[CIS PIDD] [cis-pidd] Severe aphthous ulcers in an adolescent with CVID

[Paris, Kenneth]

Jane,



Having those types of lesions on oral AND labial mucosa makes me think of lichen planus.   I have a patient with a similar story, and biopsy of the oral lesions ultimately made the diagnosis of lichen planus.  After consultation with a dermatologist, we started treatment with Soriatane with good results.



Ken





Kenneth Paris MD MPH

Associate Professor of Pediatrics

Program Director, A/I Fellowship Program

Co-Director, JM Center for Primary Immunodeficiencies

LSU Health Sciences Center and Children's Hospital



Phone: 504-896-9589

Fax:  504-896-9311



Mail:

Children's Hospital New Orleans

Division of Allergy and Immunology

200 Henry Clay Avenue

New Orleans, LA 70118



________________________________
From: Jane Peake [j.peake at uq.edu.au]
Sent: Thursday, June 05, 2014 1:21 AM
To: CIS-PIDD
Subject: [cis-pidd] Severe aphthous ulcers in an adolescent with CVID

Hi all
I have a young girl with CVID who has been plagued with severe disabling aphthous ulcers for many years. Since starting on IVIg her infectious problems have largely resolved and her ulcers are better but they are still problematic. She gets them on her tongue, buccal mucosa and roof of the mouth and when she has them she finds eating and speech very difficult. Episodes are intermittent but she rarely goes more than a couple of weeks without a severe episode. She has had a couple of episodes of labial lesions but since starting doxycycline (on the advice of the gynaecologists) she has only had one episode when they had run out of the doxycycline. We have tried a variety of topical treatments – local anaesthetics and steroids. She responds well to oral steroids but these cannot be used regularly. Does anybody have any other ideas in this setting?
Thanks for any suggestions
Cheers Jane

Dr Jane Peake
Paediatric Immunologist and Allergist
Senior Lecturer
University of Queensland
level 3 Foundation Building
Royal Children's Hospital
Herston Rd, Herston QLD 4029



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