Abstract Oral ulcerations associated with ecstasy (3,4-methylenedioxymethamphetamine - MDMA) use are extremely rare, with only three cases reported in the literature to date. A 25-year-old man presented with palatal pain upon awakening following a night of recreational activity. Initial examination revealed a small, centrally located erythematous plaque with a friable surface on the soft palate. Within 12 h, the lesion progressed to a painful ulceration with irregular margins and a white pseudomembrane. Detailed history-taking revealed recent ecstasy use, with the tablet retained in the oral cavity prior to swallowing. Based on clinical findings and patient history, a diagnosis of chemical burn related to ecstasy was established. Treatment consisted of low-level laser therapy, combined with topical antiseptic gel. Complete clinical resolution was observed within five days. The stigma surrounding illicit drug use frequently leads to underreporting or delayed disclosure, which may complicate diagnosis and management.
Medeiros et al. (Mon,) studied this question.