It took this patient until age 23 to receive a diagnosis for the mouth lesion she’d had since childhood, which was mostly asymptomatic aside from occasional mucosal shedding.

The Iranian woman reported no pain or burning and told doctors the lesion had not grown or shrunk over time.

Her history included surgical repair for mitral valve prolapse, occasional propranolol for stress and no smoking or drinking.

She had occasional mucosal shedding, usually when rinsing her mouth or after long stretches without eating.