Case #824: 20-year-old-man with gingival lesion   
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Our appreciation is extended to Dr. Juan Yepes, Indiana University School of Dentistry Department of Pediatric Dentistry and Riley Hospital for Children, for contributing this case.

History: A 20-year-old man visited the family dentist about a “red patch” on the gingiva of his lower incisor. The man reported no pain. His past medical history was unremarkable.

The extraoral exam was within normal limits. The intraoral exam revealed good oral hygiene and a small, well-defined erythematous and edematous patch on the marginal gingiva in the anterior mandible.

Click to enlarge the images.

What is the most likely preliminary diagnosis?
Primary herpetic gingivostomatitis
Marginal gingivitis
Pyogenic granuloma
Mucous membrane pemphigoid