatment are crucial for recovery and preventing severe disability.

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Area of Science:

  • Internal Medicine
  • Oral Medicine
  • Endocrinology

Background:

  • Necrotizing stomatitis is rare in developed countries, typically seen in malnourished children.
  • Hypothyroidism and malnutrition can predispose individuals to severe oral infections.
  • This case illustrates a severe presentation in an elderly, malnourished male with undiagnosed hypothyroidism.

Observation:

  • A 68-year-old male presented with malaise, fever, tongue swelling, oral ulcers, and dysphagia.
  • Severe necrotic oral lesions, purpura, blisters, and bedsores were noted.
  • Symptoms developed over six months of lethargy and declining self-care.

Findings:

  • The patient's condition was diagnosed as necrotizing stomatitis secondary to malnutrition, with scorbutic skin lesions and hypothyroidism.

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  • Treatment involved oral hygiene, debridement, intravenous metronidazole, and nutritional support.
  • Recovery led to fibrosis and trismus, improving with exercises.
  • Implications:

    • Highlights the risk of necrotizing stomatitis in malnourished adults in developed nations, especially with comorbidities like hypothyroidism.
    • Emphasizes the importance of early diagnosis and multidisciplinary management for life-saving outcomes.
    • Early intervention can prevent severe facial disfigurement and mortality associated with this condition.