Chronic ulcerative stomatitis: a distinct clinical entity?

Chronic ulcerative stomatitis (CUS) is a mucocutaneous disorder which is characterised by persistent oral mucosal ulceration. The clinical appearance is often reminiscent of oral lichen planus (OLP) leading to erroneous diagnoses. The immune mediated inhibition of the CUS protein (CUSP) is implicated in the pathogenesis of CUS. CUSP acts as an anti-apoptotic protein and when its action is prevented it may result in significant epithelial injury. The objective or this article is to present the first documented case of CUS in South Africa, with relevant reference to current international literature. CUS should be considered in patients previously diagnosed with OLP but who are unresponsive to glucocorticosteroid therapy. The condition can be successfully managed using hydroxychloroquine.