Traumatic Ulcer
Susan Müller, DMD, MS
Key Facts
Terminology
Chronic traumatic ulceration of oral mucosa with unique histopathologic features
Etiology/Pathogenesis
Accidental trauma from biting or fractured teeth
Riga-Fede disease
Clinical Issues
Can occur anywhere in oral cavity
Microscopic Pathology
Ulcer bed composed of granulation tissue with mixed chronic inflammatory cell infiltrate lymphocytes, histiocytes, neutrophils, and occasionally plasma cells
Inflammation including scattered eosinophils extends into underlying muscle
Top Differential Diagnoses
Recurrent aphthous stomatitis
 Clinical photograph shows a traumatic ulcer of the lateral tongue. The patient bit the tongue while anesthetized for dental treatment. |
 Higher power photomicrograph shows the thickened fibrino-purulent covering and granulation tissue composed of a mixed inflammatory cell infiltrate. |
TERMINOLOGY
Synonyms
Traumatic ulcer with stromal eosinophilia
Eosinophilic granuloma of tongue
Traumatic granuloma
Atypical histiocytic granuloma
Riga-Fede disease
Definitions
Chronic traumatic ulceration of oral mucosa with unique histopathologic features
ETIOLOGY/PATHOGENESIS
Mechanical Damage
Accidental trauma from biting
Fractured or malposed teeth
Sharp foodstuffs
Self-Inflicted Wound
Parafunctional habits
Nocturnal clenching
Tongue and lip biting
Riga-Fede disease
Ulceration of ventral tongue caused by tongue thrusting
Occurs in infants with natal or neonatal teeth
Electrical and thermal injury
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