This is the continuation of the previous post about a middle aged woman who suffered from infected ovarian endometrioma, beta-Thalassemia/HbE disease and SLE. During her admission, someone noticed  abnormal lesion in her mouth.

lesion at lower lip

lesion at hard palate

The physical examination revealed multiple hyperpigmented lesions, approximately 2-5 mm. in diameter with sharp border at her upper and lower lips, buccal mucosa and hard palate. There were also a few small lesion at her finger tips of both hands (I can’t believe I missed them when I examined her hand earlier.). We consulted the Dermatologist and he suspected the lesions could be the sign of  Peutz Jegher Syndrome although she had no family history of any gastrointestinal polyps. The stool occult blood was negative. The patient was then scheduled for Barium enema and GI follow through to screen for polyposis. I am very sorry that I won’t be able to learn the results since my rotation ended here. If the patient really had PJS, It would be really absurd. No one should suffer from three major diseases at once (Thalassemia major, SLE and PJS).

p.s. the photoes are not very clear because I had no proper flash light when I took them.