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Painful bilateral ulcerations of the hard palate
Painful bilateral ulcerations of the hard palate Stathopoulos Panagiotis, DDS, MD, PhD,a and Gagari Eleni, DMD, DMScb Athens, Greece
A 27-year-old woman was admitted for a gradually worsening diffuse headache. Her medical history was relevant for heavy smoking, protein S deficiency, heterozygous status for factor V Leiden, and a previous deep vein thrombosis of the right leg. She had previously been given anticoagulation therapy, which the patient discontinued on her own. Cerebral magnetic resonance venography (MRV) revealed superior sagittal sinus thrombosis, for which anticoagulant treatment was initiated. Upon admission, the patient also complained of bilateral pain and numbness on the hard palate followed 3 days later by painful ulcerations (Fig 1). 1.
What is the most likely clinical diagnosis? A. Mucoepidermoid carcinoma B. Syphilis C. Necrotizing sialometaplasia D. Pleomorphic adenoma E. Foreign body reaction
2.
What is the most appropriate treatment? A. Chemotherapy B. Antibiotics C. Palatal resection D. Observation E. Corticosteroid treatment Please visit http://www.eblueimages.org to answer these questions.
From the Department of Oral and Maxillofacial Surgery,a General Hospital of Athens, K.A.T., and the Department of Dermatology,b A. Syggros Hospital for Dermatologic and Venereal Diseases, University of Athens School of Medicine. Funding sources: None. Conflicts of interest: None declared. Correspondence to: Gagari Eleni, DMD, DMSc, Department of Dermatology, University of Athens School of Medicine, Kifissias
Ave 176 and Veaki 1 St, Athens 11525, Greece. E-mail: egagari@ gmail.com. J Am Acad Dermatol 2011;65:e3. 0190-9622/$36.00 ª 2010 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2010.07.046
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A 27-year-old woman was admitted for a gradually worsening diffuse headache. Her medical history was relevant for heavy smoking, protein S deficiency, heterozygous status for factor V Leiden, and a previous deep vein thrombosis of the right leg. She had previously been given anticoagulation therapy, which the patient discontinued on her own. Cerebral magnetic resonance venography (MRV) revealed superior sagittal sinus thrombosis, for which anticoagulant treatment was initiated. Upon admission, the patient also complained of bilateral pain and numbness on the hard palate followed 3 days later by painful ulcerations (Fig 1). 1.
What is the most likely clinical diagnosis? A. Mucoepidermoid carcinoma B. Syphilis C. Necrotizing sialometaplasia D. Pleomorphic adenoma E. Foreign body reaction
2.
What is the most appropriate treatment? A. Chemotherapy B. Antibiotics C. Palatal resection D. Observation E. Corticosteroid treatment Please visit http://www.eblueimages.org to answer these questions.
From the Department of Oral and Maxillofacial Surgery,a General Hospital of Athens, K.A.T., and the Department of Dermatology,b A. Syggros Hospital for Dermatologic and Venereal Diseases, University of Athens School of Medicine. Funding sources: None. Conflicts of interest: None declared. Correspondence to: Gagari Eleni, DMD, DMSc, Department of Dermatology, University of Athens School of Medicine, Kifissias
Ave 176 and Veaki 1 St, Athens 11525, Greece. E-mail: egagari@ gmail.com. J Am Acad Dermatol 2011;65:e3. 0190-9622/$36.00 ª 2010 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2010.07.046
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