Unilateral parotid swelling or mass in the lupus erythematosus profundus person is a rare or under reported clinical scenario in existing literature. This is a case of a 49-year-old man with such presentation for whom medical management of the underlying condition led to the resolution of the swelling. Lupus erythematosus profundus must be considered as a differential diagnosis of unexplained parotid swelling to prevent incorrect diagnosis, unnecessary surgical intervention (eg, parotidectomy) and the morbidity that comes with it (eg, facial nerve weakness, Frey's syndrome etc).
Topical silver nitrate may be used in oral and maxillofacial clinical settings owing to its astringent, caustic and disinfectant properties. Uses of the toughened silver nitrate pencil stick include haemostasis at bleeding points and for the management of aphthous ulcers, hypergranulation tissue, warts and verrucas. We present an interesting case of apparent silver nitrate-induced, bisphosphonate-related osteonecrosis of the hard palate following mucosal lesion biopsy in a multiple myeloma patient receiving zoledronic acid intravenous infusions. Our review of the literature indicates that this is the first report of such a scenario. CPD/Clinical Relevance: Clinicians must consider all potential sources of chemical and mechanical trauma to the bone and overlying mucosa when managing patients at risk of developing bisphosphonate-related osteonecrosis of the jaw.
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