Oral Tuberculosis — MFDS Part 1 MCQ
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Correct answer: D — A solitary painful ulcer with irregular, undermined margins on the tongue
The best answer is D. Oral tuberculosis is rare, but its most frequently reported manifestation is a painful ulcerated lesion, and the tongue is the most commonly affected oral site. The ulcer may be persistent and irregular, sometimes with undermined margins, and can resemble malignancy or traumatic ulceration. A firm palatal nodule is not the predominant pattern, while bilateral parotid enlargement is more suggestive of systemic, inflammatory or salivary-gland disease. Bilateral reticular buccal striae are characteristic of oral lichen planus. Recurrent grouped vesicles on the vermilion border indicate herpes labialis. Histology commonly demonstrates granulomatous inflammation, but caseation and demonstrable acid-fast bacilli are not invariably present.
Reference: Gabriel AF et al. Oral and maxillofacial tuberculosis: A systematic review. Oral Diseases. 2023;29(7):2483-2492. https://pubmed.ncbi.nlm.nih.gov/35785411/