Scarring and chronic ulceration of the floor of the mouth

Abstract

CASE REPORT A 63-year-old male patient was first seen for evaluation of chronic intraoral mucosal lesions and ulcerations. His medical history revealed that 30 years earlier, he had experienced Hodgkin lymphoma (HL), which had successfully been treated by chemotherapy. The patient reported that oral lesions apparently developed soon thereafter and had been present periodically. In addition, he had been experiencing itchy cutaneous lesions on the upper trunk and arms for many years, which he claimed had been treated unsuccessfully by corticosteroids. He also had recurrent depressive episodes, which had been treated medically. Clinical examination disclosed a deep ulcerative lesion measuring 3 cm in diameter on the left anterior floor of the mouth (Figure 1). The carunculae sublinguales could not be identified, and the anterior floor of the mouth demonstrated scarring and induration on palpation. Furthermore, the buccal mucosa showed some bilateral scarring, and an erosive lesion was visible in the left buccal plane (Figure 2). The maxilla was edentulous, and in the mandible, telescopic crowns were fixed on molars bilaterally. The complete maxillary denture and mandibular overdenture were welladapted. Excoriations, erosions with crusts, and postinflammatory hypopigmentations were found on the skin of the patient’s arms, shoulders, thorax, and neck (Figure 3).