Open Access
J Oral Med Oral Surg
Volume 26, Number 2, 2020
Article Number 18
Number of page(s) 1
Section Lettre à la rédaction / Letter to the editor
Published online 30 April 2020

Covid-19 has a huge range of clinical manifestations and, due to the high number of patients involved, the diagnosis is mostly based on clinical findings or suspicions [1].

A 45-years-old female patient presented with an irregular ulcer on the dorsal side of the tongue (Fig. 1a). History of the lesion revealed 24 h painful inflammation of a tongue papilla, followed by 24 h of erythematous macula, which evolved into irregular and asymptomatic ulcer. After 10 days, the ulcer completely healed without scar.

At Day 3, after occurrence of the oral lesion, an erythematous plane lesion appeared on the big toe (Fig. 1b). It was also painful during 48 h and then became asymptomatic. General symptoms were mild asthenia. Considering the general aspects of the lesions, and despite a lack of general status alterations and symptoms, a nasopharyngeal Covid-19 test was performed at Day 8. The test was positive.

Cutaneous lesions related to Covid-19 have been described [2] and reported by dermatologists, but to our knowledge, oral lesions have not been yet described with a proven Covid-19 infection. The irregular ulcer observed occurred after a short time of macular erythematous lesion, which could be explained by vasculitis. Coronavirus disease 2019 is associated with a variable inflammatory reaction that can induce vascular inflammation [3]. Erythematous rash has been described [2] and could also be explained by an inflammatory reaction.

Thus, this irregular oral ulcer could be an inaugural symptom of Covid-19 which needs to be proven in larger cohorts of patients.

Conflict of interest

The authors have no conflict of interest to declare.

Patient's consent has been obtained for publication.


  1. Jin YH, Cai L, Cheng ZS, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020;7:4. [PubMed] [Google Scholar]
  2. Recalcati S. Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol 2020 Mar 26 [Online ahead of print]. [Google Scholar]
  3. Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of Coronaviruses on the cardiovascular system: a review. JAMA Cardiol 2020 Mar 27 [Online ahead of print]. [Google Scholar]

© The authors, 2020

Licence Creative CommonsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

All Figures

thumbnail Fig. 1

a: Irregular oral ulcer of the tongue at Day 4. b: Erythematous plane lesion of the toe.

In the text

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