A 19 year old female presented with spontaneous intra - oral
bleeding of two days duration. The patient reported that
she was, until recently, in good general health and also that
she had an uncomplicated parturition three years ago. She
recently started noticing blood in her stools and felt increasingly
lethargic. There was no history of trauma or intra-oral
intervention that may have initiated the bleeding.
The clinical examination revealed marked pallor of the facial
skin and multiple small petechiae were seen on both of
her forearms. The intra-oral examination identified marked
halitosis and multiple haemorrhagic lesions with a variable
appearance, being plaque-like on the lip, nodular on the
tongue and fungating and exophytic on the palate and in
the retromolar regions. Even delicate manipulation of the
tissues produced profuse bleeding.