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Painful ulcers on gingiva, tongue, and buccal mucosa

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We had one clue that helped explain the ulcers in the patient’s mouth: He had an accompanying low-grade fever.


 

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A 29-year-old man with no prior history of mouth sores abruptly developed many 1- to 1.5-mm blisters on the gingiva (FIGURE 1A),tongue (FIGURE 1B), and buccal mucosa ­(FIGURE 1C), which evolved into small erosions accompanied by a low-grade fever 5 days prior to presentation. The patient had no history of any dermatologic conditions or systemic illnesses and was taking no medication.

Irregular ulcerations with a yellowish membrane and erythematous halo on the gingiva (A), lesions on the ventral surface of the tongue (B), and multiple grouped ulcerations on the buccal mucosa (C). IMAGES COURTESY OF ROBERT T. BRODELL, MD

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