Case #25:

Case profile:

Patient: Adult, either sex.

Case record:

Chief Complaint: The patient has had a persistent, progressive sore mouth of three months duration. The sores have always been in the same location. The patient has not noticed blisters in his mouth. Eating spicy food and drinking fruit juice makes the discomfort worse. The patient has not been treated for this problem. The patient has a history of chronic eczema of unspecified type, but this has not been a problem since the oral discomfort began.   Medical History: The patient reports a history of rheumatoid arthritis of 8 years duration and has been receiving injections of gold salts for several years to treat the arthritis. The patient has lost five pounds since the oral discomfort began.   Dental History: The patient had all the maxillary teeth extracted due to periodontitis and has been wearing a maxillary denture for twelve years. The current denture is four years old. The patient cannot wear the denture very long due to oral discomfort.   Clinical Findings: The lesions consist of multiple, large ulcers covered by fibrin clots present on the buccal mucosa and ventral surface of the tongue bilaterally. A Nikolsky's sign is not present. The ulcers are tender to palpation. They are fixed to surface mucosa but not to underlying structures.

Images:

Ulcers on the Left Buccal Mucosa LG   Ulcers on the Right Buccal Mucosa LG   Ulcers on the Ventral Surface of the Tongue LG