Rapid Communication| Volume 132, ISSUE 3, P260-266, September 2021

Painful nonhealing oral ulcers in a 60-year-old male patient

Published:March 31, 2021DOI:
      A 60-year-old male patient came to the oral medicine clinic for evaluation of his nonhealing oral sores, which had persisted for 12 months. He complained of painful tongue ulcers that affected his ability to eat and contributed to a 35-pound weight loss over the last 5 months. The patient reported fatigue in the last 3 months, accompanied by a 5-week history of skin abnormalities. He also had a brief history of a scrotal lesion in the past. The patient had been evaluated and treated by multiple providers throughout the past year without positive outcomes. His primary care physician (PCP) had initially prescribed magic mouthwash and acyclovir to manage the oral ulcers. Three months previously, the patient's general dentist had referred him to an oral surgeon for a biopsy of the tongue lesions, which were diagnosed by a general pathologist as “ulceration with reactive changes and dense mixed inflammatory infiltrate.” Additional treatment included a dexamethasone rinse that the patient only used briefly because it exacerbated his oral pain.
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