Recurrent Aphthous Ulcers : Definition , Causes , C/F , D/D , Treatment

November 12, 2011 | By | Reply More

Recurrent Aphthous Ulcers : Definition , Causes , C/F , D/D , Treatment

Definition :  Recurrent aphthous ulcers are among the most common oral mucosal lesions, with a prevalence of 10–30% in the general population.

Etiology  : The cause remains unclear. Recent evidence supports the concept that cell-mediated immune responses play a primary role in the pathogenesis. Several predisposing factors have been reported, such as trauma, allergy, genetic predisposition, endocrine disturbances, emotional stress, hematological deficiencies, and AIDS.

Clinical features  :

  • Three clinical variations have been recognized: minor, major and herpetiform ulcers.
  • Minor aphthae are the most common form, and they present clinically as small, painful, round ulcers 3–6 m m in diameter, covered by a whitish-yellow membrane and surrounded by a thin red halo.
  • The lesions may be single or multiple (two to six), and they heal without scarring in 7–12 days.
  • The major form is characterized by deep painful ulcers, 1–2 cmin diameter, that persist for 3–6 weeks and may cause scarring .
  • The number of lesions varies fromone to five. The herpetiformvariation is characterized by small, painful, shallow ulcers, 1–2 mm in diameter, with a tendency to coalesce into larger irregular ulcers .
  • Characteristically, the lesions are multiple (10–100), persist for one or two weeks, and heal without scarring.
  • The non-keratinized movable mucosa is most frequently affected in all three clinical variations of the disease.
  • The diagnosis of aphthous ulcers is exclusively based on clinical criteria.

Differential diagnosis ;

  • Herpes simplex,
  • hand-foot-and mouth disease,
  • chancre,
  • Behçet disease,
  • cyclic neutropenia,
  • erythema multiforme,
  • FAPA syndrome,
  • Sweet syndrome.

Treatment : Topical steroids. In severe cases, intralesional steroid injection

or systemic steroids in low doses (10–20 mg prednisone) for four

to eight days can reduce the symptoms dramatically.

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Category: Dental, Oral Pathology

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