Diffusely erythematous and hemorrhagic gingiva.

A 60-year-old woman was referred for evaluation of diffusely hemorrhagic and erythematous lesions of the maxillary and mandibular attached gingiva. The patient had no known allergies, was not a tobacco user, and denied alcohol use. Her medical history was significant for suppurative otitis media, obstructive sleep apnea, hypertension, coronary artery disease, and recurrent pulmonary emboli. Her daily medications included apixaban. Her family history was significant for a first-degree relative (mother) with polycythemia vera. Dr. Keteyian is a resident, Department of Oral and Maxillofacial Surgery, Geisinger Health System, Danville, PA. Dr. Shem is a resident, Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY. Dr. Shupak is an assistant professor, Department of Oral Medicine and Maxillofacial Surgery, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA. Dr. Peters was an assistant professor of dental medicine, Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center, New York, NY, when the work described in this article was conducted. He now is an associate professor, Department of Oral and Maxillofacial Pathology, Geisinger Commonwealth School of Medicine, Geisinger Health System, Danville, PA.