Manuscript:
A 50-year-old woman was referred to the department of dentistry
complaining of xerostomia and mouth burning on her tongue. The patient
suffered from anorexia and dysphagia. The patient’s medical history
included chronic renal failure in the hemodialysis stage. She started
hemodialysis 2 months ago with one session per week.
Extraoral examination showed ulcerative, hemorrhagic and crusting
lesions localized on the nostril rim, philtrum and superior lip (Figure
1). Intraoral examination revealed the presence of multiple hemorrhagic
ulcerations involving the dorsal surface of the tongue, buccal mucosa
and mucous surfaces of the lips. Lesions were covered by an adherent
thick white-yellowish membrane (Figure 2).
Laboratory studies showed a creatine level of 711 µmol/L and a blood
urea nitrogen level of more than 32 mmol/L. A diagnosis of hemorrhagic
ulcerative uremic stomatitis was made. Hemodialysis sessions were
doubled and partially resolution of oral mucosal lesions was seen after
10 days.
Uremic stomatitis is a rare manifestation associated with longstanding
uremia in chronic renal failure patients [1]. Its evolution is
favorable with earlier institution of renal
replacement therapy [2]. This case shows that this condition should
always be suspected by the dentist when the context of advanced renal
disease is present.
[1] Barie E. De la stomatite uremique. Arch Gen Med 1889;2:415-32.
[2] Liao C-Y, Wu C-C, Chu P-L. Uremic stomatitis.
QJM 2017;110:247–8.