Concluded Case

Oral pigmentation

A 44 year old white collar job male patient presented with oral pigmentation since one year. Can't consume any spicy food at all. Underwent routine oral candidiasis treatment like anti fungal mouth gel and itraconazole without any benefits. Patient was taking injectable gym steroids like testosterone, deca durabolin, Trenbolone available in the black market. Due to side effects and present oral symptoms stopped all steroids past one year, however he used steroids for almost a year. Non hypertensive, non diabetic, no obesity. Non-smoker, non-alcoholic, no other habits. Has h/o fungal /yeast infection on neck since one year, responding to topical anti fungals. Lesions reduced. CNS Conscious /oriented. No other comorbidities. Please help with diagnosis, or provisional or differential diagnosis/diagnoses. Plan of management. Thank you

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Concluded answer

Candidiasis Erosive lichen planus? Adv cbc and biopsy

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Resistant candidiasis with oral lichen planus,,

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D/d Lichenoid reaction Lichen planus FDE Oral lichen planus is a chronic condition. There is no cure, so the treatment focuses on helping severe lesions heal and reducing pain or other discomfort. If you have no pain or discomfort and if only white, lacy lesions are present, you may not need any treatment. For more-severe symptoms, you may need one or more of the options below. Treatments such as topical numbing agents can be used to provide temporary relief for areas that are particularly painful. Corticosteroids may reduce inflammation related to oral lichen planus. One of these forms may be recommended: Topical. Mouthwash, ointment or gel is applied directly to the mucous membrane — the preferred method. Oral. Corticosteroids are taken as a pill for a limited amount of time. Injection. The medication is injected directly into the lesion. advice RBS, CBC, Elisa, biopsy

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Oral candidiasis..? Stomatitis..? Leukoplakia..? Fissured tongue..?

Looks like Oral Candidiasis

Oral Leukoplakia, candidiasis Fissured tongue Advice , ornigreat gel , multivitamin, mantane oral hygiene

Inj. Lynex. 300mg1×1.betnisol.mix.tab.roxid150mg.b.d... Syrup. Aristozyme. 20m.l.b.d...tab, a. To. Z. O. D

Thank you doctor
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Hello doc Looks like during to long term use of steroids There is opportunistic information like candidiasis Any habit history ???

Non-smoker. No other habits.
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Fissured tongue Candidiasis Leukoplakia Poor oral hygiene Stomatitis

Thank you doctor
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? ORAL TRUSH .. WITH .. OLP .. ? FRICTIONAL KERATOSIS .. NEED'S .. HPE..STUDY ..

I agree
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Resistant oral candidiasis Biopsy needed Do CBC ESR, CRP etc Itraconazole 200 bd Candid mouth paint Multivitamin and antioxidants Oral hygiene

Sounds good. Thanks
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