A young adult male villager in Madagascar developed painful, perioral swelling over a period of weeks.The stomatitis subsequently evolved into an anesthetic, rapidly expansive, necrotic ulcer with oral incontinence (Figure 1).A period of social instability during the preceding months likely caused malnutrition that resulted in significant weight loss. DiagnosisNoma.
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Tonna et al. (2010) studied this question.
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