Case #20:

Case profile:

Patient: Adult woman.

Case record:

Chief Complaint: The patient has a toothache involving the mandibular right first and second molars of three days duration. Blisters and painful ulcers on the right side of her face and oral mucosa began this morning. Theoral ulcers bleed when she brushes her teeth. She has not noticed anything which makes the toothache or the lesions better or worse. The patient reports that the skin lesions consist of red areas with blisters on the right side of her face and the oral lesions are present on her tongue and gums.   Medical History: No abnormalities are identified.   Dental History: Other than the chief complaint, no abnormalities are identified.   Clinical Findings: The skin on the right side of the face is erythematous and contains small vesicles and ulcers. Small ulcers are present on the right dorsum of the tongue, mucobuccal fold and the gingival papilla between the mandibular right central and lateral incisors. The mandibular right first and second molars and the surrounding mucosa are painful to palpation. The periapical radiograph reveals no evidence of periapical disease. The mandibular right first and second molars are responsive to pulp testing and give no evidence of pulpitis. No palpable lymph nodes are present.

Images:

Close-up of Chin LG Close-up of Face and Tongue LG   Mandibular Anterior Teeth and Gingiva LG   Right Mandibular Teeth and Mucobuccal Fold LG   Close-up of Right Mandibular Teeth and Gingiva LG   Periapical Radiograph of Mandibular Molars LG