Successful management of oral plasmacytosis mucosae with fluticasone proprionate mouthwash

Plasmacytosis Mucosae (PM) is a rare, benign inflammatory disease which affects primar- ily the oral and upper aero-digestive tract although other mucous membranes are report- edly affected. Its treatment can be challenging and there is limited evidence of effectiveness. This paper reports the successful management of PM of the oral cavity with fluticasone propionate 400mcg as a mouthwash and reviews the literature of topical treat- ments.
The case is a female patient with a long history of multiple intra oral erosions, of liche- noid appearance, which was diagnosed histologically as PM. The patient was successfully managed with topical Fluticasone proprionate 400mcg as a mouthwash twice a day for flare ups, with improvement in the oral erosions and symptoms. An electronic search up to March 2016 of the databases; Pubmed Central, National Library of Medicines Medline and Cochrane Library was carried out for case reports, observational studies, letters to the editor and clinical trials of the use of topical treatment for PM of the oral cavity.
Eleven case reports were identified, involving use of 3 topical treatments: Fusidic Acid, Tetracycline Ointment and Betamethasone mouthwashes. Other treatments described include: monitoring with no action, improved oral hygiene, withdrawal of suspected aller- gens, corticosteroids, Thalidomide, excision, carbon dioxide laser excision and cryother- apy, with variable levels of improvement.
We believe this to be the first case report of a case of PM of the oral mucosa managed successfully with Fluticasone proprionate 400mcg as a mouthwash. Further clinical trials with standardised outcome measures are necessary for better understanding of the options for treatment.