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3 Suspicious Orofacial Findings

3 Suspicious Orofacial Findings

  • All benign? All malignant? Or some combination?

  • This 57-year-old man says his tongue has looked like this his entire life and has always been asymptomatic. Is this geographic tongue, fissured tongue, laceration of the tongue, glossitis?

  • Answer: B. Fissured tongue. The condition usually occurs in the midline. There may be single or multiple, shallow or deep, fissures; prevalence is about 2%-5%, slightly more common among males. Etiology is unknown.

  • Gingival hypertrophy was an incidental finding during a routine physical exam of this 53-year-old man. Treatment with which of the following might be cause of drug-induced gingival hypertrophy: cyclosporine, calcium channel blockers, phenytoin, all of these.

  • Answer: D. All of the these. This patient had started taking phenytoin following a seizure 4 years before this picture was taken. Gingival hypertrophy ensued a year later. Etiology of the condition is unclear. Risk factors include poor oral hygiene with gingivitis and dental plaque.

  • This 50-year-old male presented with a left nasal lesion of several years’ duration. It was asymptomatic; it was removed by shave excision. The most likely diagnosis is: verruca, basal cell carcinoma, squamous cell carcinoma.

  • Answer: A. Verruca The lesion was sent for pathologic diagnosis as this is a somewhat unusual location for a simple wart. The vast majority require only removal or destruction.

Two of these lesions were identified during routine physical exams, one was the presenting symptom. All benign? All malignant? Or some combination. Click through the slides to find out.


"Something else to worry about!" That's one helluva introduction. I suppose if one of the lesions were a melanoma, the tone would not be so cavalier. According to Delta Dental, 'many people undergo oral health care services more often than they see their PCP's. Rest assured that the Oral Medicine people in your ranks will continue to refervto the appropriate care givers along with the continous monitoring of bloods pressures, anticoagulation and diabetes care plans. Your patients are safe with us. It ain't just teeth, ya know!!

Dr. Arnold @


Xavier @

eographical tongue


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