case_images: PMC3357015_01
case_images: Preoperative facial view
case_images: JISP-16-104-g001.jpg
case_images: PMC3357015_01_JISP-16-104-g001.jpg
case_images: F1
case_images: Intraoral examination revealed moderate gingival inflammation [Figure 1] with clinical attachment loss of approximately 4 mm (buccally) in relation to 45, 46, 47, and 48.
case_images: Preoperative view of the lesion
case_images: JISP-16-104-g002.jpg
case_images: PMC3357015_01_JISP-16-104-g002.jpg
case_images: F2
case_images: Whole of the buccal gingiva in the 4th quadrant was bright red in appearance [Figure 2] .
case_images: Intraoral periapical radiograph
case_images: JISP-16-104-g003.jpg
case_images: PMC3357015_01_JISP-16-104-g003.jpg
case_images: F3
case_images: Patient was advised intraoral periapical radiograph [Figure 3] initially, followed by an orthopantomogram [Figure 4] which showed no bony involvement.
case_images: Orthopantomogram
case_images: JISP-16-104-g004.jpg
case_images: PMC3357015_01_JISP-16-104-g004.jpg
case_images: F4
case_images: Patient was advised intraoral periapical radiograph [Figure 3] initially, followed by an orthopantomogram [Figure 4] which showed no bony involvement.
case_images: Post preliminary therapy
case_images: JISP-16-104-g005.jpg
case_images: PMC3357015_01_JISP-16-104-g005.jpg
case_images: F5
case_images: Hexi-M gel 3-4 times daily for 1 week. However, healing was not satisfactory after 1 week recall [Figure 5].
case_images: Post biopsy
case_images: JISP-16-104-g006.jpg
case_images: PMC3357015_01_JISP-16-104-g006.jpg
case_images: F6
case_images: HbsAg which was reactive. Hence, excisional biopsy of the lesion was performed and the patient was put on amoxicillin 250 mg + clavulanic acid 125 mg t.i.d. for 5 days post biopsy [Figure 6].
case_images: Histopathologic section: Dashed arrow denotes attempted keratin pearl formation, black colored arrow denotes absence of epithelial rete pegs, and red colored arrow denotes altered nuclear/cytoplasmic ratio
case_images: JISP-16-104-g007.jpg
case_images: PMC3357015_01_JISP-16-104-g007.jpg
case_images: F7
case_images: The surface epithelium showed normal stratification with absence of rete ridges [Figure 7].
case_images: Chest radiograph
case_images: JISP-16-104-g008.jpg
case_images: PMC3357015_01_JISP-16-104-g008.jpg
case_images: F8
case_images: To rule out secondaries from lung, chest X-ray was taken [Figure 8] and was found to be clear.