oprm-web-case-op-st-12

Oral Pathology:  Soft Tissue Case #12

 

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Patient: Young adult woman.

Chief Complaint:
Patient requests a routine examination.

Medical History:
No abnormalities are identified.

Dental History:
Routine care.

Clinical Findings:
A symmetrically distributed, dark red and blue area approximately 2 x 3 cm is located on the soft palate. The lesion is not thickened, is tender to palpation, and does not blanch upon pressure. It is fixed to the surface mucosa but not to the underlying structures. The patient was unaware of the lesion.

Clinical Image
blue lesion of left buccal mucosa
Maxillary Teeth, Soft and Hard Palate

 

There are no radiographs available for this case.

There are no lab reports available for this case.

There are no charts available for this case.

Summary:|
This is a pigmented, localized surface lesion
  ~Pigmented – Dark red and blue
  ~Localized

Lesions to Exclude from the Differential Diagnosis:
Intravascular Lesions
  ~Do not blanch
Tattoo
  ~Color
  ~Lesion is very large for a tattoo
Melanocytic lesions
  ~Color
Vascular Lesions
  ~Blanch on pressure
Hematoma
  ~Thickened
Petechiae
  ~Appearance – round, red pinpoints

Lesions to Include in the Differential Diagnosis:

Ecchymosis
  ~Does not blanch
  ~Is not thickened
  ~This bruising has a typical pattern from fellatio, wretching, or coughing

Management:
Once the diagnosis is established, no treatment is required.  Explain the nature of the lesion to the patient.  Record findings and diagnosis in the patient’s chart.  Remember that vomiting and wretching can also result in ecchymosis of the soft palate.

Final Diagnosis:
Ecchymosis, in this case secondary to fellatio