Chronic ulcerative stomatitis (CUS) is a mucocutaneous disorder
which is characterised by persistent oral mucosal ulceration. The
clinical appearance is often reminiscent of oral lichen planus (OLP)
leading to erroneous diagnoses. The immune mediated inhibition
of the CUS protein (CUSP) is implicated in the pathogenesis of
CUS. CUSP acts as an anti-apoptotic protein and when its action
is prevented it may result in significant epithelial injury.
The objective or this article is to present the first documented
case of CUS in South Africa, with relevant reference to current
international literature. CUS should be considered in patients
previously diagnosed with OLP but who are unresponsive to
glucocorticosteroid therapy. The condition can be successfully
managed using hydroxychloroquine.