First, I’m going to start off by saying it is awkward and embarrassing to put photos online of the inside of one’s mouth. But I’m doing this in case it helps someone else. So I apologize up front if the photos of the oral petechiae are offensive. I don’t mean them to be. It’s just that a photo is the best way to describe what is going on with me and since these petechiae *might* be related to the food I eat it seems appropriate to put what I’ve learned on a food sensitivity blog….
Back in October I wrote a post entitled Wheat, Oral Petechiae and Me. Since then I have learned a few things that might be of interest to those who also have this problem or are curious about it.
We were able to get 3 petechiae biopsied and examined by an oral pathologist. The first two were biopsied on February 3rd. Basically the results were benign. The report did say that the tissue “is notable for the presence of patchy infiltrates of lymphocytes and histiocytes.” No one really explained to me the meaning of that. The diagnosis was “Focal keratosis and mild chronic mucositis.” The oral pathologist wanted another biopsy to be sent in Michel’s solution. We were able to do that so the tissue could be sent out for direct immunofluorescence. The results of that examination showed that there was “no immunopathologic evidence for any antibody-mediated bullous disease at this time.”
I clarified with the the periodontist who had done the biopsies what this all meant since he has looked at my mouth several times. He basically said that I have a very healthy mouth that gets petechiae and purpura for some unknown reason. He has never seen anything like it. And for the record, neither has the oral surgeon, my primary care doctor, a GI doctor, 2 allergists and an infectious diseases doctor. No one knows exactly what is going on or why….and believe me it’s not because the doctors haven’t looked. I’ve had a bazillion tests run on me! I will mention that the 2nd allergist that I saw also did percutaneous testing on me. I did not react to wheat and oats on those tests. (I did have a mild reaction to those foods with the first allergist.)
I still somewhat suspect that it is food related…..but I’m not yet 100% sure of this. When I wanted to get the biopsies done, I called the periodontist’s office and asked if there was a time I could come in that week. It was Tuesday morning when I called. She said, “How about Wednesday at 11?” When I was talking with her on the phone, I had no petechiae present. But I said “Sure, I think I can make some appear. I’ll call you if none show up.” I hung up the phone and the next morning ate some sunflower seed butter, rice and quinoa. I ended up with one petechiae on my left buccal mucosa, one on my right buccal mucosa and two on the roof of my mouth! I got the two petechiae on the buccal mucosas biopsied, which really meant it was very hard to eat after that since the inside of my mouth was sore in two places!! But I was happy to get the biopsies done!
I repeated the eating of the sunflower seed butter and quinoa in front of my doctor a week later (on February 9th) to see if the petechiae would appear, but none did. None had appeared since the 3rd when they were biopsied. I saw the periodontist on the 10th to get the stitches out of my cheeks and he said that the oral pathologist wanted another biopsy and would I be willing to give one. I said sure, but there were none in my mouth at that time. Since I suspected I could bring them out, I went home and ate some sunflower seed butter, quinoa, rice cakes and hemp seed, all foods I suspected as bringing them out. (I didn’t want to eat wheat since I was pretty sure wheat brought them out and yet when I avoided wheat they still showed up….so if it is food doing this, I was trying to identify what foods were the cause.)
Sure enough, by that evening on the 10th, I had a petechiae appear on the back lower right gum. On the 11th I ate more rice, quinoa, hemp seed and sunflower seed butter and had a petechiae show up on the lower left gum. That is the one that got biopsied. (This meant that I couldn’t open my mouth very wide at all to get food in due to the incision. Before I couldn’t chew the food due to the incisions inside both cheeks; now I could chew the food, I just couldn’t open my mouth wide enough to get the food in!)
It seems, if it is food doing this, that sometimes I need to eat the food a few days in a row to get them to appear. Either I was able to make them appear for the biopsies by eating those foods, or I just got lucky. That is still to be determined.
I have not eaten hemp seed, quinoa or sunflower seed butter since. I have eaten white jasmine rice and have had no petechiae with that (or any other adverse symptom that I can tell). It is really nice to have a grain in the diet!!
I seem to get petechiae if I eat out at restaurants. I had 11 days without any, then got one on the left buccal mucosa. Was it from the one tablespoon of Kefir I had had daily for the previous 4 days? Greek non-fat yogurt did not give me petechiae….was it the yeast in the Kefir? Or is it not related to food? I am constantly asking myself these kinds of questions. The most recent occurrence happened on the 13th when 3 showed up on the left buccal mucosa. The day before I had eaten some homemade thin skinned white potatoes (not organic). I ate a few pieces, including the skin. My throat and upper mouth felt weird, so I stopped eating them after several bites. Were the petechiae somehow related to those potatoes? I don’t know. For sure the feeling I got in my mouth and throat were related to the potatoes.
Everyone agrees that they aren’t normal. Doctors are grateful that I don’t feel them and that they go away on their own. But the fact remains that no one knows exactly what causes them. If I figure anything more out, I will let you know. In the meantime, I am always grateful when I don’t have them in my mouth for they are unsettling when they appear, especially the large ones!