A 53-year old female was referred by her local general
medical practitioner to an oral medicine specialist for the
management of a persistent ulcer on the left side of her tongue.
The lesion had been present for at least three months and
was not responding to treatment by topical antiseptic agents.
The earlier removal of a molar in close proximity to the lesion,
in an attempt to exclude the possibility of traumatic ulceration,
had also yielded no beneficial effects. Upon examination,
the patient appeared clinically healthy but presented with a
history of emphysema due to chronic cigarette smoking. The
emphysema was currently being managed by oral inhalation
steroids. Even though smoking cessation had previously been
advised, she failed to comply and was currently still smoking
more than 10 cigarettes per day.