Two cases of chronic oral ulcers effectively treated with systemic corticosteroid therapy: Circumorificial plasmacytosis and traumatic ulcerative granuloma with stromal eosinophilia.

Chronic oral ulcers are induced by various causative factors. Biopsy from an active site around ulceration is critical for both the definitive diagnosis and proper treatment. We report two cases of chronic oral ulcers, circumorificial plasmacytosis (CP) and traumatic ulcerative granuloma with stromal eosinophilia (TUGSE). A 65-year-old man presented with a mucosal ulcer on the right half of the lower lip. The dense plasmacytic inflammatory infiltration was histologically consistent with CP. A 32-year-old woman presented with a mucosal ulcer on the right mouth commissure. The dense mixed inflammatory cell infiltrates composed of eosinophils, lymphocytes and histiocytes extending from the submucosal tissue to underlying striated muscle fibers were histologically consistent with TUGSE. p.o. administration of corticosteroid was effective in both cases. A broad differential diagnosis is required for chronic oral ulcers. If the oral ulcer did not respond to the first therapy, clinical re-evaluation and biopsy is essential.

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