Oral ulcer due to dabigatran capsule

Description 

An 80-year-old man with cerebral infarction and no neurological deficits was hospitalised for right empyema. Although the patient's condition improved with antimicrobial therapy and right thoracic drainage, a swelling in his right cheek was observed during clinical rounds. Oral examination revealed ulceration on the right buccal mucosa (figure 1A) with an embedded blue solid matter (figure 1B), which was removed. After confirming the history of prescribed medications, the removed matter was determined to be a dabigatran capsule (figure 1C), and oral ulcer due to dabigatran was suspected. With conservative measures, re-epithelialisation was achieved within 2 weeks.

Figure 1

(A) Oral ulcer on the right buccal mucosa, (B) the removed solid matter, (C) the dabigatran capsule.

Dabigatran is currently used as an alternative to warfarin for venous thromboembolism and non-valvular atrial fibrillation. Dabigatran is formulated with...

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