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A 53-year-old male with a history of myelodysplastic syndrome/acute myeloid leukemia, 9 months after myeloablative allo-HSCT with cGVHD of the oral cavity (managed with topical steroids), skin, myofascial/joints and eyes, presented with new onset of diffuse white hyperkeratotic changes with focal demarcated plaque-like lesions on the maxillary and mandibular facial gingiva, hard palate mucosa, and mandibular lingual gingiva (Fig