case_images: PMC11807799_01
case_images: (A-I) Mucosal physical examination: diffuse erosive stomatitis. (A-C) Scattered vesicles on the red mucous membranes of the upper and lower lips. (D-F) Extensive vesicles and congestion of the mucous membranes of the ventral and dorsal part of the tongue bilaterally. (G-I) Extensive vesicles and exudate on the buccal mucous membranes.
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case_images: F1
case_images: Oral examination revealed extensive white reticulation with reticulations, superficial erosions and erythema across oral mucosa (Figures 1A-I).
case_images: (A-G) Histopathological and imaging findings. (A) Dense lymphocytic infiltration within the epithelium ("mossy appearance") with liquefactive degeneration of basal cells, indicative of interfacial dermatitis. (B) Basal cell liquefaction accompanied by dense lymphocytic infiltration. (C) Clarification needed: "Untwisting of the vertebral column":consider specifying histopathological or structural relevance, as this phrase seems out of context for histology. (D) Cellular degeneration and keratinization surrounded by peripheral lymphocytic infiltration. (E,F) Direct immunofluorescence (DIF): Negative for intercellular deposits of IgG and C3. (G) PET/CT imaging: a soft tissue mass on the right side of the upper mediastinum and trachea with mild FDG metabolic activity.
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case_images: F2
case_images: A biopsy of the right buccal mucosa showed dense infiltration of epithelial lymphocytes within the lamina propria and liquefied degeneration of basal cells consistent with interfacial dermatitis (Figures 2A-D). Direct immunofluorescence (DIF) revealed no deposition of immunoglobulin G (IgG) or Complement 3 (C3) in the epidermal intercellular spaces or basement membrane zone (Figures 2E, F). Computed tomography (CT) and PET/CT scans revealed a soft tissue mass on the right side of the upper mediastinum and trachea with mildly increased FDG metabolism, suggesting the possibility of reactive lymph node inflammation (Figure 2G).
case_images: (A-F) Complete healing of oral mucosa after surgery. (A) The original vesicles of the red lip mucosa healed completely from before. (B) The vesicles of the dorsal tongue mucosa and the ventral tongue mucosa healed completely from before. (C-D) The original vesicles of the buccal mucosa healed completely from before, and the exudation disappeared. (E-F) Other mucosal erosions of the oral cavity have completely healed from the previous condition.
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case_images: F3
case_images: Her intraoral symptoms resolved completely within 1 month after surgery, after which the prednisolone dosage was gradually tapered to a maintenance dose of 2 mg/day, which she continued for 1.5 years (Figure 3).