patient is more than 50 yr old male, chronic bidi smoker, has been having history of discharge extra oral since 2 years, the picture 1 I got from a colleague is of 2-3 months back, the picture 2 is from today. the lesion looks really necrotic, there is a strange associated halitosis. intraorally I could see white patches, patient was not able to open his mouth more than two fingers. clinical differential diagnosis were lupus, sarcoidosis, squamous cell carcinoma, actinomyces, NOMA. views and pointers please.

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Should check with systemic diseases... and about pain chewing... And diseases like HIV...and biopsy as soon as possible doc..could be premalignant condition

Scc vs bcc vs lupus vulgaris

Squamous Cell Carcinoma of lip & buccal mucosa. Adv Biopsy MRI PNS & Neck for nodal involvement and further management.

Dx: OSMF And Nodular BCC Get a biopsy done Further proceed ahead with advice after report and oncosurgeon advice

Inability to open mouth light m point to oral submucous fibrosis which is premalignant condition History of tobacco use and ulcerative growth suggest squamous cell carcinoma as diagnosis Adv Biopsy and histopathology

It seem to be case of squamous cell carcinoma Get a check up by dental surgeon for intra oral examination Get a biopsy and HPE and treatment according to HPE report

Clinically it is squamous carcinoma Get Incisional Bx.report. Treat as per report with consultation by ONCOLOGIST n Oncosurgeon

Squamous cell carcinoma

Cancrum Oris / Nodular Bcc, get HIV status notified first...then would be able point about management.

HIV status negative.
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