Punctate oral erosions: Self-limited 'sore' - Or something more serious?

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Viral and fungal infections, autoimmune conditions, immunodeficiency, drug reactions, contact allergy, and trauma all can precipitate punctate oral lesions. Herpetic lesions must be distinguished from aphthous ulcers, which lack a preliminary vesicular phase and have a more intense erythematous halo; herpetic lesions tend to occur in clusters and involve the fixed mucosa. Extremely large aphthous ulcers that persist for several weeks or months can mimic a carcinoma; biopsy is indicated. Because of their rarity in immunocompetent persons, fungal and cytomegalovirus infections in the oral cavity are clinical markers for AIDS. Drug-induced oral lesions can be diagnosed on the basis of the drug and medical history and a complete blood cell count; lesions usually appear when the white blood cell count falls below 2,000/μL. Eosinophilic ulcers are reactive lesions in the oral cavity that are deep and generally larger than 1.5 cm, with indurated borders; biopsy is essential to rule out carcinoma.

Original languageEnglish
Pages (from-to)2220-2236
Number of pages17
Issue number9
StatePublished - Sep 1998


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