PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
Plasma cell gingivitis is a condition, thought to represent a hypersensitivity response, which affects the gingival tissues, usually in the anterior maxilla, where it often appears as an asymptomatic, diffuse, erythematous and papillary lesion which bleeds readily with minimal trauma. The aetiology is often difficult to elicit but may be related to specific allergens, neoplasia or it may be of unknown origin. Many cases have been reported in the literature over the last 4-5 decades, related to a variety of aetiological factors, and at one point it was thought to have disappeared until further cases were subsequently reported. The reported case was a 41-year-old female who was referred to the department with bleeding gingivae by her general dental practitioner. She underwent routine examination and clinical investigation, which did not reveal anything abnormal. Biopsy of the palatal mucosa showed the specimen to contain a plasmacytic infiltrate. The patient subsequently underwent patch testing to identify potential allergens, which demonstrated positive responses to sodium metabisulphite, used in many cleaning agents, and cinnamaldehyde, which is used as a flavouring agent in a number of foods. The patient then developed laryngeal cord lesions very similar in appearance to the oral lesions, and it was thought that the lesions may be related to occupational exposure to an environmental allergen (such as a component of a cleaning agent). Management initially involved the use of systemic prednisolone in reducing doses, followed by inhaled steroids and steroid mouthwashes, which brought some improvement in symptoms.
Keywords: hypersensitivity reaction, laryngeal cord, plasma cell gingivitis