Necrotic ulcerative stomatitis in a patient with long-standing celiac disease: a case report

Celiac disease is the most common chronic gastroenterological disease. One of the extraintestinal manifestations of this multifaceted disease are changes in the oral mucosa. However, ulceration leading to the destruction of the soft and hard tissues of the orofacial region has not been reported so far. We report on the development of necrotizing ulcerative stomatitis in a 41-year-old woman with celiac disease. The initial ulcerative lesion was located in the lower lip mucosa. Necrosis of all layers of the left side of the lip and oral commissure progressed very quickly. The resulting defect required plastic reconstructive surgery. We successfully compensated for the defect by applying a combination of two flaps from the remaining tissue of the lower lip. Oral competence was established immediately after the operation, and a very good esthetic appearance two months later.