PMC5855273_01
Gingival overgrowth in relation the maxillary right quadrant
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F1
The swelling had been present for approximately 6 months and was gradually increasing in size to attain the present dimension [Figure 1].
(a) Poikilodermatous changes on the face; (b) Sclera appeared icteric
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F2
The patient presented with multiple hyper- and hypo-pigmented macules distributed all over the body including face with prominent poikilodermatous changes, xerosis, atrophy of the skin, sparse, and thin hair [Figure 2a]. Sclera appeared icteric [Figure 2b].
(a)The dorsum of the hands revealed marked cigarette paper-like wrinkling (b) Intra oral view showing ulceration on buccal mucosa
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F3
The dorsum of the hands and feet revealed cigarette paper-like wrinkling [Figure 3a]. Oral hygiene instructions included the use of a soft toothbrush, nonfoaming toothpaste, chlorhexidine mouthwash, and 20% benzocaine ointment for application on mucosal ulcers [Figure 3b].
(a) Orthopantomogram revealing mixed dentition period (b) Intraoral periapical radiograph of the affected region
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F4
Periapical aspect of 75 revealed presence of tooth bud of 35 and the mesial root resorption of 85 [Figure 4a and b].
(a) Histopathological image revealing hyperkeratosis and mild reactive atypia in the basal cells scanner; (b) Histopathological image revealing proliferation of vascular channels with perivascular area showing inflammatory infiltrate mainly showing plasma cells and lymphocytes with few polymorphonuclear leukocytes (x200); (c) Histopathological image revealing plasma cells (flame-shaped cells) (x400 high power)
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F5
Collagenized stroma with deeper areas showed predominantly plasma cells aggregates around the dilated blood vessels; thus, overall features suggested a diagnosis of "granulomatous lesion with plasma cell infiltrate" [Figure 5a-c].
Postoperative view at the end of 3 months
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F6
The patient was followed up for 1, 2, and 3 months [Figure 6].