History of the present illness
This is a 20-year old white male who presented to his dentist with a 1-year history of widespread white lesions involving several oral sites including the bilateral buccal mucosa, bilateral vestibules and upper and lower lips.  At the time of presentation, the lesions (Fig 1& 2) were diffuse, corrugated to verrucoid and rough in consistency.  There were areas of focal ulceration associated with a mild burning sensation. 

 

Figure 1. This clinical photograph was taken at presentation.  Note the diffuse white corrugated lesions of the right buccal mucosa.           

Figure 2. This clinical photograph was taken at presentation.  Note the diffuse white corrugated lesions of the left buccal mucosa.