EOSINOPHILIC ULCER OF THE TONGUE

By Gary M. White, MD


The eosinophilic ulcer is a benign, self-healing ulcer of the tongue of unknown cause. Trauma has been suspected. Histologic examination shows an ulceration with eosinophils prominent within the inflammatory infiltrate.

Clinical

The classic history is a rapidly developing ulcer with raise, indurated borders that forms on the posterior aspect of the tongue. It then spontaneously resolves in a few weeks.

Workup

The differential diagnoses include trauma-induced, infection, autoimmune diseases and rarely malignancies.

Treatment

Acute ulcerations may be observed for spontaneous healing. Lesions that persist should be biopsied. If the patient is HIV-positive or otherwise immune-compromised infections such as Herpes, Candida and Histoplasmosis may be considered. Biopsy, culture, and/or presumptive treatment may be considered depending upon the clinical situation.

Other therapies that have been used include antibiotics, topical, intralesional and/or systemic corticosteroids, curettage, cryosurgery and surgical excision.

References

Lesion on the tongue with no history of trauma. Ann Stomatol (Roma). 2012 Jan-Mar; 3(1): 11–13.

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