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June 1991

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1991;117(6):686-689. doi:10.1001/archotol.1991.01870180122026

PATHOLOGIC QUIZ CASE 1  Susan E. Dozier, MD; Catherine C. Newman; Dayna G. Diven, MD; Stephen K. Tyring, MD, PhD, Galveston, TexA 59-year-old Hispanic woman presented with a 3-year history of recurring ulcerations over her mouth and tongue and occasionally on her vaginal and nasal mucosa. The ulcers were described as painful and slow to heal, with frequent development of new ulcerations. Before presenting to the dermatology clinic at the University of Texas Medical Branch, Galveston, the patient had been treated first with a short course of methylprednisolone, with some healing of the oral ulcers, and second with colchicine for 2 years, with no improvement in healing or decrease in the incidence of new lesions. The patient denied any complaints of fever, gastrointestinal symptoms, visual changes, or neurologic symptoms.Nikolsky's sign was absent on initial presentation of the lesions. The ophthalmologic examination performed at that time revealed no ocular changes. An autoimmune panel performed 6 months after the onset of the patient's lesions showed no evidence of anti-DNA, anti-Smith, anti-ribonucleoprotein, antinuclear,

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