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Recurrent oral ulcerations
Current event plus at least one previous episode in past six months.

This is a 3-year-old child with recurrent oral ulcerations. Angular cheilitis presents as erythema or fissuring of the corners of the mouth.

Oral ulcerations were diagnosed as
1. herpes simplex ulcerations,
2. recurrent aphthous ulcers (RAU),
and 3. atypical ulceration.

RAU were diagnosed according to their clinical presentation on nonattached
oral mucosa. History of RAU was also contributory.

Aphthous ulcerations and large persistent ulcerations are presented in the oral cavity.

Atypical ulceration (formerly described as ulceration nonspecified) presented as large persistent ulcerations (with yellow-grey pseudomembrane) particularly located on the fauces.

This type of ulcer is now generally considered
to represent major aphthous ulcerations. Some of these are extremely resistant to therapy in HIV-infected patients.

This condition is one of the most common oral manifestations seen in HIV-infected children around the world [ref 1, 2].

References:
1. Coogan MM, Greenspan J, Challacombe SJ. Oral lesions in infection with human immunodeficiency virus. Bulletin of the World Health Organization 2005;83:700-6.
2. Reichart PA, Khongkhunthian P, Bendick C. Oral manifestations in HIV-infected individuals from Thailand and Cambodia. Med Microbiol Immunol 2003;192:157-60.

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