Clinical and Radiographic Findings

The generalized oral ulcers were progressive and painful. Though mostly superficial, they were preventing the patient from eating and from optimum oral hygiene care. As a result of the ulcers, he lost weight. The ulcerative lesions included those on the hard plate (Figure 1), the maxillary labial/buccal gingiva (Figures 2), and the mandibular labial/buccal and lingual gingiva (Figure 3). There was no evidence of vesicles, bullae, or of Nikolsky's sign.

Figure 1 This photograph was taken at first presentation where diffuse superficial to focally rolled bordered ulcers are noted involving the hard palate and palatal gingiva.

Figure 2 This photograph was taken at first presentation where diffuse superficial ulcers are noted to involve the maxillary buccal gingiva.

Figure 3 This photograph was taken at first presentation where diffuse superficial ulcers are noted to involve the mandibular buccal gingiva.