Eosinophilic ulcer of the oral mucosa

Eosinophilic Ulcer of the Oral Mucosa
Other names	Traumatic eosinophilic granuloma, traumatic ulcerative granuloma with stromal eosinophilia
Specialty	Dentistry, Oral and Maxillofacial Pathology
Symptoms	Painful ulceration, swelling, redness, and tenderness in the oral mucosa
Causes	Unknown, possibly related to trauma or hypersensitivity reaction
Diagnostic method	Clinical examination, biopsy, histopathological analysis
Treatment	Conservative management, topical corticosteroids, surgical excision in rare cases
Prognosis	Excellent, self-limiting condition

Eosinophilic Ulcer of the Oral Mucosa (also known as traumatic eosinophilic granuloma or traumatic ulcerative granuloma with stromal eosinophilia) is a rare benign condition characterized by painful ulceration, swelling, redness, and tenderness in the oral mucosa. It is considered a self-limiting condition with an excellent prognosis.

Signs and Symptoms

Eosinophilic ulcer of the oral mucosa typically presents as a solitary ulceration in the oral cavity. The ulcer is usually painful and may be associated with swelling, redness, and tenderness. It commonly affects the tongue, buccal mucosa, or lips. The size of the ulcer can vary, ranging from a few millimeters to several centimeters in diameter. The surrounding mucosa is usually intact and unaffected.

Causes

The exact cause of eosinophilic ulcer of the oral mucosa is unknown. However, it is believed to be associated with trauma or a hypersensitivity reaction. Trauma, such as accidental biting or irritation from sharp teeth or dental appliances, is thought to trigger the development of the ulcer. Some cases have been reported following dental procedures or orthodontic treatment. It is also suggested that an immune-mediated hypersensitivity reaction may play a role in the pathogenesis of this condition.

Diagnosis

The diagnosis of eosinophilic ulcer of the oral mucosa is primarily based on clinical examination and confirmed through histopathological analysis. A thorough medical and dental history should be obtained to identify any potential triggering factors. The characteristic clinical features, such as the presence of a painful ulcer with surrounding erythema and edema, aid in the diagnosis. However, a definitive diagnosis requires a biopsy of the lesion.

Histopathological examination of the biopsy specimen reveals a dense infiltrate of eosinophils within the ulcerated area. The eosinophils are typically present in the superficial and deep layers of the ulcer. The underlying connective tissue may show varying degrees of inflammation and fibrosis. The absence of atypical cells or malignancy helps differentiate eosinophilic ulcer from other oral lesions.

Treatment

Eosinophilic ulcer of the oral mucosa is a self-limiting condition that usually resolves spontaneously within a few weeks to months. Therefore, conservative management is the primary approach. This includes providing symptomatic relief through the use of topical analgesics or anesthetics to alleviate pain and discomfort.

In some cases, topical corticosteroids may be prescribed to reduce inflammation and promote healing. These medications can be applied directly to the ulcerated area. However, their use should be limited to a short duration due to potential side effects associated with long-term corticosteroid use.

Surgical excision of the ulcer is rarely necessary and is reserved for cases that do not respond to conservative management or when there is a concern for malignancy. Regular follow-up visits are recommended to monitor the healing process and ensure the absence of any complications.

Prognosis

The prognosis for eosinophilic ulcer of the oral mucosa is excellent. The condition is self-limiting, and most ulcers heal spontaneously within a few weeks to months without any residual scarring. Recurrence is rare, but if it occurs, it is usually associated with persistent trauma or underlying systemic conditions.

See Also

• Oral ulcer
• Oral pathology
• Dentistry

References

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