Case presentation A 56-year-old woman presented to a dental clinic with complaints of teeth discoloration, damaged anterior teeth, and a blackish area next to the gingiva on one of her front teeth (Cover image) . The patient was embarrassed as she would often get comments that there was "something stuck" in between her teeth. The patient also had brownish-black spots on her upper and lower lips. History of the present illness The patient was diagnosed with idiopathic thrombocytopenic purpura (ITP) ten years ago.
At that time, her hematologist recommended that she should not undergo any dental surgery to avoid clotting-related adverse events. However, for the next five years, the patient was on periodic prednisone injections as advised by her local physician for intermittent bleeding and bruising. Thereafter, the patient consulted a rheumatologist who diagnosed the patient with lupus…
