oprm-web-case-op-st-26

Oral Pathology: Soft Tissue Case #26

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Patient: Adult male.

Summary of Visuals:
The skin of the chest, palms, and soles contains multiple lesions exhibiting a concentric pattern of erythematous rings alternating with rings that are of normal skin color. A large ulcer on the right soft palate is covered by a white fibrin clot. Ulcers are also present on the uvula, buccal mucosa, and labial mucosa.

Chief Complaint:
The patient has had persistent oral discomfort of four days duration. The lesions bleed when the patient brushes his teeth. The patient says the lesions have spread to other areas since first noted. He has not noticed blisters. Eating and brushing his teeth make the discomfort worse. Rinsing with baking soda did not result in improvement. The patient also reports a history of oral "canker sores."

Medical History:
The patient smokes one and a half packs of cigarettes per day and reports a history of athlete's foot.

Clinical Findings:
The oral lesions consist of painful ulcers on the right soft palate, uvula, and buccal and labial mucosa bilaterally. A Nikolsky's sign is not present. The oral mucosal ulcers bleed during palpation. The skin of the palms, soles, and chest contains multiple, mildly tender lesions exhibiting a concentric pattern of erythematous rings alternating with rings of normal skin color. No lymph nodes are palpable.