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Oral Diagnosis & Oral Medicine Competency

Oral Diagnosis & Oral Medicine Competency. Tim Dixon Pt # 546-5-60 Pics taken 10/19/10. Patient History. 58 Year old Caucasian Male Seeking regular dental care Pt presents with type II diabetes (well controlled) Cardiovascular problems (triple bypass) Previous tobacco user

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Oral Diagnosis & Oral Medicine Competency

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  1. Oral Diagnosis & Oral Medicine Competency Tim Dixon Pt # 546-5-60 Pics taken 10/19/10

  2. Patient History • 58 Year old Caucasian Male • Seeking regular dental care • Pt presents with type II diabetes (well controlled) • Cardiovascular problems (triple bypass) • Previous tobacco user • Taking 3 medications • Aspirin • Humalog Mix 5050 • MetFORMIN

  3. Lesion Description • Pt presents with vermillion boarder that has a whitish discoloration and loss of definite demarcation between lip and regular skin. • Appears to involve the lower lip significantly more than the upper lip • epithelial origin

  4. Pt Dialogue • How Much time do you spend in the sun? (Used to spend all Day outside) • Do you wear sunscreen? (didn’t use to, now uses chap stick with spf) • How long have you had this for? (Wasn’t really sure) • Has your doctor told you about this and the possible future prognosis? (Yes) • Have you been monitoring the situation for any sort of change? (Yes) • Do you notice it to be worse at different times of the year? (Not really sure, his lips get chapped in winter)

  5. Differential Dx • Acquired dyskeratotic leukoplakia • Squamous cell carcinoma

  6. Provisional Dx • Actinic Chelitis Treatment & Prognosis All pt should be treated seeing that there is approximately a 10% chance of conversion to Squamous Cell Carcinoma there are several tx options most of which will be associated with some sort of post op pain and discomfort. • 5-fluorouracil • Imiquimod • Chemical peel • Eletrosurgery • Carbon dioxide laser • scalpel vermillionectomy,

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