Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review

Sarah G. Fitzpatrick, Donald M. Cohen, Ashley N. Clark

Research output: Contribution to journalReview articlepeer-review

78 Scopus citations


Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.

Original languageEnglish
Pages (from-to)91-102
Number of pages12
JournalHead and Neck Pathology
Issue number1
StatePublished - Mar 15 2019

Bibliographical note

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.


  • Aphthous stomatitis
  • Herpetic gingivostomatitis
  • Oral erythema multiforme
  • Oral lichen planus
  • Oral lymphoma
  • Oral medication related ulcer
  • Oral squamous cell carcinoma
  • Oral ulcer
  • Oral vesiculobullous lesions
  • Traumatic oral ulcer

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Otorhinolaryngology
  • Oncology


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