Symptomatic Oral Crohn's Disease in an Adolescent

Crohn's Disease (CD) is a granulomatous inflammatory disease that can affect any part of the gastrointestinal tract. Oral ulcers can appear months or years before intestinal signs or symptoms are seen, which can lead to a diagnosis of other granulomatous inflammatory diseases, including or facial granulomatosis. A 16-year-old female diagnosed with CD presented with asymptomatic white linear patches and erosions bilaterally in mandibular vestibules. Cobble-stoning lesions were seen on the buccal mucosa bilaterally, and pyostomatitis vegetans was seen palatally. Non-alcoholic oral chlorohexidine rinse was prescribed. The patient was referred to an oral surgeon for a biopsy of the retromolar pad, which confirmed the presence of granulomatous inflammation consistent with CD. The patient was told to follow up with a gastroenterologist for a CD medication adjustment. At a two-week follow-up following an increase in adalimumab, her oral mucosa showed marked improvement compared to her initial presentation.