Oral necrosis accompanying giant cell arteritis

Area of Science:

• Vascular pathology
• Oral medicine
• Geriatric medicine

Background:

• Necrosis of oral tissues can occur in elderly patients.
• Potential causes include hypothermia and significant blood loss.
• Fingertip necrosis is a recognized, though uncommon, manifestation associated with giant cell arteritis.

Observation:

• Two elderly patients presented with oral tissue necrosis post-hospitalization.
• One patient also exhibited fingertip necrosis.
• Biopsy of the oral lesion revealed an ischemic event.

Findings:

• The oral lesions were characterized by ischemic catastrophe.
• Histological confirmation of giant cell arteritis was absent in both cases.
• Clinical assessment by physicians and a dermatologist suggested giant cell arteritis as the likely diagnosis.

Implications:

• This case series highlights the potential for oral necrosis as a manifestation of vascular compromise in the elderly.
• It underscores the diagnostic challenges in cases of suspected giant cell arteritis without definitive histological findings.
• Further investigation into the link between systemic vascular events and oral tissue necrosis is warranted.