A 19-year-old woman was was hospitalized with severe mouth pain. Pain over the past several weeks with increasing severity. Affecting her mood and behavior, become withdrawn,uncooperative. Previously been hospitalized for weight loss, dehydration and large bowel edema. During her present hospitalization she was being assessed for anorexia nervosa, systemic lupus erythematosus as well as inflammatory bowel disease. At present, she was discovered to have anti-nuclear antibodies as well as anti-histone antibodies.
Her SS-A and SS-B titers yielded negative results. Started a course of famciclovir, for a suspected oral herpetic infection. Previous medication: famotidine. Intraoral examination revealed large, superficial ulcerations affecting her lower labial mucosa and to a lesser extent, her upper labial mucosa. The right and left buccal mucosa had similar ulcerations. The involved mucosa…
