Images of physical examination findings and biopsy results. A-D: Gross examination of the oral mucosa demonstrated multiple aphthous ulcers and erythema. (A) A large, painful white ulcer with surrounding erythema located on the soft palate is present. (B) Demonstrates large, shaggy, inflamed ulceration of the lower lip. Granulation tissue, scarring and ulceration were also observed on biopsy of the lower labial mucosa. (C & D) Ileal biopsy revealed villous blunting, crypt elongation, increased inflammation in the lamina propria, and increased intraepithelial lymphocytes (C-low power, D-high power).