title: Eosinophilic ulcer: the role of stress-induced psychoneuroimmunologic factors.
abstract: BACKGROUND
  Eosinophilic ulcer (EU) is a rare pathology and its etiology is still slightly known. It is a benign lesion characterized by fast-growing ulceration with elevated and indurated borders, most commonly affecting the tongue.
  
  
  METHODS
  The authors describe a case of EU on a lingual border that was initiated and had its clinical behavior altered by the psychological stress the patient was experiencing.
  
  
  CONCLUSIONS
  This paper discusses the stress effects that alter the individual's immunologic response, thus attracting mast cells and eosinophils towards the mucosal epithelium, which are involved in eosinophilic ulcer. The authors make an association between eosinophilic ulcer and atopic dermatitis, two diseases that appear to have a similar, though not fully defined, etiology. The psychological stress factor was considered a predisponent factor for eosinophilic ulcer etiology and its interference in the etiology and evolution of this disease should be considered.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University Center of Pará-CESUPA, Belém, Brazil. ribeiroalr@ig.com.br
authors.forename: André Luis Ribeiro
authors.initials: AL
authors.lastname: Ribeiro
authors.forename: Fábio Rafael de Oliveira
authors.initials: FR
authors.lastname: Mendes
authors.forename: Sérgio de Melo
authors.initials: Sde M
authors.lastname: Alves
authors.forename: João de Jesus Viana
authors.initials: Jde J
authors.lastname: Pinheiro
mesh_terms: D015746:Abdominal Pain / Q000276:immunology / Q000523:psychology; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000276:immunology / Q000523:psychology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019226:Oral Ulcer / Q000276:immunology / Q000523:psychology*; D011598:Psychoneuroimmunology; D013315:Stress, Psychological / Q000276:immunology*; D014060:Tongue Diseases / Q000276:immunology / Q000523:psychology*; D014062:Tongue Neoplasms / Q000175:diagnosis