Eosinophilic ulceration of the tongue.

Background. Eosinophilic ulceration of the tongue is a classic condition li ttle reported in the literature. We describe a case in a patient taking nic orandil. Case report. An 84-year-old patient consulted for an ulceration of the tong ue which had progressed for 5 months. The ulcer was very painful and the pa tient had lost 2.5 kg. The patient had been taking nicorandil at the dose o f 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 c ompletely regressed within one month without withdrawal of nicorandil. Discussion. This was a typical case of eosinophilic ulceration of the tongu e, both from the point of view of the clinical expression and the histologi cal findings. A nicorandil-induced ulcer was ruled out on clinical (low dai ly dose, delay to onset) and histological arguments as well as the spontane ous regression without drug withdrawal. Nicorandil may have played a role i n the abnormally long duration of the ulceration.