Allan J. Olitsky, DDS; Scott E. Olitsky, MD


May 16, 2012

Clinical Presentation: A Man With Vascular Oral Lesions

A 66-year-old man presented to the dental office for routine dental care. During the course of his evaluation and treatment, multiple red spots on his lips, tongue, and oral mucosa were observed. The spots bled spontaneously and with minimal contact.

Dental and Medical History

The patient had a history of frequent nosebleeds; he experienced multiple nosebleeds in a single day. The nosebleeds lasted minutes or hours and were often profuse. He had undergone multiple nasal cauterizations for the treatment of his nosebleeds. He also experienced chronic anemia that required blood transfusions on several occasions. His family history was significant for a grandfather, father, paternal aunt, brother, and multiple children who also suffered from frequent nosebleeds. Several family members also required blood transfusions.

Dental Examination

Examination at the time of presentation showed a pale man with multiple red lesions on his lips, oral mucosa, and tongue (Figure). The lesions bled with minor trauma during cleaning. Some of the lesions were slightly elevated and blanched with pressure.

Figure. Multiple vascular oral lesions on patient's tongue.


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