Compilato et al proposed the Simple-Complex-Destroying (S-C-D) classification system for a patient with a long-standing oral ulcer. The authors are from the University of Palermo, II University of Naples, New York University and University of Foggia.


Patient selection: ulceration not healing withing 2 weeks, classified as complex


Complex lesions may be classified by preceding or association lesions:

(1) white lesions

(2) red lesions

(3) vesiculo-bullous lesions


Conditions with white lesions:

(1) oral lichen planus

(2) lichenoid drug reaction

(3) lichenoid mucositis

(4) graft-vs-host disease (GVHD)

(5) SLE

(6) squamous cell carcinoma


Conditions with reddish lesion:

(1) atrophic or erosive lichen planus

(2) nutritional deficiency

(3) oral mucositis secondary to chemoradiation

(4) drug-induced

(5) squamous cell carcinoma

(6) neutropenia or agranulocytosis

(7) leukemia

(8) malignant lymphoma (non-Hodgkins or Hodgkins)

(9) myeloma

(10) histiocytosis X


Conditions with vesiculo-bullous lesions:

(1) pemphigus

(2) bullous oral lichen planus

(3) subepithelial blistering disease, immune-mediated


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