REPORT OF A CASE
An 18-year-old man presented with a 3-month history of painful sores in his mouth, epigastric pain, and a weight loss of 11.25 kg (25 lb). Recent analysis of the patient's blood sample by his personal physician was said to show "problems with his liver." He denied any cutaneous lesions; specifically genital or perianal ulcers. He also denied penile discharge and occular inflammation. Findings from a physical examination showed multiple ulcerations on both the hard and soft palates and the buccal and gingival mucosae (Fig 1).Over the ensuing month, hematochezia developed. Examination of the patient's oral cavity revealed cobblestone plaques on the mucosal surface of his lower lip, in addition to the previously noted aphthous ulcers (Fig 2). A biopsy specimen of a cobblestone plaque showed granulomatous inflammation (Fig 3). A complete blood cell count revealed the hemoglobin to be 124 g/L (normal, 140 to
Weiss JS, Gupta AK, Regezi J, Rasmussen JE. Oral Ulcers and Cobblestone Plaques. Arch Dermatol. 1991;127(6):892. doi:10.1001/archderm.1991.01680050137019
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