NONSPECIFIC ULCER IN THE SOFT PALATE: TREATMENT CHALLENGE

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 130; no. 3; p. e119
• Main Authors: SCHUSSEL, JULIANA L., HURCZULACK, MARCIO, MOBILE, RAFAEL ZANCAN, ZANICOTTI, ROBERTA T. STRANADINOLI, RAMOS, GYL HENRIQUE A., SASSI, LAURINDO M.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.09.2020
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2020.04.044

A female patient, 58 years old, presented for consultation with a painful ulcer in the soft palate. She reported a rare dermatologic condition called pyoderma gangrenosum (PG), which was being treated with corticotherapy. Oral exam showed a diffuse ulcer with necrotic areas and a partially destroyed uvula. A biopsy was performed with unspecific results. The diagnosis was compatible with PG. We prescribed topic corticotherapy and pain control. After a month the soft palate showed great improvement but partial tissue was lost. Later, the patient presented with oropharyngeal complaints, and another biopsy was performed with the same unspecific result. The patient developed stomach ulcers, and 6 months after the first visit was diagnosed with acute lymphoid leukemia, an expected complication of the disease. PG incidence is estimated to be 3 to 10 cases per million population, extracutaneous manifestations are an uncommon finding, and diagnosis and treatment are challenging. Differential diagnosis may include other autoimmune diseases.