This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Head and neck, Subject name: Surgery
[{'content': 'Multiple pencil ulcers are seen in all except \nSelect and explain. \nA. Aphthous ulcers, B. Herpes ulcers, C. Tuberculous ulcers, D. Carcinomatous ulcers', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Carcinomatous ulcers are painless but may become painful in advanced stages, with extension into surrounding tissues.', 'role': 'assistant'}]