Delayed diagnosis and inappropriate clinical management of nicorandil-induced oral lesions: a case report

Abstract Oral ulcers have a number of causes, as a result their etiology can be difficult to determine. Clinical management can range from simple treatment of the symptoms to extensive surgical excision, as in the case of malignant ulcers. Nicorandil, an anti-angina drug, has been identified as a potential trigger for cutaneomucosal ulcers. This article reviews the importance of taking down the full medical history when seeking side effects of treatments. We present the case of a 70-year-old patient with chronic ulceration of the oral mucosa. The cause of ulceration as a side effect of taking nicorandil was delayed as the team that initially managed the patient hypothesised a malignant etiology. As a result, they performed a partial glossectomy for diagnostic and therapeutic purposes. After extensive examination of the patient's medical history and current treatments, nicorandil was identified as the potential trigger. The patient finally recovered following discontinuation of nicorandil.