CHRONIC ULCERATIVE STOMATITIS: A CASE REPORT

A 55-year-old Caucasian male patient with difficulty eating due to painful intra-oral ulcers for approximately 2 weeks was seen at the clinic. In the anamnesis he reported hepatitis C (genotype 3 A) with sustained virologic response for 20 years, rheumatoid arthritis for 5 years, thrombocytopenia for 2 years, and hyperuricemia. On physical examination, alopecia and brittle, scaly, and dystrophic nails were observed. The intra-oral examination revealed the presence of multiple erosive and ulcerated lesions, surrounded by white hyperkeratotic striate resembling those of erosive oral lichen planus. Incisional biopsy revealed mucosal fragment partially covered by stratified squamous epithelium exhibiting, in the lamina propria, intense chronic and acute diffuse inflammatory infiltrate and presence of granulation tissue. The patient was treated with topical and systemic corticosteroids, without strong signs of clinical improvement. The presented clinical picture led to the diagnosis of chronic ulcerative stomatitis.