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But what is this oral lesion? #2

A 41-year-old man was referred to our department for a dental examination to evidence and eliminate dental infections before receiving a kidney transplant.

The patient is HIV-positive. He smoked 20 cigarettes a day. His medical history revealed chronic renal failure, chronic HCV infections and a high blood pressure. The patient’s medical treatment is speciafolding, Renagel, antiviral therapy, Amlor and Bisoce.

1

The physical examination of the oral cavity is carried out and revealed asymptomatic lesions on both cheek mucosa. Extractions of 26, 27, 28, 37 and 38 are indicated.

1. Describe the lesions (primary lesions):

Cheek mucosa: shredded white plaque on a non-inflammatory mucosa.
Forward: whitish to yellowish individualized papules on an inflammatory mucosa.

2. What are your hypothesis and differential diagnosis?

Morsicatio Buccarum: lesions caused by a biting habit, usually with nervous patients.
Forward: Fordyce’s spot which are ectopic sebaceous glands.

3. Do you need additional medical tests?

None are needed, it is a clinical diagnostic.

4. What are the things to do?

No treatment is needed. Inform and reassure the patient about the benign nature of these lesions.

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