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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 347:430-436 August 8, 2002 Number 6
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Case 24-2002 — A 48-Year-Old Man with Persistent Erosive Oral Lesions
George T. Gallagher, and Stephen Lyle

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Presentation of Case

A 48-year-old man was admitted to the Ambulatory Disease Service of the Massachusetts Eye and Ear Infirmary because of severe chronic oral lesions.

For several years, the patient had taken ibuprofen because of pain in the back and knees. Sixteen months before admission, he stopped taking the ibuprofen before undergoing surgery for cervical disk disease. The procedure was followed by the development of left ulnar pain, for which he began taking oxycodone–acetaminophen. About three months later, swelling and erythema developed in the right leg. The soles of both feet became red and cracked, and the fingernails and toenails dropped off . . . [Full Text of this Article]

Differential Diagnosis

Physical Causes

Aphthous Stomatitis and Related Conditions

            Herpetic Stomatitis and Herpetiform Aphthous Stomatitis

            Major Aphthous Stomatitis

Behçet's Syndrome

Autoimmune Disorders

            Lichen Planus

            Pemphigoid

            Pemphigus Vulgaris

            Other Autoimmune Conditions

Clinical Diagnosis

Dr. George T. Gallagher's Diagnosis

Pathological Discussion

Anatomical Diagnosis




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