Multiple Painful Oral Ulcerations

Abstract

REPORT OF A CASE A 38-year-old woman presented with a 3-month history of painful sores in her mouth. These started on her inner lip and progressed to involve many areas of the oral mucosa, including the tongue. She did not recall any previous blisters and had no nasal, conjunctival, genital, or anal lesions. She reported no prior rash or mucous membrane lesions and denied any medical problems, medicinal intake, or risk factors for human immunodeficiency virus (HIV). No constitutional symptoms were reported. There were many 0.5- to 1.5-cm circular, indurated, hypertrophic, exquisitely tender, superficially ulcerated lesions with white pseudomembranes scattered throughout her oral mucosa and they were especially prominent on her labial and buccal mucosa (Figure 1). Lesions were also seen on her tongue and tonsillar fossae (Figure 2). There was no lymphadenopathy. Her physical examination was otherwise unremarkable. An incisional biopsy specimen was taken from a lesion on the