History of the present illness

This is a 44-year-old white male with numerous pink/white papillary lesions, some of which are exophytic and many of which are flat and spongy (Figures 1 & 2). The papillary exophytic lesions are present on the lips, bilateral buccal mucosa and vestibule, tongue and floor of mouth. The flatter, spongier lesions are present on the gingiva and hard palate. These lesions are of over two years' duration. The lesions on the buccal mucosa become trapped between teeth when eating, making it hard to chew. The patient has similar lesions in the peri-anal area that are being treated with topical 5 FU cream, while the oral lesions are treated with combined surgical removal and weekly intra-lesional injections with three million units of alpha interferon B.

Figure 1 Photograph represents the typical appearance of the oral cavity at multiple visits of the University of Washington Oral Medicine Clinic. Note the multiple, variable size pink/white papillary lesions of the buccal mucosa and spongy flat pink/red lesions of the gingiva (upper and lower).

Figure 2 Photograph represents the typical appearance of the oral cavity at multiple visits of the University of Washington Oral Medicine Clinic. Note the generalized spongy flat pink/red lesions of the palatal gingiva and hard palate.