A 58 years male patient C/O Dry cough and slight pain while swallowing since 1 month. O/E reddish patch over the posterior aspect of palate. He is a chronic smoker since many years. Kindly give your valuable opinion regarding Dx and Rx

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Palatal ulcers with granulation seen. May require biopsy to rule out Infective vs neoplastic etiology.

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IT'S A..CASE OF.. ? PALATAL..ULCER.. NEED'S.. HISTOPATHOLOGICAL STUDY..

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Palatel ulcer Ad biopsy to R/O Malignancy Hamycin lotion locally Nsaid orally Becosule cap 1 bd Soft & liquid diet

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Palate ulcer ask for CBC ESR Blood SUGAR HIV VDRL and BIOPSY

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Hi doctor , patient is already a chronic smoker so there will be more chances of carcinoma of the soft palatal area . We have to check for cervical lymph node enlargements and tenderness , u already specified patient is complaining of defficulty in swallowing . Immediately we have to go for tissue biopsy . And any weight loss in this one month , because of defficulty in swallowing he might be less intake of food . Avoid spicy , chilly diet , only liquid diet is preferable . Immediate plan of action is we have to tell him to discontinue the smoking habit . Candid mouth paint r gel should apply on to the ulcerative area Chest x ray is very much needed . Because of ulceration on palatal tissue the patient wil have severe halitosis problem by sure , so mouth wash with 10:1 dilution is manditory and if there is any tender palpable lymph nodes and tissue biopsy report may get squamous cell carcinoma of the palate . So if it is in initial stages then radiation is very much needed ,so that the benine growth may not transform in to malignant tumor . Take any evening rise of temparature we can think of pulmonary tuberculosis due to chronic history of smoking and may be fibrosis of lungs . Vitamin c tablets twice daily 2 . Mouth wash three times after taking fluid diet 3 avid spicy food only liquid diet with high protein is advisable 4 smoking habit should stop immediately 5 B complex tablet once daily . 6 cap Amoxicillin 250 mg 8 hourly for one week 7 apply candid gel topical application after gargling and after taking food 8 high protein diet is suggestable 9 weight monitaring is very much needed 10 chronic smokers will have thickening of all blood vessels so atherosclerosis problem may be there so garlic pearls wil help in reducing hyperlipemia . 11. If biopsy report matches with squamous cell carcinoma then radiation is mandatory in war foot basis .

I felt that it's a raised lesion. May be an erithroplakia. Advice Edge biopsy of palate.

ACUTE PHARYGITIS NEEDS E N T CONSULTATION

Chronic smoker with slowly progressing growth over the oropharynx - may be a case of malignancy. This patient definately require biopsy . So don't delay. Immediately refer to a surgeon.

Kindly also rule out GRRD. Else possibly viral infection, If there are lymph nodes palpable. If the nodes are fixed, the erosion is indurated, it’s carcinoma. Go for a biopsy.

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Also it could be a Lukoplakia going with the Pt habit history. It is an erosion kind of lesion. But the term Erythroplakia is no more in use, been removed. Hence the term “leukoplakia”. Possibly to early/well defined carcinoma as the term “carcinoma in situ” is also removed from use.

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