History of the present illness
This is an 18-year-old male who was referred to Dr. Jackson for the extraction of his third molar teeth. He was seen initially on December 19, 2005, when he complained of soreness to his third molars. Extra-oral examination was unremarkable. Intra-oral examination revealed no signs or symptoms of an acute infection, but revealed a lesion of unknown duration on the mid-dorsal tongue. This lesion was firm, red in color, measured 3-4 mm with no inflammation, and appeared to be devoid of surface filliform papillae (Fig 1).  The lesion was otherwise asymptomatic.  The patient denied any tobacco and alcohol use.  An excisional biopsy was performed on December 20, 2005 and was submitted for histologic evaluation.