Case #11:

Case profile:

Patient: Adult male.

Case record:

Chief Complaint: The patient is concerned about mucosal lesions of the palate and gingiva covering the mandibular third molars. The palatal lesion is nonpainful. The patient has been aware of it for three weeks, during which time it has increased in size. It has not been treated. The gingival lesions cover the mandibular third molars. Purple patches are present on the skin of the temples bilaterally.   Medical History: The patient reports hypotension. He states that he was hospitalized for hepatitis-B six years ago. He reports purple skin lesions on the temples and anterior neck of two weeks duration.   Dental History: The patient seeks routine dental treatment every two to three years. He had a dental evaluation of the gingival swelling covering the mandibular third molars approximately two months ago.   Clinical Findings: A 3 x 2 cm, purple, surface lesion is present on the hard palate. Purple surface lesions are present around the mandibular third molars, on the temples bilaterally, and on the neck. The skin lesions and the oral mucosal lesions are thickened but flat. All the thickened lesions are compressible, nontender, fixed to surface mucosa and underlying structures, and blanch upon pressure. Ecchymotic areas present at the junction of the hard and soft palate are not thickened. Anterior and posterior cervical lymph nodes and posterior auricular lymph nodes are enlarged, firm, and nontender. The posterior auricular nodes are fixed to surrounding structures.

Images:

Purple Lesion of the Hard Palate LG