case_images: PMC10838493_01
case_images: Extraoral condition on the first visit; (A) Reddish and peeling skin on the face; (B) Dry and exfoliative lips; (C) Nail thickening and joints appearing stiff.
case_images: IMCRJ-17-77-g0001.jpg
case_images: PMC10838493_01_IMCRJ-17-77-g0001.jpg
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case_images: His face looked symmetrical, and the skin was scally, dry, and reddish (Figure 1A). The lips were dry and peeling, and there were painful fissures at both corners of the lips (Figure 1B). The nails appeared thickened with a ragged texture (Figure 1C).
case_images: The clinical appearance of intraoral dryness: (A) Upper labial mucosa; (B) Lower labial mucosa; (C) Right buccal mucosa; (D) Left buccal mucosa; (E) Palatum; (F) Tongue dorsum; (G) Right lateral tongue; (H) Left lateral tongue; (I) Tongue ventral; (J) Floor of the mouth.
case_images: IMCRJ-17-77-g0002.jpg
case_images: PMC10838493_01_IMCRJ-17-77-g0002.jpg
case_images: f0002
case_images: Intraoral examination revealed dryness and a glassy appearance of the oral mucosa, and the mouth mirror was adherent to the buccal mucosa (Figures 2A-D). The palate had a glassy appearance and was free of debris (Figure 2E). The tongue was erythematous, depapillated, and lobulated; two-thirds of the anterior dorsal tongue had shallow longitudinal fissures, and the mouth mirror stuck to the dorsal tongue (Figures 2F-H). The ventral tongue appeared glassy (Figure 2I). There was no saliva pooling on the floor of the mouth (Figure 2J).