Oral Manifestations of Graft Versus Host Disease – Clinical Presentations After Allogeneic Hematopoietic Cell Transplantation

Oral chronic graft versus host disease (OcGvHD) is characterized by a myriad of clinical signs and symptoms. The oral health status can be debilitating to the patient by exacerbated mucosal symptoms and decreasing quality of life. Oral manifestations may acutely present as mild to moderate erythematous lesions on mucosal surfaces, painful recurrent mucosal ulcers, and salivary gland hypofunction. At later stages, oral lesions presents with more severe signs and symptoms, including lichenoid lesions characterized by white striations, plaques, and erosions resembling oral lichen planus, mucosal atrophy characterized by thin, fragile mucosa prone to ulcerations and oral infections, trismus due to temporomandibular joint fibrosis, persistent salivary gland hypofunction leading to dysphagia and increased risk of caries and oral candidiasis, and heightened susceptibility to bacterial and viral infections due to impaired mucosal integrity. Amongst oral manifestations, other organs may be involved including the skin, eyes, liver and gastrointestinal tract. The oral manifestations of OcGvHD should be carefully monitored for its progression due to its malignant potential. This case report presents oral manifestations of OcGvHD appeared to develop 4 months after allogeneic hematopoietic cell transplantation in a 58-years old male patient who was referred to the Oral Medicine clinic from his hematologist for evaluation of widespread oral lesions.