Oral Cues to Disease

2. Over the past few months, this 43-year-old woman has had multiple severely painful, slow-healing oral ulcers, resulting in the erosion of the lower lip. She reports pain on swallowing and occasional bloody nose after blowing in the morning.

Diagnosis: Vesiculo-bullous lesions in the mouth may be seen with pemphigus vulgaris or bullous pemphigoid. Pemphigus vulgaris, an autoimmune intraepithelial blistering disease, often manifests as flaccid bullae or painful ulcerations in the oral cavity prior to the onset of skin lesions.

For more information, see “Oral lesions you can’t afford to miss.” J Fam Pract. 2015;64(7):392-399.