Management of Chronic Ulcer Mimicking Oral Squamous Cell Carcinoma in Down Syndrome Child with Motoric Disorders

Abstract

Introduction: Down syndrome is a congenital genetic disorder caused by an error in cell division, resulting in the presence of an additional third chromosome 21. Down syndrome is one of the leading causes of intellectual disability. Millions of these patients face various health issues. This study aimed to provide information about the challenges in the management of chronic ulcer mimicking OSCC in Down Syndrome child with motoric disorders. Case: A 12-year-old boy with Down Syndrome and motoric disorders was referred to Oral Medicine Department. In the extraoral examination, the patient had a dysmorphic face and dry lips. Lymph node examination could not be assessed because the patient wore a cervical collar. The intraoral examination showed an irregular ulcer with 1×0.7 cm in diameter, indurated margin, and white-yellowish base at the right lateral border of the tongue. The 55 teeth were sharp and caused an occlusion trauma to the right lateral border of the tongue. The patient was diagnosed with a chronic traumatic ulcer mimicking OSCC based on clinical examination. The medication given to the patient were sodium chloride 0.9%, povidone-iodine mouthwash 1%, and petroleum jelly. Conclusion: Children with Down syndrome often suffer from orofacial abnormalities which can affect their oral health and their family’s quality of life. Dental and oral care for Down Syndrome children with motoric disorders required some challenges and collaboration with their parents, families, and caregivers.