DISCUSSION CASE       DISCUSSION CASE A grid of six dental photographs under the heading 'DISCUSSION CASE', showing various intraoral views such as frontal teeth, side arches, and the tongue. This is the top-right photograph in the grid, presenting a close-up frontal view of the upper and lower dental arches, likely part of a discussion case. A middle-row, left-side photo showing a rear view of the mouth focused on the palate area and the back teeth. A middle-row, right-side photo focusing on the inner side wall of a cheek (buccal mucosa) and the adjacent molars, consistent with a discussion case. A bottom-left photo displaying the underside of the patient's tongue (ventral view) and the lower dental arch. A bottom-right photo showing another upper side view of the oral cavity, including teeth and gums, linked to the 'DISCUSSION CASE' section. DISCUSSION CASE Case description: **58-year-old Female presenting with oral burning sensation of 2 months duration. Her medical history is significant for hypertension managed with hydrochlorothiazide and diabetes managed with metformin. She is an ex-smoker of 30 years (packet of cigarettes per day), having quit 10 years ago. She does not drink alcohol. Her last dental visit was 12 months ago.** Activity: 1. Identify the pathosis and describe the clinical features 2. What is the differential diagnosis? 3. What are the relevant clinical investigations? 4. What is the diagnosis? 5. How would you manage this patient?   #### Patient Profile and Chief Complaint A 58-year-old female presents with a burning sensation in the oral cavity that has persisted for two months. #### Medical and Social History - **Medical History:** Significant for hypertension and diabetes. - **Medications:** Currently managed with hydrochlorothiazide (for hypertension) and metformin (for diabetes). - **Smoking History:** Ex-smoker with a 30-year history (one pack per day); quit 10 years ago. - **Alcohol Consumption:** None. - **Dental History:** Last professional dental visit was 12 months ago. #### Clinical Assessment Tasks 1. Identify the pathosis and describe the clinical features. 2. Determine the differential diagnosis. 3. Identify the relevant clinical investigations required. 4. Establish the definitive diagnosis. 5. Outline the management plan for this patient. Left panel clinical photo showing the buccal mucosa and lower lip with visible inflammation or erythema, associated with a case of an 58-year-old female presenting with oral burning sensation. Right panel clinical photo showing the lower face and lip, highlighting the appearance of vermillion border and associated pathology in the patient described as a smoker with hypertension and diabetes. [^1]: Original PDF page 1: [[16. Allergies and Immune mediated disease case 2.pdf#page=1|16. Allergies and Immune mediated disease case 2, p.1]] [^2]: Original PDF page 2: [[16. Allergies and Immune mediated disease case 2.pdf#page=2|16. Allergies and Immune mediated disease case 2, p.2]]