Etiology • A benign, self-limiting, reactive process of oral mucosa of
unknown origin • Some cases with no history of antecedent trauma
Clinical Presentation • Rapid onset • Painful, indurated, crateriform ulcer • Several weeks mean duration • 60% occur on the tongue (lateral/ventral) • Average diameter 1 to 2 cm
Microscopic Findings • Crateriform ulcer with fibrinous surface • Deeper areas with granulation tissue, endothelial proliferation • Inflammatory infiltrate with prominent macrophages • Underlying muscle injury present with eosinophilic infiltrate
Diagnosis • History and appearance • Biopsy results/microscopic findings
unknown origin • Some cases with no history of antecedent trauma
Clinical Presentation • Rapid onset • Painful, indurated, crateriform ulcer • Several weeks mean duration • 60% occur on the tongue (lateral/ventral) • Average diameter 1 to 2 cm
Microscopic Findings • Crateriform ulcer with fibrinous surface • Deeper areas with granulation tissue, endothelial proliferation • Inflammatory infiltrate with prominent macrophages • Underlying muscle injury present with eosinophilic infiltrate
Diagnosis • History and appearance • Biopsy results/microscopic findings
Differential Diagnosis: Clinical • Squamous cell carcinoma • Major aphthous ulcer • Lymphoma • Syphilis • Granulomatous disease
• Sarcoidosis • Wegener’s granulomatosis • Tuberculosis
Differential Diagnosis: Microscopic • Lymphoma • Angiolymphoid hyperplasia with stromal eosinophilia
Treatment • Excision • Observation only • Topical or intralesional corticosteroids
Ulcerative Conditions 109
Prognosis • Healing usually within 10 days if excised • Most lesions heal after a few to several weeks without recur-
rence. • Rare cases have multiple recurrences.