Volume 34, Issue 1 e14578
REVIEW ARTICLE

Oral manifestations of COVID-19 disease: A review article

Behzad Iranmanesh

Behzad Iranmanesh

Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran

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Maryam Khalili

Maryam Khalili

Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran

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Rezvan Amiri

Rezvan Amiri

Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran

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Hamed Zartab

Hamed Zartab

Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran

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Mahin Aflatoonian

Corresponding Author

Mahin Aflatoonian

Leishmaniasis Research Center, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran

Correspondence

Mahin Aflatoonian, Leishmaniasis Research Center, Afzalipour Hospital, Kerman Medical University, Kerman, 761614111, Iran.

Email: [email protected]

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First published: 25 November 2020
Citations: 175

Abstract

Dysgeusia is the first recognized oral symptom of novel coronavirus disease (COVID-19). In this review article, we described oral lesions of COVID-19 patients. We searched PubMed library and Google Scholar for published literature since December 2019 until September 2020. Finally, we selected 35 articles including case reports, case series and letters to editor. Oral manifestations included ulcer, erosion, bulla, vesicle, pustule, fissured or depapillated tongue, macule, papule, plaque, pigmentation, halitosis, whitish areas, hemorrhagic crust, necrosis, petechiae, swelling, erythema, and spontaneous bleeding. The most common sites of involvement in descending order were tongue (38%), labial mucosa (26%), and palate (22%). Suggested diagnoses of the lesions were aphthous stomatitis, herpetiform lesions, candidiasis, vasculitis, Kawasaki-like, EM-like, mucositis, drug eruption, necrotizing periodontal disease, angina bullosa-like, angular cheilitis, atypical Sweet syndrome, and Melkerson-Rosenthal syndrome. Oral lesions were symptomatic in 68% of the cases. Oral lesions were nearly equal in both genders (49% female and 51% male). Patients with older age and higher severity of COVID-19 disease had more widespread and sever oral lesions. Lack of oral hygiene, opportunistic infections, stress, immunosuppression, vasculitis, and hyper-inflammatory response secondary to COVID-19 are the most important predisposing factors for onset of oral lesions in COVID-19 patients.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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