**CASE DISCUSSION** **Case description:** *52-year-old male presented with a 6-week history of a painful lesion, which he has been treating with Kenalog with no response. His medical history is significant for diabetes, hypertension and hypercholesterolemia. He is a smoker of 30 years, smoking 15 cigarettes per day and reported consuming two alcoholic drinks per day, on average. He is edentulous and his current dentures are 5 years old.* **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 History and Presentation A 52-year-old male presented with a 6-week history of a painful lesion. The patient has been treating the area with Kenalog, but reported no response to the medication. #### Medical and Social History - **Medical Conditions:** Diabetes, hypertension, and hypercholesterolemia. - **Social History:** - Smoker for 30 years (15 cigarettes per day). - Alcohol consumption: Average of two drinks per day. - **Dental Status:** Edentulous; current dentures are 5 years old. #### Case 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? Clinical photo of an intraoral view showing a mucosal lesion. The image displays the oral cavity with pinkish-red tissue and a visible area that appears to be inflamed or ulcerated, consistent with the case description of a painful lesion in a 52-year-old male smoker. [^1]: Original PDF page 1: [[Injuries Case 2.pdf#page=1|Injuries Case 2, p.1]]