[Eosinophilic ulceration of the tongue]

Eosinophilic ulceration of the tongue is a classic condition little reported in the literature. We describe a case in a patient taking nicorandil.

An 84-year-old patient consulted for an ulceration of the tongue which had progressed for 5 months. The ulcer was very painful and the patient had lost 2.5 kg. The patient had been taking nicorandil at the dose of 10 mg/d for a year. Biopsies of the tongue ulcer confirmed the diagnosis of eosinophilic ulceration. Immunohistochemistry determined predominantly T-cell infiltration. Search for Epstein-Barr virus was negative. The ulcer completely regressed within one month without withdrawal of nicorandil.

This was a typical case of eosinophilic ulceration of the tongue, both from the point of view of the clinical expression and the histological findings. A nicorandil-induced ulcer was ruled out on clinical (low daily dose, delay to onset) and histological arguments as well as the spontaneous regression without drug withdrawal. Nicorandil may have played a role in the abnormally long duration of the ulceration.