PMC4615852_01
PMC4615852_02
Keratotic plaques over the dorsal surface of the palms.
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fig1
Skin of both palms and soles was peeling off, leaving an underlying red shiny area (Figures 1, 2, and 3).
Keratotic plaques which peel off leaving underlying reddish areas over the ventral surface of the skin.
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fig2
Skin of both palms and soles was peeling off, leaving an underlying red shiny area (Figures 1, 2, and 3).
Peeling off of the skin over the feet.
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fig3
Skin of both palms and soles was peeling off, leaving an underlying red shiny area (Figures 1, 2, and 3).
PMC4615852_03
Intraoral picture showing maxillary arch with spacing of teeth between 11, 12, 13, 21, 22, and 23.
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fig4
Intraorally, the patient presented 28 teeth with proclination of 21 and 11, spacing in relation to 11, 12, 13, 21, 22, and 23, rotations in relation to 44, 35 (Figures 4 and 5), erupting teeth in relation to 44, a smooth diffuse swelling of the gingiva in relation to 36 and 37, and increased mobility and apical shift in position of gingival margin in relation to 11, 21, and 41.
Intraoral picture showing mandibular arch with distoangular rotation of 34 and mesioangular rotation of 44.
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fig5
Intraorally, the patient presented 28 teeth with proclination of 21 and 11, spacing in relation to 11, 12, 13, 21, 22, and 23, rotations in relation to 44, 35 (Figures 4 and 5), erupting teeth in relation to 44, a smooth diffuse swelling of the gingiva in relation to 36 and 37, and increased mobility and apical shift in position of gingival margin in relation to 11, 21, and 41.
Intraoral picture showing proclination of upper anteriors.
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fig6
There was generalized bleeding on probing and deep periodontal pockets especially in relation to 11, 21, 36, 37, 41, and 46 (Figure 6).
Orthopantomograph of the patient.
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fig7
There was vertical bone loss in relation to 11, 21, 36, 37, 41, and 46 (Figures 7, 8, 9, and 10).
Intraoral periapical radiograph showing bone loss in relation to 11, 12.
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fig8
There was vertical bone loss in relation to 11, 21, 36, 37, 41, and 46 (Figures 7, 8, 9, and 10).
Intraoral periapical radiograph showing vertical bone loss in relation to 46.
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fig9
There was vertical bone loss in relation to 11, 21, 36, 37, 41, and 46 (Figures 7, 8, 9, and 10).
Intraoral periapical radiograph showing vertical bone loss in relation to 36.
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fig10
There was vertical bone loss in relation to 11, 21, 36, 37, 41, and 46 (Figures 7, 8, 9, and 10).
PMC4615852_04
PMC4615852_05
Surgical exploration in relation to 36.
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fig11
Based on her clinical and radiographic features, further treatment comprised of surgical periodontal therapy with regenerative periodontal procedures using osseograft in relation to the vertical defect of 36 and 46 (Figures 11 and 12).
Placement of osseograft in relation to 36.
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fig12
Based on her clinical and radiographic features, further treatment comprised of surgical periodontal therapy with regenerative periodontal procedures using osseograft in relation to the vertical defect of 36 and 46 (Figures 11 and 12).