PAGD Keystone Explorer Spring 2021

A 54 year old female patient presents to your practice seeking a second opinion. This patient saw her PCP several months ago who noticed several white patches in her mouth and prescribed nystatin with a diagnosis of oral thrush. The patient sees her physician regularly, takes no medications, and her medical history is non- contributory. You observe striated white and red lesions on both buccal mucosa, the labial vestibules, dorsum of tongue, and entire hard palate. Ulcerations are noted sporadically on these tissues among the striations, and the attached gingiva shows areas of ulceration. The patient’s entire mouth is painful. Eating and even talking are difficult for her, and her oral hygiene has deteriorated. She denies lesions in her genitourinary tissues, but has noticed plaque-like lesions on her scalp and abdomen. Case III 12 www.pagd.org Q dentistry issues