Does a person with lupus get sores in their mouth?

Answer 1

How can Lupus affect the mouth?

One of the most common features of lupus is mouth ulcers. This often occurs during flares along with increased joint pains rashes and hair loss. Fortunately in most people when the disease settles the mouth ulcers settle as well, although stress or tiredness can also make mouth ulcers worse. Mouth ulcers can be painful and uncomfortable and it they are an ongoing problem there are simple treatments available such as antiseptic mouthwashes and sometimes steroid lozenges or paste. In the vast majority of people these simple measures, and controlling of disease flares with low dose steroids and/or tablets such as hydroxychloroquine, are all that is required. Very occasionally ulceration of the mouth or nose can be more severe and if it does not respond to these simple measures there are more specialist drugs available.

The importance of oral hygiene must not be forgotten. Keeping teeth brushed and giving up smoking are even more important in people with lupus. If the mouth is particularly sore a soft toothbrush can be used. Some people with lupus can develop discoid skin lesions which are slightly elevated, red areas of skin. The term discoid came from their appearance of looking like red coins or discs on the skin. Similar lesions can occur inside the mouth or nose and occasionally they can also ulcerate.

This type of problem is much less common in people with systemic lupus and is more likely to occur in people whose condition is fairly limited to the skin. Again common sense such as the importance of oral hygiene, stopping smoking etc applies. Depending on the type of lesion, steroid paste and antimalarial tablets such as hydroxychloroquine and/or mepacrine are often used to treat this type of lupus disease. There is some suggestion that people with discoid lupus in the mouth, where it is very florid, may be at greater risk of this turning into cancer. People can read this and get very worried about it. It should be pointed out that this is very unusual and really only applies to the most extreme cases but obviously will be carefully watched for in that very small number of individuals.

Having a chronic condition such as lupus may increase the likelihood slightly of getting some other conditions that can affect the mouth even though they are not necessarily related in their mechanisms. Thus cold sores and oral thrush can sometimes occur. In general the small doses of oral steroids that are used to treat lupus do not mean infections in the mouth are much more likely. However, drugs to prevent thrush will be given where, for example, people are being treated with cyclophosphamide infusions, to try and stop this happening. The lining tissue of the lower bowel and the genital tract is similar to that of the nose and mouth and so often problems that affect one can affect the other.

On the whole lupus affecting the mouth, nose and eyes are generally relatively mild problems. Sjogren's syndrome (dry eyes and dry mouth) occurs frequently but is usually mild. Mouth ulcers are unpleasant but can be dealt with in most cases fairly simply. Similarly mild problems affecting the eyes are common, but if something out of the ordinary develops suddenly, such as decreased vision in one eye, or a red, painful eye, then you may need to see an eye specialist straight away, either through an eye casualty department, if available, or your GP and it may not be sensible to wait until the following day when an appointment is available. In those circumstances it may also be sensible to let your lupus specialist know what is happening so that everybody is aware of what is going on.

Answer 2

Lupus can cause oral ulcers, sores, and thrush.