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Mouth Diseases

Small Ulcer on Superior Area of Hard Palate

06/30/2010

Question:

I have hay fever, asthma and other food allergies which increases/decreases according to the season and where I live.

I have always had a itchy roof of my mouth (hard palate) for as long as I can remember, I usually use my tongue, or toast or something and drives me and my family mad. However more recently this has become more itchy without hayfever symptoms.

Now it is a approx .2 x.2mm size type ulcer whic has a white macerated edge and then redened surroundingarea. I have a referral to a ent specialist, there is only one in town who will not be returning off leave till 3 weeks time. I am now becoming very concerned as I am now more aware of this and not sure if it is slowly getting worse as it is itchy all the time. Any ideas. I believe this tiny itchy lump has been with me for at least 15 years but has only now become a nuisance and concern.

Answer:

You also may want to have your dentist evaluate the condition. I am a bit confused as superior implies the uppermost aspect of the site, and in this case superior palate is already superior; is it more toward the front of the mouth (anterior) or in the back (posterior); or is it on the hard palate or soft palate?

Location for an ulcerative lesion could help in determining the type and possible cause.

Size wise, .2mm x .2mm is mighty small and almost indiscernible, whereas 2mm x 2mm could be similar to the lesions associated with herpes simplex, especially if it occurs on the hard palate.  

Other possibilities could be aphthous ulceration or trauma (dry toast abrasion!). The itchy sensation is a difficult situation to directly link with why it is occurring and what is causing it. Allergens can precipitate this problem as could post nasal drip associated with rhinitis or hay fever type reactions.  

In my experience sometime the sensation can be driven by some form of nerve damage or irritation that is similar to that seen in "Burning Mouth Syndrome", in which altered sensation can result in the form of burning, pain, itching, and is not associated with any identifiable lesion or pathologic sign.

Again I would suggest you have your dentist examine this while it is still observable, as your ENT exam in 3 weeks there may be nothing to evaluate.

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University