This is the oral pathology case of a purple asymptomatic "bump" on the lower gums of a 74-year-old female patient. Clinical assessment reveals a 3 x 3 mm soft, fluctuant nodule located on the lower attached gingiva between teeth Nos. 27 and 28.
Editor's note: This article first appeared in Breakthrough Clinical, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.
Presentation and patient history
A 74-yr-old female presented with the complaint of an asymptomatic “bump” on her lower gums (figures 1 and 2). The patient stated that the lesion had been present for 10 months. A previous general dentist had referred her to an endodontist who performed root canal treatment on her tooth. At that time, the endodontist lanced the lesion and a clear fluid came out. He then placed the patient on a prescription of the antibiotic amoxicillin. However, the papule did not disappear and became darker. The patient presented to a dermatologist for further evaluation.
Clinical exam
Physical examination revealed a 3 x 3 mm purple papule located on the lower attached gingiva between teeth Nos. 27 and 28. Palpation revealed a soft, fluctuant nodule that was asymptomatic to the touch.
Figure 1: Initial presentation of "bump" on patient's lower gums
Figure 2: A 3 x 3 mm purple papule on lower attached gingiva
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Editor's note: This article first appeared in Breakthrough Clinical, the clinical specialties newsletter created just for dentists. Browse our newsletter archives to find out more and subscribe here.