l8 year old male presented with these type of oral painful lesions.lesions reoccur every 3 months with submandibular lymph node enlargement . lesions r quite extensive involving other areas of mouth . diagnosis n treatment.

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DD- 1. Pemphigus Vulgaris / other vesiculobullous diseases for - large size of the ulcer recurrence pain against - recurrence once in 3 month 2. Apthous ulcer for - recurrence pain . against - large size Investigation - Biopsy

Take the proper medical dental and drug history of the pt,.any habits... can be chemical burn.. allergic reaction..vesiculobulbous lesions..etc..not apthous ulcers... biopsy will confirm the diagnosis and treat accordingly..till then put the pt on Antioxidants and Bcomplex.. Also go for basic routine investigation including viral markers..

Maam patient has a habit of chewing panparag.

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D/D- Bullous pemphigus Pemphigoid Drug reaction Aphtous ulcer (Unlikely) Inv- Biopsy from lesion FNAC from Lymphnode. Blood profile ESR,CRP RA-factor, cANCA, pANCA, ANA Treatment- Should be aimed at finding the primary underlying cause. Symptomatic management and oral hygiene

Apathous ulcer. It's painful.self limiting. Lactobacillus tab. Dologel mouth paint locally before and after meals.

R We treating symptomatically sir? Dologel local application will soothe but not the treatment ,I feel

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Do biopsy as must investigation Any history of recurrent uveitis or conjunctivitis or urinary tract infections

Pemphigus vulgaris for large size of ulcer recurrence for once in 3 month investigation biopsy advised

Plz Send the patient to any oral surgeon you r not specialised in oral surgery

Dr.Nitesh better to retake history of the patient,it looks like erythematous patch due to burn while eating hot food or patient is having deleterious habits....

How is his dental hygiene? Any blood reports? Particularly sr B12

Poor dental hygiene

Recurrent Apthous ulceration Treatment oral steroids

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