Gingival manifestations of Wegener's granulomatosis

Localized Wegener's granulomatosis is characterized by necrotizing granulomatous disease affecting the upper and lower respiratory tracts, mucosa, and skin. Without treatment, disseminated necrotizing vasculitis and focal necrotizing glomerulonephritis usually follow. Although oral lesions are relatively common, they have been infrequently described and have rarely been reported as the sole manifestation of this disease. In this report, we present two cases of early Wegener's granulomatosis which featured hyperplastic gingival lesions as the initial presenting lesion. Clinical findings and histological evaluation of tissue obtained from the gingival lesion following incisional and excisional biopsies supported the diagnosis of Wegener's granulomatosis. These cases illustrate that less-frequently occurring entities should be considered in the differential diagnosis of localized gingival lesions which fail to respond to conventional therapy.