ORAL MANIFESTATION OF ULCERS BY IMMUNOSSUPRESSION: A CASE SERIES

Immunosuppression is defined as the reduction of activity or efficiency of the immune system. Neutropenia is the decrease in the number of neutrophils, which can cause ulcers in the oral cavity. The first patient, a 32-year-old HIV-positive patient with tuberculosis, presented ulcers on the upper and lower labial mucosa, bilateral buccal mucosa, and tongue. The second, a 47-year-old HIV-positive patient, had ulcers on the tongue and buccal mucosa. The third, a 17-year-old patient with osteosarcoma of the femur, metastasis in lung, lymph nodes, and tibia who is undergoing chemotherapy, had ulcers on bilateral buccal mucosa. In all 3 patients, incisional biopsy, histopathologic examination (chronic inflammatory infiltrate), and culture (negative for alcohol-acid resistant bacili, herpes, and cytomegalovirus) were performed. By exclusion, it was classified as ulcers by immunosuppression. The treatment of the patients occurred with normalization of the immunologic problems and mouthwashes with chlorhexidine 0.12% and laser therapy. There was complete healing of the ulcers.