Oral diagnosis and medicine competency case
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Oral Diagnosis and Medicine Competency Case. Seth Rush Team 2 UMKC SOD 2012 Chart #: 546-6-24. Patient History. 78 year old Caucasian female Pt. came if for routine dental care Pt. has a history of: broken jaw, broken ankle rectal abscess degenerative arthritis w/ pain back

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Oral Diagnosis and Medicine Competency Case

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Oral diagnosis and medicine competency case

Oral Diagnosis and Medicine Competency Case

  • Seth Rush

  • Team 2

  • UMKC SOD 2012

  • Chart #: 546-6-24


Patient history

Patient History

  • 78 year old Caucasian female

  • Pt. came if for routine dental care

  • Pt. has a history of:

    • broken jaw, broken ankle

    • rectal abscess

    • degenerative arthritis w/ pain back

    • Heart valve problem (pt. does not recall exact details)

    • Hypothyroidsism

    • Frequent kidney stones

    • Urinary tract infection 1 year ago


Medications

Medications

  • Crestor (for cholesterol)

  • Lexapro (for anxiety/depression)

  • Synthroid (for hypothyroidism)


Lesion description

Lesion Description

  • Multiple bullae/vesicles on the on the right buccal mucosa

  • The lesions have well-defined borders and are asymmetric

  • The lesions involve the oral epithelium

  • The lesions have an erythmatous border


Patient dialouge

Patient Dialouge

  • When did you first notice the lesions?

    • About 2 days prior to the appointment

  • Do the lesions cause any discomfort?

    • Yes, very severe pain

  • Have the lesions changed in size/location?

    • Not to the patient’s knowledge

  • Have you ever had any lesison like this before?

    • No, this is the first time

  • Do you have any other lesions anywhere else on your body?

    • No, only these lesions

  • Have you seen a doctor/dentist about these lesions?

    • Yes, my doctor said these were cold sores and gave me a topical steroid


Differential diagnosis

Differential Diagnosis

  • Mucous Membrane Pemphigous

  • Erythema Multiforme

  • Pemphigus Vulgaris

  • Linear IgA diseases

  • Aplastic anemia

  • Uncontrolled Diabetes


Treatment

Treatment

  • A biopsy was note performed, because the patient was referred to AEGD

  • The lesions should be biopsied to determine a definitive diagnosis

  • Topical corticosteroids

  • Systemic corticosteroids

  • Immunosuppresive drugs


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