ORAL CHRONIC ULCER: A DIAGNOSIS CHALLENGE

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 129; no. 1; p. e86
• Main Authors: DA SILVA, EDUARDO LIBERATO, CARRARD, VINÍCIUS COELHO, VISIOLI, FERNANDA, DAROIT, NATÁLIA BATISTA, LEPPER, TATIANA WANNMACHER, FLORES, ISADORA LUANA, DE CAMPOS HILDEBRAND, LAURA
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.01.2020
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2019.06.355

An 85-year-old retired white man sought the dentistry service with an ulcerated lesion without symptomatology in the attached gingiva between upper molars. The ulcer presented approximately 1 × 1 cm surrounded by a white plaque. He has hypertension, hypercholesterolemia, hypothyroidism, and prostate alteration and regularly uses metoprolol, amlodipine, simvastatin, levothyroxine sodium, and finasteride. Hematologic, laboratory, and radiographic examinations are within the normal range. The patient uses upper and lower partial dentures and denied smoking or drinking habits. However, he reported the habit of brushing the area with force. Histopathologic diagnosis suggested eosinophilic ulcer. Even after instruction of atraumatic hygiene, antifungal treatment, application of topical corticosteroids, and sublesional infiltration and photodynamic therapy, there was no regression of the lesion. Over time, the ulcer increased in size and migrated to the buccal mucosa and labial commissure. This case remains without a conclusive diagnosis, and new analyses are being made.