Case for Diagnosis: Periadenitis Mucosa Necrotica? Presented by Ralph B. Coomber, M.D., and (by invitation) Gilbert E. Ryder, M.D.
History: A 45-year-old white woman noticed a small ulcer in the right buccal-gingival sulcus, two weeks ago. Within a few days, numerous ulcers developed over buccal and gingival surfaces, associated with swelling of cheeks and chin, and localized lymphadenopathy. Ulcers also appeared over the pharyngeal area, associated with swelling of the tongue. Tenderness of the tongue and mouth have caused difficulty in eating. Prior to onset, patient had been taking Dexamyl Spansules for one year, Bephan Spacetabs (antispasmodic and antacid) for two weeks, and Pabalate H. C. (hydrocortisone) since September. All of these were prescribed for arthritis.Examination: Over the buccal mucosal and gingival areas are deep ulcerated patches. Moderate swelling of the external oral area, especially the chin, is present, with localized lymphadenopathy. The tongue is red, swollen and tender.
Wolk E, Popper M, Zimmerman MC. THE METROPOLITAN DERMATOLOGICAL SOCIETY OF LOS ANGELES. AMA Arch Derm. 1960;81(1):152–154. doi:10.1001/archderm.1960.03730010156021
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