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July 1967

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Arch Otolaryngol. 1967;86(1):122-125. doi:10.1001/archotol.1967.00760050124025

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For 15 years or more, a middle-aged South American housewife was plagued continually by recurrent episodes of ulcers in her mouth. She described them as occuring in crops approximately every two or three months, beginning as small blisters which rapidly ulcerated. The ulcers would last for two to three weeks, be intensely painful and then heal slowly over an additional two to three weeks.

Multiple examinations and laboratory tests, including cultures, serum γ-globulin determinations, and blood chemistry studies during all of this time had failed to reveal any specific abnormality. On several occasions, administration of γ-globulin seemed to help. Numerous courses of antibiotics had no influence upon the course of the disease. Cortisone in therapeutic doses has also failed to help.

Topical applications, of antibiotics, silver nitrate, and other caustics also failed to help. The ulcers seemed to have a predilection for the hard and soft palates.

Examination revealed that

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