Inflammtory lesions of the oral and genital mucosae

A multitude of disorders can cause oral ulcerations in children , but some of ulcerations are chronic and difficult to diagnose and to treat. The beginning of these disorders is often an aphthous-like lesion. A 6-year-old boy had two ulcerated patches on the lateral margin of the tongue. A diagnosis of aphthae was made, although the lesions were persistent . White striae on the dorsum of the tongue subsequently appeared , togheter with lichen sclerosus of the penis. The histopathology of a lesion of the tongue revealed lichenoid mucositis. A 14-year-old boy had a long-lasting history of deep ulcers of the gingivae with gingival hyperplasia and destructive periodontal disease leading to tooth loss. For some months the patients suffered from pustular lesions evolving into painful ulcers on the lateral aspect of the left thight. Multiple atrophic scars were present on the trunk and the extremities. A small ulcer was present on the scrotum. A biopsy taken from an area of gingival hyperplasia gave the diagnosis of pyoderma gangrenosum. A 13-year-old girl presented three ulcers on the borders of the tongue for 1 year. The lesions , interpreted as aphtae, appeared after a period of orthodontic device, and have partial resolution after a lot of local treatment. The girl sometimes showed acute painful and lymphoadenopathy. Skin biopsy revealed acanthosis and parakeratotic hypercheratosis and a granular tissue with an inflammatory infiltrate of the chorion mainly composed of lymphocytes and neutrophils . A diagnosis of self-inflicted lesion was performed. These clinical examples further demonstrate that chronic ulcerations aphthous-like may reflect different pathologies.