In Lee's book Introduction to Topological Manifolds, he discusses polygonal presentations of surfaces. He does so by means of words $W_1, \dotsc, W_n$ such that each letter that appears must appear exactly twice in $W_1, \dotsc, W_n$. He requires that words be at least three letters in length, except that two letters is allowed when there is only one word.
What kind of pathological behavior is he trying to avoid with this restriction? I'm not sure what can go wrong with multiple two-letter words.
The restriction is not meant to avoid pathological behavior; I just put it there for convenience. For example, it would be perfectly reasonable to interpret $\langle a,b\mid aa^{-1}, bb^{-1}\rangle$ as a presentation of a disjoint union of two spheres, or $\langle a,b\mid ab, ab^{-1}\rangle$ as a presentation of a projective plane. But we don't need these for proving the classification theorem, and allowing them would require a lot more special-case arguments in the proofs, because two-letter words don't correspond to polygons.