Eosinophilic ulcer of the oral mucosa: report of a recurrent case on the tongue

Abstract

Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that usually affects the tongue. The lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Microscopically, it contains a diffuse polymorphous cell infiltrate composed mainly of eosinophils. The cause of EUOM is unknown, but the condition has been attributed to trauma. We now describe a case of EUOM on the lateral surface of the tongue with recurrence on its dorsal surface 3 years later. The occurrence of multiple lesions, whether at the same time or subsequently as reported here, makes a purely traumatic origin rather unlikely and suggests that there may be a predisposition of some patients to develop EUOM. Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that is very rarely reported in the dermatological literature. It usually affects the tongue and presents clinically as an ulcer with elevated and indurated borders. Recognition is important because it often mimicks tongue cancer; however, the lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Usually the ulcer occurs in a single episode, but the possibility of recurrence at other sites has been poorly emphasized.

Eosinophilic ulcer of the oral mucosa: another histological simulator of CD30+ lymphoproliferative disorders

“…Since then, EUOM has been known in the oral pathology literature by different names, leading to further confusion. The most common terms have been traumatic granuloma of the tongue, and eosinophilic ulcer of the tongue or the oral mucosa 1–8,11–13 …”

“…Eosinophilic ulcer of the oral mucosa (EUOM) or traumatic eosinophilic granuloma is an uncommon benign self‐limited disease that has been poorly recognized in the dermatological literature 1–4 . This name has probably been used to group different entities that present as ulcers with elevated indurated borders affecting the tongue, oral mucosa or lip.…”

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

“…In 1970, this lesion was proposed as a distinct entity by Shapiro (Shapiro and Juhlin, 1970). Since then, different names such as TGSE (Elzay, 1983; Hirshberg et al , 2006); traumatic eosinophilic granuloma of the tongue (Ficarra et al , 1997; Alobeid et al , 2004) and eosinophilic ulcer of the tongue or the oral mucosa (Doyle et al , 1989; El‐Mofty et al , 1993; Mezei et al , 1995; Velez et al , 1997; Garcia et al , 2002) have been used to define this process leading to further confusion.…”

“…Pain can be associated with variable proportion of cases (from 17% to 100%) and may cause a significant impairment of food intake. Although EUOM is often a solitary ulcer, multiple or metachronus lesions (new lesions on other oral sites) (Doyle et al , 1989; El‐Mofty et al , 1993; Ficarra et al , 1997; Velez et al , 1997; Alobeid et al , 2004; Segura et al , 2006) have also been reported. There is a slight female predominance in most of the series and a peak on incidence between the sixth and seventh decades of life.…”

Eosinophilic Ulcer of the Oral Mucosa

“…The injury is identified, however, in less than 50% of cases. 2,4,[6][7][8][9][10][11] Simultaneous lesions are extremely rare. Elzay 3 argues that the presence of multiple ulcers excludes trauma as the only predisposing factor.…”