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Medically Compromised Patients Pharmacology Supporting Your Practice

Case Conference: How would you manage this case?

This case is presented by Dr. Aviv Ouanounou from the Faculty of Dentistry at the University of Toronto.

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    What is the case’s differential diagnosis?

    Is there any other information needed to come up with a diagnosis and a treatment plan?

    How would you manage this case?

    Any other questions for Dr. Aviv Ouanounou?


    1. Hamish Varshney September 15, 2015

      My initial impression would be oral leukoplakia. However, that is a clinical descriptor and not a diagnostic term. Could this be drug related? Does the patient smoke? Could this be due to irritation?
      I feel a biopsy would be necessary in determining a diagnosis for management. I am very interested in hearing the differential diagnosis and what was done to manage this condition.

    2. Marie-Claude Cholette September 21, 2015

      Previous history of similar lesions?/ Skin lesions?/Smoking?

      As my first impression (based on appearance and history) is that the recent 8 weeks of antibiotherapy would have caused changes in oral flora, I would first suspect fungal infection (candidiadis).

      Considering that high likelyhood of fungal infection, I would first swab the lesions for culture and would prescribe anti-fungal agent (Nystatin), if lesions persist, biopsy would be indicated.


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