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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Article info
Publication history
Published online: March 31, 2021
Accepted:
March 19,
2021
Received in revised form:
March 12,
2021
Received:
December 18,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
