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Patient 548-5-28

Patient 548-5-28. Ashley Popejoy Team 1 Oral Diagnosis and Medicine. Demographics. 70 year old female Hispanic Medical History Hypertension Stroke in 2008 Type II diabetic Past hx of Hepatitis (unsure of type) Sjogren’s syndrome PCN, codeine, latex and local anesthetic allergy

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Patient 548-5-28

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  1. Patient 548-5-28 Ashley Popejoy Team 1 Oral Diagnosis and Medicine

  2. Demographics • 70 year old female • Hispanic • Medical History • Hypertension • Stroke in 2008 • Type II diabetic • Past hx of Hepatitis (unsure of type) • Sjogren’s syndrome • PCN, codeine, latex and local anesthetic allergy • Medications • BP meds, insulin, pain management meds

  3. Lesion

  4. Lesion

  5. Lesion description • Multiple, small, pink, raised papules • Appears to affect epithelium/papilla • Well-defined borders • Diffuse across posterior dorsal surface of the tongue

  6. Patient Dialogue • When did you first notice these lesions? • I am unsure. • Do these lesions resolve when you are able to moisten your mouth more frequently with beverages, sugar-free candy, or mouthwash? • no • Did these lesions appear shortly after beginning one of your medications? • I don’t believe so. • Do you notice these lesions more after a dental exam? • Not that I am aware of.

  7. Differential diagnosis • First differential diagnosis • Hypertrophic Fungi form papillae of the tongue • Second differential diagnosis • Allergic reaction to latex gloves after dental exam • Provisional diagnosis • Hypertrophic Fungi form papillae of the tongue

  8. Hypertrophic circumvallate papillae • Often occurs with age • Can be the result of smoking, poor oral hygiene, or an allergic reaction • Can be painless or have symptoms of discomfort • If bacteria colonize here, can result in hairy tongue • Prognosis is excellent • No treatment is needed without symptoms

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