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Lesion | Gender predominance | Age predilection | Location | Shape of ulcer | Number of ulcers | Distinguishing features |
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Sustained traumatic ulcer | NA | NA | Tongue, lips, buccal mucosa | Symmetrical/asymmetrical | Solitary | Central removable, yellow fibrinopurulent membrane; a raised, rolled border of hyperkeratosis immediately adjacent to the area of ulceration |
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Necrotizing sialometaplasia | Men | Average age: 46 years | Palate, retromolar pad, lips | Craterlike | Solitary | Deep ulcer with a yellowish base, self-limiting, healing time between 2 and 12 weeks |
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Eosinophilic ulcer | Women | 40–60 years | Tongue, buccal mucosa | Punched out | Solitary | Slow-healing ulcer with a rolled border, surrounding erythema or keratosis, mostly asymptomatic, healing time between 1 week and 1 year |
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Ulcerative squamous cell carcinoma | Men | >40 years | Lower lip, floor of the mouth, tongue | Craterlike | Solitary | Rolled, indurated borders and a velvety base |
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Cytomegalovirus-associated ulceration | NA | NA | Keratinized and nonkeratinized mucosa | Large ulcer | Solitary, rarely multiple | Painful, necrotic, with minimally rolled border, mostly in immunocompromised patients |
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Tuberculous ulcer | Men | NA | Tongue, gingivae, floor of the mouth | Undermined borders | Solitary | May be ragged and indurated, often painful |
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Syphilitic ulceration (chancre) | NA | NA | Lips, tongue, palate | Clean-based ulceration | Solitary | Red purple or brown base, ragged rolled border, cervical lymphadenopathy |
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Oral blastomycosis | Men | NA | Any oral mucosal surface | Nonspecific ulcer | Solitary | Painless, irregular rolled borders and verrucous mucosal hyperplasia, painful, concomitant pulmonary lesions on chest radiographs |
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Oral mucormycosis | NA | NA | Palate | Verrucous ulcer | Solitary | Large deep necrotic ulcer, associated with concomitant pulmonary disease and an underlying debilitating disease |
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Pemphigus vulgaris | NA | NA | Buccal mucosa, palate, gingivae | Map-like | Multiple | Shallow irregular ulcers with peripheral extension, positive Nikolsky sign, desquamative gingivitis |
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Mucous membrane pemphigoid | Women | >50 years | Gingivae, buccal mucosa, palate | Nonspecific-appearing erythema and erosions | Multiple | Desquamative gingivitis as the most common oral presentation, blood blisters, skin lesions in 30–40% of cases |
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Bullous pemphigoid | NA | >60 years of age | Gingivae | Discrete vesicle formation | Multiple | Desquamative gingivitis as the most frequent oral manifestation, self-limiting, early remission |
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Lichen planus | Women | Middle age | Buccal mucosa, tongue, gingivae | | Multiple | Accompanying reticular or papular lesions, desquamative gingivitis, painful |
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Linear IgA disease | Women | 6th and 7th decades of life | Hard and soft palate, tonsillar pillars, buccal mucosa | Clinically indistinguishable from the oral lesions of MMP | Multiple | Vesicles, painful ulcerations or erosions, desquamative gingivitis/cheilitis |
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