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Oral Diagnosis & Oral Medicine Competency Case

Eric Tolliver 11-1-10. Oral Diagnosis & Oral Medicine Competency Case. Patient. Chart # 542-6-08 78 year old white female Patient presented with white lesion existing at least for 4 years. After questioning, the patient recalled occasional burning and sensitivity in that area .

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Oral Diagnosis & Oral Medicine Competency Case

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  1. Eric Tolliver 11-1-10 Oral Diagnosis & Oral Medicine Competency Case

  2. Patient • Chart # 542-6-08 • 78 year old white female • Patient presented with white lesion existing at least for 4 years. • After questioning, the patient recalled occasional burning and sensitivity in that area. • Pt reported having biopsy in 2007 and said lesion was not malignant. • Pt is taking several medications: Carvediol, Combivent, Lasix, Levothyroxine, Losartan

  3. Lesion • White and red, flat, diffuse, web-like lesion with poorly defined borders that is approximately 5 mm in diameter on the buccal mucosa near the occlusal plane of #31. Lesion accompanied by multiple atrophic lesions on the dorsal surface of the tongue.

  4. Clinical Photographs

  5. Patient Dialogue • When was you last oral examination? • Has this lesion ever cause any symptoms or discomfort? • Were the onset of these lesions associated with the start of a new medication? • Does a certain kind of food or liquid cause the burning sensation you are experiencing? • Have you ever noticed any changes in the color or consistency of the lesions? • Have you ever had any breakouts on your skin? • Have you ever been diagnosed with a systemic disease?

  6. Differential Diagnosis • Lichen Planus • Trauma from cheek biting • Candidiasis

  7. Provisional Diagnosis: Lichen planus

  8. Treatment • Topical steroids such as Triamcinolone or Fluocinoide can be used to treat most cases. • Stronger topical steriods, such as Dexamethasone or Clobetasol, can be used in more severe cases. • Biopsy can be administered to monitor any malignant transformations, which was done in 2007.

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