Clinical Course of Four Patients with Intractable Recurrent Oropharyngeal Ulcers

Abstract

We report four patients with intractable recurrent oropharyngeal ulcers, including two with idiopathic oropharyngeal ulcers, one with intestinal Behcet’s disease, and one with mucous membrane pemphigoid. The diagnosis of intestinal Behcet’s disease was confirmed by gastrointestinal endoscopy, and the diagnosis of mucous membrane pemphigoid was confirmed by skin biopsy. However, no causative disease could be identified in the two cases with idiopathic oropharyngeal ulcers on the basis of any of the clinical findings, blood examinations or histological analysis. The patients with idiopathic oropharyngeal ulcers were treated by steroids combined or not combined with colchicine. The patient with intestinal Behcet’s disease was treated with infliximab. The patient with mucous membrane pemphigoid was treated using a combination of steroids with diaminodiphenyl sulfone and rituximab. During clinical observation over an average period of 7 years, all the patients have maintained a good course without a recurrence of severe ulcers.