Drug-Induced Oral Ulceration — ORE Part 1 MCQ

Correct answer: A — Mycophenolate is a known cause of drug-induced oral ulceration

Mycophenolate mofetil is a recognised cause of drug-induced oral ulceration, documented in UK NHS patient information and multiple peer-reviewed transplant case series. Mechanism: direct mucosal toxicity and immune suppression-related effects both contribute. When oral ulceration develops in a transplant patient on mycophenolate, this adverse effect must be considered after infectious causes (viral, fungal, bacterial) are excluded. Option A is correct. Option C is incorrect: the medication is a documented cause. Option B is incorrect: stable renal transplant recipients do not develop ulceration from renal disease. Option E is incorrect: cyclosporine causes gingival overgrowth; mycophenolate causes ulceration. Option D is incorrect: mycophenolate can cause ulceration, not solely lichenoid reactions.

Reference: Cambridge University Hospitals NHS Trust. Mycophenolate Mofetil (MMF) for Patients with Autoimmune Disorder. Patient information leaflet, 2024. https://www.cuh.nhs.uk/patient-information/mycophenolate-mofetil-mmf-for-patients-with-autoimmune-disorder/