In 182 patients with systemic lupus erythematosus (SLE), oral mucosal ulceration occurred in 47 patients (26%), was usually painless (82%), and most often involved the hard palate (89%). Oral ulceration was associated with an increase in overall clinical activity, although this was not accompanied by significant changes in the levels or titers of C3, anti-DNA antibodies, and antinuclear antibodies. Necrotizing vasculitis was not observed. Microscopic changes were similar to the skin lesions of SLE and immunoglobulin and complement were found in both the basement membrane and blood vessel walls.Ulceration of oral mucous membranes in systemic lupus erythematosus (SLE) occurs in 7-40% of patients (1-4). Anecdotal literature and several reports (4-6) suggest that ulcers are more common during exacerbation of disease activity. Light microscopy

For moderate to severe symptoms of diabetic gustatory sweating, topical application of glycopyrrolate is safe, effective, well tolerated, and convenient.

Aseptic necrosis of the wrist in systemic lupus erythematosus (SLE) is not rare. In 156 patients with SLE, aseptic necrosis occurred in 11 patients, of whom 3 (27%) had wrist involvement. Onset of pain was insidious and the symptoms were thought to be related to synovitis due to SLE. An average of 11 months elapsed before aseptic necrosis was correctly diagnosed. An awareness of this possibility is important in the management of any patient with SLE who complains of wrist pain.Aseptic necrosis has been reported to occur in 5-6% of patients with systemic lupus erythematosus (SLE) (1,2). The most commonly affected joints are the large joints, especially the hips and knees. The large joints comprised 100% of all affected joints in Dubois and Cozen's series of 26 patients ( l ) , and the joints of 5 of 7 patients reported by Vroninks et a1 (2). A review of

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