Skip to main content

Advertisement

Log in

Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review

  • Special Issue: Colors and Textures, a Review of Oral Mucosal Entities
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Leão JC, Gueiros LA, Porter SR. Oral manifestations of syphilis. Clinics. 2006;61:161–6.

    Article  PubMed  Google Scholar 

  2. Alam F, Argiriadou AS, Hodgson TA, et al. Primary syphilis remains a cause of oral ulceration. Br Dent J. 2000;189:352–4.

    Article  PubMed  CAS  Google Scholar 

  3. Little JW. Syphilis: an update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:3–9.

    Article  PubMed  Google Scholar 

  4. Stewart RJ, Tsang CA, Pratt RH, et al. Tuberculosis —United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67:317–23.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Krawiecka E, Szponar E. Tuberculosis of the oral cavity: an uncommon but still a live issue. Adv Dermatol Allergol. 2015;32(4):302–6.

    Article  Google Scholar 

  6. Yepes JF, Sullivan J, Pinto A. Tuberculosis: medical management update. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:267–73.

    Article  PubMed  Google Scholar 

  7. Whitley RJ, Kimberlin DW, Roizman B. Herpex simplex virus. Clin Infect Dis. 1998;26:541–55.

    Article  PubMed  CAS  Google Scholar 

  8. Clarkson E, Mashkoor F, Abdulateef S. Oral viral infections: diagnosis and management. Dent Clin N Am. 2017;61:351–63.

    Article  PubMed  Google Scholar 

  9. Kolokotronis A, Doumas S. Herpes simplex virus infection, with particular reference to the progression and complications of primary herpetic gingivostomatitis. Clin Microbiol Infect. 2006;12:202–11.

    Article  PubMed  CAS  Google Scholar 

  10. Baringer JR, Swoveland P. Recovery of herpes simplex virus from human trigeminal ganglions. N Engl J Med. 1973;288:648–50.

    Article  PubMed  CAS  Google Scholar 

  11. Weathers DR, Griffin JW. Intraoral ulceratipons of recurrent herpes simplex and recurrent aphthae: two distinct clinical entities. J Am Dent Assoc. 1970;81:81–8.

    Article  PubMed  CAS  Google Scholar 

  12. Cohen SG, Greenberg MS. Chronic oral herpes simplex virus infection in immunocompromised patients. Oral Surg Oral Med Oral Pathol. 1985;59:465–71.

    Article  PubMed  CAS  Google Scholar 

  13. Amir J. Clinical aspects and antiviral therapy in primary herpetic gingivostomatitis. Paediatr Drugs. 2001;3:593–7.

    Article  PubMed  CAS  Google Scholar 

  14. Arduino PG, Porder SR. Oral and perioral herpes simples virus type 1 (HSV-1) infection: review of its management. Oral Dis. 2006;12:254–70.

    Article  PubMed  CAS  Google Scholar 

  15. Jensen LA, Hoehns JD, Squires CL. Oral antivirals for the acute treatment of recurrent herpes labialis. Ann Pharmacother. 2004;38:705–9.

    Article  PubMed  CAS  Google Scholar 

  16. Woo SB, Challacombe SJ. Management of recurrent oral herpes simplex infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:12–8.

    Article  Google Scholar 

  17. Arvin AM. Varicella-zoster virus. Clin Microbiol Rev. 1996;9:361–81.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Badger GR. Oral signs of chickenpox (varicella): report of two cases. J Dent Child. 1980;47:349–51.

    CAS  Google Scholar 

  19. Kolokotronis A, Louloudiadis K, Fotiou G, et al. Oral manifestations of infections due to varicella zoster virus in otherwise healthy children. J Clin Pediatr Dent. 2001;25:107–12.

    Article  PubMed  CAS  Google Scholar 

  20. Carmichael JK. Treatment of herpes zoster and postherpetic neuralgia. Am Fam Physician. 1991;44:203–10.

    PubMed  CAS  Google Scholar 

  21. Tidwell E, Hutson B, Burkhart N, et al. Herpes zoster of the trigeminal nerve third branch: a case report and review of the literature. Int Endod J. 1999;32:61–6.

    Article  PubMed  CAS  Google Scholar 

  22. Verbin RS, Heineman HS, Stiff RH. Localized odontalgia occurring during herpes zoster of the maxillary division of the fifth cranial nerve. Report of a case. Oral Surg Oral Med Oral Pathol. 1968;26:441–5.

    Article  PubMed  CAS  Google Scholar 

  23. Wood M. Understanding Pain in Herpes Zoster: An Essential for Optimizing Treatment. J Infect Dis. 2002;186:78–82.

    Article  Google Scholar 

  24. Straus SE, Ostrove JM, Inchauspe G, et al. NIH conference. Varicella-zoster virus infections. Biology, natural history, treatment and prevention. Ann Intern Med. 1988;108:221–37.

    Article  Google Scholar 

  25. Stankus SJ, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgia. Am Fam Physician. 2000;61:2437–48.

    PubMed  CAS  Google Scholar 

  26. Wutzler P. Antiviral therapy of herpes simplex and varicella-zoster virus infections. Intervirology. 1997;40:343–56.

    Article  PubMed  CAS  Google Scholar 

  27. Ueda T, Ogata H, Kojima Y, et al. Cytomegalovirus oral ulcers. Infection. 2014;42:235.

    Article  PubMed  CAS  Google Scholar 

  28. Dioguardi M, Troiano G, Russo LL, et al. Occult co-infection in the oral cavity with cytomegalovirus during immuno-suppression. J Transl Sci. 2015;1(2):26–8.

    Google Scholar 

  29. Jones AC, Freedman PD, Phelan JA, et al. Cytomegalovirus infections of the oral cavity: a report of six cases and review of the literature. Oral Surf Oral Med Oral Pathol. 1993;75:76–85.

    Article  CAS  Google Scholar 

  30. Sharland M, Khare MD. Cytomegalovirus treatment options in immunocompromised patients. Expert Opin Pharmacother. 2001;2(8):1247–57.

    Article  PubMed  Google Scholar 

  31. Lakshman P, Samaranayake P, Keung Leung W, et al. Oral mucosal fungal infections. Periodontol 2000. 2009;49:39–59.

    Article  Google Scholar 

  32. Napoli AJ, Donegan JO. Aspergillosis and necrosis of the maxilla: a case report. J Oral Maxillofac Surg. 1991;49:532–4.

    Article  PubMed  CAS  Google Scholar 

  33. Bell WA, Gamble J, Garrington GE. North American blastomycosis with oral lesions. Oral Surg Oral Med Oral Pathol. 1969;28:914–23.

    Article  PubMed  CAS  Google Scholar 

  34. Page LR, Drummond JF, Daniels HT, et al. Blastomycosis with oral lesions. Report of two cases. Oral Surg Oral Med Oral Pathol. 1979;47:157–60.

    Article  PubMed  CAS  Google Scholar 

  35. Ferreira OG, Cardoso SV, Borges AS, et al. Oral histoplasmosis in Brazil. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(6):654–9.

    Article  PubMed  Google Scholar 

  36. Rodriguez RA, Konuia T. Coccidioidomycosis of the tongue. Arch Pathol Lab Med. 2005;129:4–6.

    Google Scholar 

  37. Hay RJ. Overview of the treatment of disseminated fungal infections. J Antimicrob Chemother. 1991;28:17–25.

    Article  PubMed  Google Scholar 

  38. Lortholary O, Denning DW, Dupont B. Endemic mycoses: a treatment update. J Antimicrob Chemother. 1999;43:321–31.

    Article  PubMed  CAS  Google Scholar 

  39. Shah K, Guarderas J, Krishnaswamy G. Aphthous stomatitis. Ann Allergy Asthma Immunol. 2016;117:e341–3.

    Article  Google Scholar 

  40. Shim YJ, Choi JH, Ahn HJ, Kwon JS. Effect of sodium lauryl sulfate on recurrent aphthous stomatitis: a randomized controlled clinical trial. Oral Dis. 2012;18(7):655–60.

    Article  PubMed  CAS  Google Scholar 

  41. Gomes CC, Gomez RS, Zina LG, Amaral FR. Recurrent aphthous stomatitis and Helicobacter pylori. Med Oral Patol Oral Cir Bucal. 2016;21(2):e187-91.

    PubMed  Google Scholar 

  42. Miziara ID, Auaujo-Filho BC, Weber R. AIDS and recurrent aphthous stomatitis. Rev Bras Otorhinolaringol. 2005;71(4):517–20.

    Article  Google Scholar 

  43. Tan CXW, Brand HS, de Boer NKH, Forouzanfar T. Gastrointestinal diseases and their oro-dental manifestations: part 1: Crohn’s disease. Br Dent J. 2016;221(12):794–9.

    Article  PubMed  CAS  Google Scholar 

  44. Tan CXW, Brand HS, de Boer NKH, Forouzanfar T. Gastrointestinal diseases and their oro-dental manifestations: part 2: Ulcerative colitis. Br Dent J. 2017;222(1):53–7.

    Article  PubMed  CAS  Google Scholar 

  45. Macho VMP, Coelho AS, Veloso e Silva DM, de Andrade DJC. Oral manifestations in pediatric patients with coeliac disease: a review article. Open Dent J. 2017;11:539–45.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Cantekin K, Arslan D, Delikan E. Presence and distribution of dental enamel defects, recurrent aphthous lesions and dental caries in children with celiac disease. Pak J Med Sci. 2015;31(3):606–9.

    PubMed  PubMed Central  Google Scholar 

  47. Bulur I, Onder M. Behçet disease: new aspects. Clin Dermatol. 2017;35:421–34.

    Article  PubMed  Google Scholar 

  48. Pak S, Logemann S, Dee C, Fershko A. Breaking the magic: mouth and genital ulcers with inflamed cartilage syndrome. Cureus. 2017;9(10):e1743.

    PubMed  PubMed Central  Google Scholar 

  49. Wu D, Xin J, Liu J, Zhou P. The association between interleukin polymorphism and recurrent aphthous stomatitis: a meta-analysis. Arch Oral Biol. 2018;93:3–11.

    Article  PubMed  CAS  Google Scholar 

  50. Vitale A, Orlando I, Lopalco G, Emmi G, Cattalini M, Frediani B, Galeazzi M, Iannone F, Rigante D, Cantarini L. Demographic, clinical and therapeutic findings in a monocentric cohort of adult patients with suspected PFAPA syndrome. Clin Exp Rheumatol. 2016;34(6 Suppl 102):77–81.

    PubMed  Google Scholar 

  51. Scully C, MacFadyen E, Campbell A. Oral manifestations in cyclic neutropenia. Br J Oral Surg. 1982;20(2):96–101.

    Article  PubMed  CAS  Google Scholar 

  52. Femiano F, Gombos F, Scully C. Sweet’s syndrome: recurrent oral ulceration, pyrexia, thrombophlebitis, and cutaneous lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:324–7.

    Article  PubMed  Google Scholar 

  53. Edgar NR, Saleh D, Miller RA. Recurrent aphthous stomatitis: a review. J Clin Aesthet Dermatol. 2017;10(3):26–36.

    PubMed  PubMed Central  Google Scholar 

  54. Maderal AD, Salisbury PL, Jorizzo JL. Desquamative gingivitis: clinical findings and diseases. J Am Acad Dermatol. 2018;78:839–48.

    Article  PubMed  Google Scholar 

  55. Yuan A, Woo S-B. Adverse drug events in the oral cavity. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119:35–47.

    Article  PubMed  Google Scholar 

  56. Celentano A, Tovaru S, Yap T, Adamo D, Aria M, Mignogna MD. Oral erythema multiforme: trends and clinical findings of a large retrospective European case series. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120:707–16.

    Article  PubMed  Google Scholar 

  57. Heinze A, Tollefson M, Holland KE. Chiu YE. Characteristics of pediatric recurrent erythema multiforme. Pediatr Dermatol. 2018;35:97–103.

    Article  PubMed  Google Scholar 

  58. Webster K, Golbold P. Nicorandil induced oral ulceration. Br Dent J. 2005;198(10):619–21.

    Article  PubMed  CAS  Google Scholar 

  59. Müller S. Oral manifestations of dermatologic disease: a focus on lichenoid lesions. Head Neck Pathol. 2011;5:36–40.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Müller S. Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol. 2017;30:54–67.

    Article  Google Scholar 

  61. Cheng YS, Gould A, Kurago Z, Fantasia J, Müller S. Diagnosis of oral lichen planus: a position paper of the American academy of oral and maxillofacial pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(3):332–54.

    Article  PubMed  Google Scholar 

  62. Alaizari NA, Al-Maweri SA, Al-Shamiri HM, Shugaa-Addin B. Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis. Aust Dent J. 2016;61:282–7.

    Article  PubMed  CAS  Google Scholar 

  63. Fortuna G, Massimo A, Schiavo JH. Drug-induced oral lichenoid reactions: a real clinical entity? A systematic review. Eur J Clin Pharmacol. 2017;73:1523–37.

    Article  PubMed  Google Scholar 

  64. Fitzpatrick SG, Honda KS, Sattar A, Hirsch SA. Histologic lichenoid features in oral dysplasia and squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;117(4):511–20.

    Article  PubMed  Google Scholar 

  65. Montague LM, Bhattacharyya I, Islam NM, Cohen DM, Fitzpatrick SG. Direct immunofluorescence testing results in cases of premalignant and malignant oral lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(6):675–83.

    Article  PubMed  CAS  Google Scholar 

  66. Yamanaka Y, Yamashita M, Innocentini LMA, Macedo LD, Chahud F, Ribeiro-Silva A, Roselino AM, Rocha MJA, Motta AC. Direct immunofluorescence as a helpful tool for the differential diagnosis of oral lichen planus and oral lichenoid lesions. Am J Dermatopathol. 2018;40:491–7.

    Article  PubMed  Google Scholar 

  67. Jajarm HH, Asadi R, Bardideh E, Shafaee H, Khazaei Y, Emadzadeh M. The effects of photodynamic and low-level laser therapy for treatment of oral lichen planus—a systematic review and meta-analysis. Photodiagnosis Photodyn Ther. 2018;23:254–60.

    Article  Google Scholar 

  68. Gupta S, Gosh S, Gupta S. Interventions for the management of oral lichen planus: a review of the conventional and novel therapies. Oral Dis. 2017;23:1029–42.

    Article  PubMed  CAS  Google Scholar 

  69. Giuliani M, Troiano G, Cordaro M, Corsalini M, Gioco G, Lo Munzio L, Pignatelli P, Lajolo C. Rate of malignant transformation of oral lichen planus: a systematic review. Oral Dis. 2018. https://doi.org/10.1111/odi.12885.

    Article  PubMed  Google Scholar 

  70. Kridin K. Subepidermal autoimmune bullous diseases: overview, epidemiology, and associations. Immunol Res. 2018;66:6–17.

    Article  PubMed  Google Scholar 

  71. Ohki M, Kikuchi S. Nasal, oral, and pharyngolaryngeal manifestations of pemphigus vulgaris: endoscopic ororhinolaryngologic examination. Ear Nose Throat J. 2017;96(3):120–7.

    Article  PubMed  Google Scholar 

  72. Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, Amagai M. Pemphigus. Nat Rev Dis Primers. 2017;3:17026.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Hong GH, Khan IR, Shifera AS, Okeagu C, Thorne JE. Incidence and clinical characteristics of ocular involvement in mucous membrane pemphigoid. Ocul Immunol Inflamm. 2018;19:1–5.

    Article  Google Scholar 

  74. Bagan J, Jiménez Y, Murillo J, Bagan L. Oral mucous membrane pemphigoid: a clinical study of 100 low-risk cases. Oral Dis. 2018;24:132–4.

    Article  PubMed  CAS  Google Scholar 

  75. Maderal AD, Salisbury P, Jorizzo JL. Desquamative gingivitis: diagnosis and treatment. J Am Acad Dermatol. 2018;78(5):851–61.

    Article  PubMed  Google Scholar 

  76. Di Zenzo G, Carrozza M, Chan LS. Urban legend series: mucous membrane pemphigoid. Oral Dis. 2014;20:35–54.

    Article  PubMed  Google Scholar 

  77. Gilvetti C, Porter SR, Fedele S. Traumatic chemical oral ulceration: a case report and review of the literature. Br Dent J. 2010;208(7):297–300.

    Article  PubMed  CAS  Google Scholar 

  78. Kang S, Kufta K, Sollecito TP, Panchal N. A treatment algorithm for the management of intraoral burns: a narrative review. Burns. 2018;44:1065–76.

    Article  PubMed  Google Scholar 

  79. Nahlieli O, Eliav E, Shapira Y, Baruchin AM. Central palatal burns associated with the eating of microwaved pizzas. Burns. 1999;25:465–6.

    Article  PubMed  CAS  Google Scholar 

  80. Harrison R, Hicklin D. Electronic cigarette explosions involving the oral cavity. J Am Dent Assoc. 2016;147(11):891–6.

    Article  PubMed  Google Scholar 

  81. Cowan D, Ho B, Sykes KJ, Wei JL. Pediatric oral burns: a ten-year review of patient characteristics, etiologies and treatment outcomes. Int J Pediatr Otorhinolaryngol. 2013;77:1325–8.

    Article  PubMed  Google Scholar 

  82. Jainkittivong A, Aneksuk V, Langlais RP. Oral mucosal lesions in denture wearers. Gerodontology. 2010;27:26–32.

    Article  PubMed  Google Scholar 

  83. Carlson DL. Necrotizing sialometaplasia: a practical approach to the diagnosis. Arch Pathol Lab Med. 2009;133(5):692–8.

    PubMed  Google Scholar 

  84. Butler JN, Kobayashi TT. Traumatic ulcerative granuloma with stromal eosinophilia: a malignant-appearing benign lesion. Cutis. 2017;100:E28–31.

    PubMed  Google Scholar 

  85. Shen WR, Chang JY, Wu YC, Cheng SJ, Chen HM, Wang YP. Oral traumatic ulcerative granuloma with stromal eosinophilia: A clinicopathological study of 34 cases. J Formos Med Assoc. 2015;114(9):881–5.

    Article  PubMed  Google Scholar 

  86. Hirschberg A, Amariglio N, Akrish S, Yahalom R, Rosenbaum H, Okon E, Kaplan I. Traumatic Ulcerative granuloma with stromal eosinophilia. A reactive lesion of the oral mucosa. Am J Clin Pathol. 2006;126:522–9.

    Article  CAS  Google Scholar 

  87. Salisbury CL, Budnick SD, Li S. T-cell receptor gene rearrangement and CD30 immunoreactivity in traumatic ulcerative granuloma with stromal eosinophilia of the oral cavity. Am J Clin Pathol. 2009;132:722–7.

    Article  PubMed  Google Scholar 

  88. Yang EC, Tan MT, Schwarz RA, Richards-Kortum RR, Gillenwater AM, Vigneswaran N. Noninvasive diagnostic adjuncts for the evaluation of potentially premalignant oral epithelial lesions: current limitations and future directions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:670–81.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Porter S, Gueiros LA, Leão JC, Fedele S. Risk factors and etiopathogenesis of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:603–11.

    Article  PubMed  Google Scholar 

  90. Nikitakis NG, Pentenero M, Georgaki M, Poh CF, Peterson DE, Edwards P, Lingen M, Sauk JJ. Molecular markers associated with development and progression of potentially premalignant oral epithelial lesions: current knowledge and future implications. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:650–69.

    Article  PubMed  Google Scholar 

  91. Rethman MP, Carpenter W, Cohen EE, Epstein J, Evans CA, Flaitz CM, Graham FJ, Hujoel PP, Kalmar JR, Koch WM, Lambert PM, Lingen MW, Oettmeier BW Jr, Patton LL, Perkins D, Reid BC, Sciubba JJ, Tomar SL, Wyatt AD Jr, Aravamudhan K, Frantsye-Hawley J, Cleveland JL, Meyer DM. American dental association council on scientific affairs expert panel on screening for oral squamous cell carcinomas. Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. JADA. 2010;141(5):509–20.

    PubMed  Google Scholar 

  92. Awadallah M, Idle M, Patel K, Kademani D. Management update of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:628–36.

    Article  PubMed  Google Scholar 

  93. Müller S. Oral epithelial dysplasia, atypical verrucous lesions and oral potentially malignant disorders: focus on histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:591–602.

    Article  PubMed  Google Scholar 

  94. Francisconi CF, Caldas RJ, Oliveira Martins LJ, Fischer Rubira CM, da Silva Santos PS. Leukemic oral manifestations and their management. Asian Pac J Cancer Prev. 2016;17(3):911–5.

    Article  PubMed  Google Scholar 

  95. Rosebush MS, Allen CM, Accurso BT, Bajocchi RA, Cordell KG. Oral mycosis fungoides: a report of three cases and review of the literature. Head Neck Pathol. 2018. https://doi.org/10.1007/s12105-018-0923-5.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Swerdlow SH, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. In: World Health Organization classification of tumours. Lyon: IARC; 2016.

    Google Scholar 

  97. Al-Hakeem DA, Fedele S, Carlos R, Porter S. Extranodal NK/T-cell lymphoma, nasal type. Oral Oncol. 2007;43:4–14.

    Article  PubMed  Google Scholar 

  98. Rodrigo JP, Suarez C, Rinaldo A, Devaney KO, Carbone A, Barnes L, Heffner DK, Ferlito A. Idiopathic midline destructive disease: fact or fiction. Oral Oncol. 2005;41:340–8.

    Article  PubMed  Google Scholar 

  99. Dojcinov SD, Venkataraman MD, Raffeld M, Pittaluga S, Jaffe ES. EBV positive mucocutaneous ulcer—a study of 26 cases associated with various sources of immunosuppression. Am J Surg Pathol. 2010;34:405–17.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Hart M, Thakral B, Yohe S, Balfour HH, Singh C, Spears M, McKenna RW. EBV-positive mucocutaneous ulcer in organ transplant recipients: a localized indolent post-transplant lymphoproliferative disorder. Am J Surg Pathol. 2014;38:1522–9.

    Article  PubMed  Google Scholar 

  101. McCormack C, Huang Q. EBV1 mucocutaneous ulcer: a new entity of WHO 2017. Blood. 2018;131(17):1993.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarah G. Fitzpatrick.

Ethics declarations

Conflict of interest

All authors declare no conflicts of interests.

Ethics Approval

This article does not contain any studies with human participants or animal performed by any of the authors.

Informed Consent

Not applicable for this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fitzpatrick, S.G., Cohen, D.M. & Clark, A.N. Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review. Head and Neck Pathol 13, 91–102 (2019). https://doi.org/10.1007/s12105-018-0981-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-018-0981-8

Keywords

Navigation