Concluded Case

❄ 67yrs M presents with Burning mouth to slightest spicy food, Erythema & Ulcer in left buccal sulcus for last 6 months, non-responsive to earlier treatment elsewhere. No oral habit, known controlled diabetic & hypertensive. Dx & Management...

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Concluded answer

Erosive lp??

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Thanks everyone for your kind & valuable opinion. My D/D is Erosive Lichen Planus, my only clue were the lips lesion. Topical Triamcinolone & etc prescribed. Planning for imaging & biopsy on 14th day if ulcer don't heal.

Well, i think it to be a case of Grinspan syndrome, where hypertension, diabetes and oral lichen planus occurs together. But, i will keep lichenoid drug reactions as a d/d too. As yes this can be due to drugs taken for diabetes and hypertension. Provisional diagnosis- Oral lichen planus (Grinspan syndrome) D/d- Lichenoid drug reaction.

Agreed to Dr Chinmay
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D/d Could be Non healing ulcer due to Diabetes Mellitus Traumatic Inflammatory ulcer ( induced by faulty restoration or sharp foreign body / ceramic has chip off ) Drug induced(aspirin) Erosive lichen planus (grinspan syndrome) Infectious Rx Patients medication should be reevaluated Reevaualtion of DM status Removal of prosthesis Rexidine m gel Ointment containing epidermal growth factor 60mcg Lycopene containing antioxidant therapy Prednisolone 20mcg twice daily

Gingivitis due to poor oral hygeine Nutrition deficency major apthos ulcer Lignocain gel tropical Corticosteroid tropical Corticosteroid oral 4 mg bd Good multivitamin with antioxident and lycopein Oral prophylaxis

Visible dyspeptic ulcer treat constipation if any . Give neurobion tab ,Folic acid ,b12 s l. Add cephalosporin if necessary .

Erythroplakia

Maintain oral hygiene, good mvbv , local lignocaine , corticosteroid

Some lesion may be mucocele, specially 37, due to either food lodgment or irritation, some of part seen like red erythromatous lesion on gingival areas, on lips may it be erosive lichen planus, but any history of hyposalivation, nutritional deficiency, any chronic systemic disseas??

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irrigation hyperkeratosis

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