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JAMA Dermatology Clinicopathological Challenge
March 2015

Nonhealing Tongue Ulcer in an Indian Man

Author Affiliations
  • 1Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
JAMA Dermatol. 2015;151(3):333-334. doi:10.1001/jamadermatol.2014.3399

A 40-year-old man, who resided in the eastern part of India, was referred to us from the department of otorhinolaryngology for evaluation of a nonhealing ulcer on the tongue present for the last 4 months. The lesion had started as a small painless mass on the right lateral aspect of the tongue, which gradually grew and subsequently ulcerated. It was asymptomatic except for causing mild difficulty in eating. The patient could not recall any history of trauma or tongue bite preceding the lesion. He denied consuming tobacco or alcohol regularly. He had type 2 diabetes mellitus for 2 years, which was well controlled with oral hypoglycemic agents. The patient had no systemic complaints. There was no history of high-risk behavior for human immunodeficiency virus (HIV) acquisition. On physical examination, there was a single well-defined ulcer measuring 2 × 2 cm on the right lateral aspect of tongue with a clean base and irregular and elevated heaped-up margins (Figure 1A). There was no underlying induration, friability, or bleeding on manipulation. The rest of the oral cavity was normal. A 3-mm punch biopsy from the edge of the ulcer was taken and sent for histopathological examination (Figure 1B and C).

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