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Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5724
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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bump on my botXXXXX XXXXXp.

Customer Question

I have a bump (about 5/8") on my botXXXXX XXXXXp. It is whitish/grey and is subdural. Seems dry but very sensitive. This came on after a round of splits on either corner of my mouth. My dentist diagnosed this as fungal and prescribed a medication which worked immediately, but does nothing for my bump. Do you have an opinion. Thanks for your time. Linda.  PS You probably should know I'm type 2 diabetic, well controlled.

Submitted: 11 months ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 11 months ago.
Hello-- I'm Mark Bornfeld DDS. Welcome, and thank you for putting your trust in me!

Would you be able to provide a photograph of the involved area? You may use the "paper clip" icon on the text entry form toolbar to upload a digital picture. Alternatively, you may send your picture to a photo hosting site, such as Imgur, Flickr or Photobucket, and provide a link to the picture in a reply to this information request. This will allow me to provide a more accurate and relevant response...
Customer: replied 11 months ago.

I'm sorry I don't have access to digital photo transfer. Linda

Expert:  Mark Bornfeld, DDS replied 11 months ago.
Then please provide additional information:

--how long has the bump been there?
--during that time, has it changed in any way? (please describe)
--have you had similar lesions before?
--if so, were they in the same place, or where they in different locations in the mouth?
--describe the surface texture (smooth, rough)
--describe the consistency (hard, soft, fluctuant- filled with fluid)
--please indicate whether you have any autoimmune disease (e.g., rheumatoid arthritis, lupus, Crohn's, lichen planus, pemphigoid, psoriasis, etc.)

This will allow me to provide a more accurate and relevant response...
Customer: replied 11 months ago.

--approx 3 mo
--not really


--I did have a bout of "Lichen Planus" last year, which started in my mouth as trench mouth(?)


--the LP lesion did start in my mouth -- all over, roof of mouth, under my trongue, even sub lingual tonsils; they were all over my body, in my ears, under my arms, even in my vagina


-- smooth, slighly raised, hard, no fluiod suspected


--only tghe lichen planus, whioch is in remission atr the moment.

Expert:  replied 11 months ago.
A few observations:

--Lichen planus does not start as trench mouth; they are separate and unrelated conditions, although there is no reason they cannot occur simultaneously.

--Other muco-cutaneous disorders, such as lichenoid reactions and mucous membrane pemphigoid, can be mistaken for lichen planus, but...

--Usually, oral lichen planus manifests in the mouth in an easily recognizable way.

--When these conditions cannot be identified on sight, a biopsy followed by conventional histologic exam and direct immunofluorescence studies can more conclusively derive a diagnosis.

--Most importantly, your description bears little resemblance to either lichen planus or other autoimmune mucocutaneous disorders. Had you stated that the lump seemed like a blister, or was intermittent, that might suggest a vesiculo-bullous condition like pemphigoid or pemphigus, or even a mucous retention cyst. But a solid lump suggests a solid lesion.

Most of these solid lesions are what we call "reactive"-- they represent proliferative connective tissue, sometimes referred to as either a "fibroma", or a "pyogenic granuloma", or a "giant cell granuloma". When less conspicuously bloody or filled with blood vessels, they're usually just "fibromas".

However, that is not to say that a diagnosis can be assumed. More serious conditions, including infection, granulomatous disease, and even malignancy of either the surface tissue or the minor salivary glands can occur in this area. Especially because a photograph is unavailable, this would necessitate a formal diagnostic assessment.

The best type of clinician to do the job would be a clinical oral pathologist or an oral surgeon. Your general dentist can provide you with an appropriate referral, or you may consult the online directories of either the American Association of Oral and Maxillofacial Surgeons or the American Academy of Oral & Maxillofacial Pathology.

Hope this helps...
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5724
Experience: Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
Mark Bornfeld, DDS and other Dental Specialists are ready to help you
Customer: replied 11 months ago.

Thank you, XXXXX XXXXX start with my own dentist and will be seeing my oral surgeon (dental implant) within the month. So I should have answers by months' end. Thank you for your time and consideration. Should I have a future need I will be back. Linda Roland

Expert:  Mark Bornfeld, DDS replied 11 months ago.
You're welcome. Good luck!
Customer: replied 11 months ago.

Thanks Dr., but I think I'm fine for now. If I find myself in need I'll be in touch. Linda Roland

Expert:  Mark Bornfeld, DDS replied 11 months ago.
Ok-- good luck!

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