Primary Tuberculosis of Buccal and Labial Mucosa: Literature Review and a Rare Case Report of a Public Health Menace

Table 3

Differential diagnosis of oral ulcers is presented [14, 28].

Oral disease	No. of ulcers	Pain/soreness	Course & duration	Clinical picture
Oral TB	Single	Primary oral TB—painless, secondary oral TB—painful	Chronic ulcer for >3 weeks, chronic cough, haemoptysis	Ragged, indurated, and irregular margins, Trélat granules, cobblestone appearance
Recurrent aphthous stomatitis	Single/multiple	Yes	Recurrent ulcers, spontaneous healing after 7–30 days	Shallow ulcer, inflamed halo
Traumatic ulcers	Single/multiple	Yes	Spontaneous healing after elimination of traumatic factor/institution of anti-inflammatory therapy	Inflamed base, shallow or deep ulcer, margins slightly elevated
Malignant ulcer	Single/multiple	Initially—painless, later—painful	Chronic ulcer, developing slowly	Nodular, punched-out ulcer with irregular margins, indurated base, fixed lymphadenopathy
Syphilis	Single	No	Ulcer lasting for 2–6 weeks, spontaneous healing	Smooth, indurated margins
Histoplasmosis	Single/multiple	Yes	Chronic ulcer for >3 weeks, persistent cough, pulmonary changes	Irregular, indurated margins
Ulcerative lichen planus	Single/multiple	Yes	Recurrent ulcers may be preceded by subepithelial bullas	Shallow ulcer, Wickham’s striae present