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
Multiple pencil ulcers are seen in all except 
Select and explain. 
A. Aphthous ulcers, B. Herpes ulcers, C. Tuberculous ulcers, D. Carcinomatous ulcers
D: Carcinomatous ulcers
Answer: D: Carcinomatous ulcers 
Explanation: Carcinomatous ulcers are painless but may become painful in advanced stages, with extension into surrounding tissues.