It is imperative that a biopsy be performed to establish a definitive diagnosis. Microscopic examination reveals a surface ulceration composed of fibrin entrapping viable and non-viable neutrophils. The surface epithelium adjacent to the ulceration is often thickened and may demonstrate overlying hyperkeratosis. The connective tissue stroma beneath the ulcer bed is markedly well vascularized and composed of loosely arranged collagen fibers interspersed with fibroblasts. The most conspicuous feature of the connective tissue is the presence of a dense inflammatory infiltrate composed predominantly of histiocytes, lymphocytes, and plasma cells intermixed with numerous eosinophils.
Treatment consists of eliminating an obvious source of trauma, if present.
In most cases, healing will occur after the lesion has been surgically excised and primary closure has been obtained. Recurrence is extremely rare. Unlike aphthous ulcers, eosinophilic ulcers do not respond well to corticosteroid therapy. Juan is certified by the American Society of Clinical Pathologists. His primary responsibility in the histology laboratory is to oversee safety issues.