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JAMA Clinical Challenge
June 16, 2015

Recurrent Oral Ulcers

Author Affiliations
  • 1Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia
JAMA. 2015;313(23):2373-2374. doi:10.1001/jama.2015.1637

A 44-year-old man with a history of gastroesophageal reflux disease and anxiety presents for evaluation of mouth ulcers recurring for the past 2 years. The painful ulcers resolve within 2 weeks but recur on different mucosal surfaces. He denies new medications, foods, or oral hygiene products and involvement of cutaneous or other mucosal surfaces. He is uncertain whether he has a family history of oral ulcers. He was previously prescribed anesthetic rinses and fluconazole, without benefit. His current medications include omeprazole and lorazepam. Intraoral examination demonstrates an ulcer with a pseudomembrane and erythematous halo on the left lateral surface of the tongue (Figure). Physical examination results are otherwise normal.

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