Eosinophilic ulcer of the oral mucosa: a distinct entity or a non‐specific reactive pattern?

Abstract

Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon self-limited oral condition that clinically manifests as a solitary ulceration with elevated indurate borders affecting the tongue, buccal mucosa or lip. Microscopically, it is characterized by a polymorphic inflammatory infiltrate with a prominent polymorphonuclear eosinophilic component extending deep into the submucosa, underlying muscle and salivary glands. Large mononuclear cells probably corresponding to histiocytes, myofibroblasts or activated lymphoid cells are also frequently observed. The exact pathogenetic mechanisms implicated in the development of EUOM are poorly understood; however, the possibility that trauma may play a role in its development has been often postulated. Since its original description, the possibility that EUOM could be either considered an individualized disorder or a non-specific reactive pattern secondary to several stimuli has been discussed. EOUM may show some overlapping features with some entities such as atypical histiocytic granuloma, mucosal angiolymphoid hyperplasia with eosinophilia, and Kimura disease. The clinical and histopathological features and the differential diagnosis of EUOM are reviewed and its existence as a distinct disease discussed.

Oral Eosinophilic Ulcer, an Epstein-Barr Virus-Associated CD30+ Lymphoproliferation?

“…The lesion usually shows a peripheral erythematous zone and white or yellowish base and may be covered by a slough (fibrinous membrane). Eosinophilic ulcer is often solitary, but multiple synchronous or metachronous lesions have also been described [29]. Occasionally, EU may be macular or present as an erythroplakic or leukoplakic lesion.…”

“…Furthermore, the pediatric variant of EU, i.e. Riga-Fede disease, may be the presenting sign of underlying rare neurologic disorders, such as congenital autonomic dysfunction with generalized pain loss, familial dysautonomia (Riley-Day syndrome) [19,32] or self-mutilation disorders [29]. …”

“…clobetasol, flucinonide, triamcinolone) or mouthwash, intralesional or oral steroids, topical antibiotics, curettage, and cryotherapy. In selected cases, radiotherapy can be applied [6,7,29]. …”

Eosinophilic ulcer of the tongue: a rare and confusing clinical entity

“…Eosinophilic ulcer of the oral mucosa was first described in adults by Popoff in 1956 and, in 1970, it was identified as a distinct entity by Shapiro and Juhlin 6 7. Since then, names such as eosinophilic ulcer, traumatic eosinophilic granuloma of the tongue, traumatic granuloma, atypical histiocytic granuloma and TUGSE have been used to describe the lesion.…”

Eosinophilic ulcer of the tongue in an 80-year-old Iranian woman after a psychologically stressful event

“…Owing to the rapid growth, ulcerative nature and indurated borders of the usually single lesion, this condition can mimic SCC 1 2 6. In our patient, the clinical feature was so similar to SCC that the ENT specialist talked to the patient and her family about the necessity of hemiglosectomy and ipsilateral lymph node dissection after confirming the diagnosis by pathology.…”