Localized Scleroderma in a 12-Year-Old Girl Presenting as Gingival Recession. A Case Report and Literature Review

Abstract

Scleroderma is a connective tissue disorder that displays considerable clinical heterogeneity. This case describes a 12-year-old girl who presented with a localized form of the disease. The consequences were a severe and progressive localized gingival recession affecting two maxillary incisors, a localized lip defect and scarring of the forehead. The case illustrates the difficulties in diagnosis and management of young patients with localized scleroderma.

A rare cause of gingival recession: morphea with intra-oral involvement

“…40 In the literature only a few cases of morphea associated with dental or gingival lesions are described. 2,[9][10][11] In these cases, progressive recession of the gingiva, alveolar bone resorption, and eventually mobility of the affected teeth could be observed. Tang et al saw no change after treatment with doxycycline and, therefore, administered intralesional corticosteroids; the results of this therapy were not published.…”

“…Injections of local anesthetic and placement of grafts and flaps might trigger the formation of morphea lesions or might compromise the healing of these tissues. 11 Clinical activity usually persists for 3 to 5 years, but even after longer periods, new lesions may appear. 40 In the literature only a few cases of morphea associated with dental or gingival lesions are described.…”

“…Management of oral hygiene and caries prevention were able to keep the morphea lesion stable for 4 years. 11 After labial frenectomy with excision of the associated scarred mucosa, the vascular supply to the maxillary incisor region was compromised, leading to poor healing. Eventually the two right maxillary incisors had to be extracted, and restorative treatment was purposed.…”

“…7,8 Only a few cases have been described in which the intra-oral tissues are involved. 2,4,[9][10][11][12][13] Described here is a case of morphea causing intra-oral symptoms and its follow-up.…”

Sklerodermie im Kindesalter: Diagnostik und Therapie

“…Die Diagnose wird in der Regel erst im 10. Lebensjahr 3 Jahre gestellt [2,9]. Die Aufklärung der letzten Jahre hat zu einer früheren Diagnosestellung, durchschnittlich im 4.-5.…”