History of the present illness

This is a 78-year-old white female who has had a uniformly blue lesion in her hard palate for over two years. It is otherwise asymptomatic and is not present anywhere else. The patient reports long-term use of the following drugs: Plaquenil (20mg) 1-2x/day; Simvastatin (5mg) 1-3x/day; Prednisone (1.4mg) as needed; Plavix (75mg) 1x/day; Protonix (40mg) as needed; Zyrtec (10mg) as needed; Tylenol (regular strength) as needed and Ferrous Sulfate (125mg) 1x/day.

Figure 1 Clinical photograph of the lesion taken at the first visit. Note the flat, uniform color, diffuse blue color involving almost all the hard palate.