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Revealing a rare inflammatory oral manifestation in a 6-year-old child
  1. Samapika Routray1,
  2. Amit Kumar Adhya2,
  3. Joseph John3 and
  4. Punit Dikhit1
  1. 1 Department of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  2. 2 Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  3. 3 Department of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Samapika Routray, dent_samapika{at}


A 6-year-old child with an episodic history of ulcerations over buccal mucosa was found to have severe inflammation on the palatal aspect of permanent first molars with grade 2 mobility bilaterally. Radiographical features were suggestive of bone loss around permanent molars extending to the distal aspect of the deciduous first molars. The clinical and radiographical findings were indicative of periodontal degeneration without any apparent cause visible intraorally. Further biopsy was done from the rashes present on the malar prominences, which showed nodular aggregates of atypical cells in superficial dermis. These large histiocytic cells with vesicular nuclei and nuclear grooves were immunopositive for CD1a and S100, concluding the diagnosis of Langerhans cell histiocytosis. For treatment, patient was referred to Department of Haemato-oncology and chemotherapy was suggested as per protocol.

  • malignant disease and immunosuppression
  • pathology
  • paediatrics
  • dentistry and oral medicine
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  • Contributors SR, AKA, JJ and PD all have contributed equally in case concepts, case report design, data acquisition, manuscript preparation, manuscript editing and final manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.

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