Recurrent aphthous ulceration (RAU) is considered to be the most common oral mucosal lesion that presents initially in childhood or adolescence. Recurrent aphthous-like lesions occurring in middle-aged patients over many years is uncommon. A 46-year-old male with a history of RAU of more than 10 years is reported. The histopathologic appearance of his buccal mucosa biopsy was diagnosed as an intraepithelial bullous lesion. Indirect immunofluorescence evaluation of the biopsy specimen was IgG and C3 positive at the intercellular epithelium space. The definitive diagnosis was oral pemphigus. Long-term aphthous-like lesions in the middle-aged patient together with desquamative gingivitis should be carefully considered.
Kobkan Thongprasom and Warangkana Yanyongkasemsuk
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