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Article: Volume 43 Number 10 Page 988 - December 2016

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  Dent Update 2016; 43: 988-988

Clinical Challenges Q&A:  Clinical Challenges Q&A 26. Mouth and Skin Ulcerations

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Abstract: A 25-year-old woman presented with a chronically sore mouth. Her soreness appeared one week after a skin rash appeared on her scalp, buttocks and abdomen. The patient suffered only from osteoarthritis and in crisis used piroxicam tablets. Clinical examination revealed oral malodour (halitosis) associated with a large superficial ulceration in her lower lip (Figure 1), a white coated, partially depapillated tongue, with painful red areas of ulcerations in her dorsum, buccal mucosae and floor of mouth. Together with the oral ulcers, a few large flaccid skin bullae were seen. Biopsy from the tongue near to the ulceration revealed epithelial acantholysis.

Author notes: Dimitrios Malamos, DDS, MSc, PhD, DipOM, Oral Medicine Clinic, National Organization for the Provision of Health Services (IKA), Athens, Greece, and Crispian Scully, CBE, MD, PhD, MDS, MRCS, BSc, FDS RCS, FDS RCPS, FFD RCSI, FDS RCSE, FRCPath, FMedSci, FHEA, FUCL, DSc, DChD, DMed(HC) and Emeritus Professor, University College London, UK.