Presenter: Scott C. Wickless, DO; Amy B. Cardellio, DO; Anthony Cardellio, DO
Dermatology Program: St. John Oakland Hospital
Program Director: Amy B. Cardellio, DO
Submitted on: July 1, 2004
CHIEF COMPLAINT: Painful lesions in the mouth
CLINICAL HISTORY: Patient presented with mild to moderate pain of the mouth and tongue for approximately five years. Stated was semi-controlled with topical steroid and antifungal preparations. Patient also noted spots appearing sporadically on the scalp. No history of bone marrow transplant, hematopoietic stem cell transplantation, transfusion of irradiated blood products, or solid organ transplantation.
PHYSICAL EXAM:
Mouth: Buccal and gingival mucosa with numerous violaceous plaques and erosive patches of erythema. Tongue with extensive thick-white violaceous plaques and erosive involvement.
Scalp: Multiple scattered erythematous patches with scale.
Genitalia: Labia with multiple reticulated plaques; sparing of the perineum and rectum.
LABORATOY TESTS: N/A
DERMATOHISTOPATHOLOGY:
The sections show irregular mucosal acanthosis. There is a dense band-like lymphocytic infiltrate with focal hydropic degeneration and rare cytoid bodies. Representational images courtesy of David Mehregan, MD.
DIFFERENTIAL DIAGNOSIS:
- Pemphigus Vulgaris
- Discoid Lupus Erythematosus
- Graft vs Host Disease
- Lichen Planus
- Psoriasis
