TMSS Medical College Journal

Eosinophilic ulcer is a rare self-limiting chronic benign lesion of the oral mucosa with pathogenesis still unclear. It may resemble malignancies, traumatic ulcerations and some infections such as deep fungal infections, tuberculosis and primary syphilis. However, trauma has been found to be a contributing factor in a majority of the cases. As the condition is perhaps unknown to medical personal and due to the confusion in the literature with eosinophilic granuloma, we think the following case report deserves presentation. This is a case report of ulcerative granuloma in the lateral border of tongue with history of recurrent trauma from sharp tooth. The ulcer rapidly healed afier incisional biopsy and definite diagnosis was achieved only combining histologic finding and clinical follow up.

Eosinophilic ulcer (EU) is a rare self-limiting chronic benign condition. This entity was first described in 1881 by the Italian physician, Antonio Riga, and as additional cases were subsequently published by F. Fede in 1890, it has been known as Riga-Fede disease." Clinically, the ulceration has been most frequently found in tongue and it is characterized by the presence of mildly indurated borders which may resemble malignancies, traumatic ulcerations and some infections such as deep fungal infections, tuberculosis and primary syphilis. EU also has been referred as traumatic ulcerative granuloma with stromal eosinophilia, traumatic eosinophilic granuloma, traumatic granuloma and ulcerative eosinophilic granuloma. In infants, usually on the ventral surface of the anterior tongue secondary to trauma from newly erupted primary teeth, EU is referred as Riga-Fede disease.” Trauma has been found to be a major cause. Microscopically, it is characterized by a diffuse polymorphic cell infiltrate composed predominantly of eosinophils, B and T lymphocytes, macrophages, and large atypical cells involving the superficial mucosa and extending deep into the submucosa causing degeneration of the underlying muscle.