Clinical  and Radiographic Findings

The patient developed a generalized erythematous rash and papular urticarial eruption on the extremities, hand, feet, trunk, back, chest (Fig 2), face and lips. She developed sloughing epithelium, especially of the hands (Fig 3). The oral cavity showed multiple ulcers of 1-2 mm in size on the upper and lower alveolar ridges and palate (Fig 1). The oral ulcers were symptomatic; the patient had difficulty eating and drinking hot food and beverages and spicy food.

Fig 1. This clinical photograph is taken at week 1. It illustrates multiple irregular ulcers on the edentulous maxillary alveolar ridge and a small ulcer involving the mucosa covering a small torus palatinus.


Fig 2. This clinical photograph is taken at week 1. It illustrates extensive skin rash involving the chest, upper extremities, neck and shoulders.