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,
- Behçet disease,
- cyclic neutropenia,
- erythema multiforme,
- FAPA syndrome,
- Sweet syndrome.
or systemic steroids in low doses (10–20 mg prednisone) for four
to eight days can reduce the symptoms dramatically.