Multiple painful oral ulcers of 1-week onset
A 78-year-old woman sought urgent dental treatment with a 7-day history of painful, enlarging oral ulcers. Her medical history included osteoporosis, for which she took alendronate. The oral examination showed multiple, large necrotic ulcers involving the tongue (Figure 1A), buccal mucosa (Figure 1B), labial mucosa (Figure 1C) and palatal mucosa, tonsillar fossa, and gingiva (Figure 1D). There was no …