11. Ulcers

A 42-year-old secretary, currently not employed, complained of recurrent oral ulceration. She suffered from ulcers occasionally as a child and teenager, ameliorated whilst she smoked from age 18–37, but which became much worse when she stopped at that age. The ulcers were typically 2–4 mm in diameter and rarely affected the palate or gingivae, but involved most other areas, especially the vestibules. They occurred in crops of 3–4 and lasted up to 3 weeks. She had had remissions for only very few days. She had had a couple of episodes of genital ulceration 5 years previously. There were no cutaneous, gastro-intestinal, ocular or joint problems and cardiorespiratory or bleeding problems.

The medical history included epilepsy since age 18 years, for which she used phenytoin. The patient had no known allergies or history of fever. She had been multiply investigated, including HIV exclusion. She had tried Corsodyl, Corlan, Adcortyl, Bonjela, Ambesol, Frador and Canker.