case_images: PMC9581649_01
case_images: Intense edema and erythema localized to the adherent vestibular gingival mucosa, from elements 1.5 to 2.5.
case_images: CRID2022-2992656.001.jpg
case_images: PMC9581649_01_CRID2022-2992656.001.jpg
case_images: fig1
case_images: The local objective clinical examination revealed intense edema and erythema localized to the adherent vestibular gingival mucosa, from elements 1.5 to 2.5 (Figure 1).
case_images: (a) The panoramic histological picture shows an oral mucosa punch biopsy, with highly cellular stroma (hematoxylin-eosin 20x). (b) At higher magnification, the oral mucosa appears spongiotic with mononuclear cell exocytosis, associated with dense stromal inflammation (hematoxylin-eosin 100x). (c) The stroma displays an intense infiltration of normal-appearing plasma cells (hematoxylin-eosin 200x). (d) Plasma cells are polyclonal, expressing both kappa (kappa light chain immunostaining 200x). (e) Lambda light chains (lambda light chain immunostaining 200x).
case_images: CRID2022-2992656.002.jpg
case_images: PMC9581649_01_CRID2022-2992656.002.jpg
case_images: fig2
case_images: The microscopic findings showed an intense inflamed infiltrate, predominantly plasmacellular, in the peripheral context of the lamina propria with edema and intra-epithelial spongiosis (Figures 2(a)-2(e)).
case_images: Intra-operative view, treatment performed with a diode laser, with a wavelength of 635 nm, 600-mum fiber, and a handpiece with 1 cm diameter lens. A power of 300 mW was used, with continuous emission mode and with application times not exceeding 1 minute/cm2 (fluence 22 J/cm2), carrying out grid-like scanning movements.
case_images: CRID2022-2992656.003.jpg
case_images: PMC9581649_01_CRID2022-2992656.003.jpg
case_images: fig3
case_images: A power of 300 mW was used, with continuous emission mode and with application times not exceeding 1 minute/cm2 (fluence 22 J/cm2), carrying out grid-like scanning movements (Figure 3).
case_images: The trend of measured values over time-related to: (a) Visual Analogue Scale (VAS) and (b) Numeric Pain Rating Scale (NPRS) denotes a decrease in reported symptoms.
case_images: CRID2022-2992656.004.jpg
case_images: PMC9581649_01_CRID2022-2992656.004.jpg
case_images: fig4
case_images: Furthermore, there were significant symptomatic reductions found after the first two therapeutic sessions (Figures 4(a) and 4(b)).
case_images: Six month after the end of treatment the mucous membranes of the lining appeared normo-chromic and normo-perfused in the absence of inflammation and symptoms.
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case_images: PMC9581649_01_CRID2022-2992656.005.jpg
case_images: fig5
case_images: U/mL); Proteinase 3 antibodies: 21.8 (normally absent). Upon objective examination, the mucous membranes of the lining appear normo-chromic and normo-perfused in the absence of inflammation and symptoms (Figure 5).
case_images: At the last check carried out in 2022, the patient's mucous membranes did not show signs of inflammation or recurrence of the original lesions.
case_images: CRID2022-2992656.006.jpg
case_images: PMC9581649_01_CRID2022-2992656.006.jpg
case_images: fig6