PMC7755351_01
series of pictures showing target lesions on extremities (A, B), multiple encrustations, ulcerations with clinically evident bleeding (C, D, E)
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F1
Significant history of throat infection and common cold two weeks back for which he took azithromycin and diclofenac sodium prescribed by the local private practitioner, subsequently he developed irregular ulceration and hemorrhagic crust on the lips (Figure 1 A) extraorally. Intraorally, diffuse erosions, irregular ulcerations were noticed on bilateral buccal mucosa, tongue (Figure 1 B, C, D). A diagnostically significant finding was the presence of multiple concentric target or iris lesions on palmar surfaces (Figure 1 E).
post-operative pictures showing complete regression of the lesions
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F2
Patient was advised to discontinue the medication and was commenced with tab Prednisone 30mg b.d along with benzydamine hydrochloride (tantum) mouthwash and evaluated after a week (Figure 2).
PMC7755351_02
pre-operative pictures showing diffuse erosions and encrustations were noticed on bilateral buccal mucosa, lower labial mucosa and tongue
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F3
Intraorally encrustations, diffuse multiple ulcers, and erosions were noticed on the lower labial mucosa, bilateral buccal mucosa and tongue which were covered by pseudo-membrane, bleeding on provocation was present and were tender on palpation (Figure 3).
complete regression of lesions of bilateral buccal mucosa and partial regression on lower labial mucosa and tongue was noticed
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F4
The patient was commenced with tab Acyclovir 400mg t.i.d., along with tantum mouthwash for a week and evaluated after a week (Figure 4).