• Clinical science

Aphthous stomatitis (Recurrent oral aphthae…)

Abstract

Aphthous stomatitis (also known as canker sores) is characterized by frequent recurrent mouth ulcers. The cause of these painful, mostly benign sores is unknown, but they commonly occur after minimal trauma (e.g., biting the tongue). There are several types of aphthae, all of which can only be treated symptomatically.

Epidemiology

  • Very frequent

References:[1]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

References:[1][2]

Clinical features

  • Painful mucosal ulcers in nonkeratinized areas of the mouth and throat
  • Recurrence is common
  • No systemic symptoms
  • Efflorescence: round to oval, crater-like appearance on yellowish-grey base and erythematous margins


References:[1]

Subtypes and variants

  • Minor aphthous ulcers
    • Size: 5–10 mm
    • Heal within 1–2 weeks without scarring
    • Occur in 80% of affected patients
  • Major aphthous ulcers
    • Size: bigger (20–30 mm) and deeper than minor aphthous ulcers
    • Prolonged healing over several weeks with scarring
  • Herpetiform ulcers
    • Size: small (1–3 mm diameter)
    • Tendency to cluster
  • Bednar's aphthae
    • In infants, ulcer on the palate after trauma
    • Heals completely without treatment

References:[1][2][3][4]

Differential diagnoses

See “Differential diagnosis” in acute tonsillitis

The differential diagnoses listed here are not exhaustive.

Treatment

References:[1]

Prognosis

  • Benign, often recurrent
  • If ulcers persist for longer than 6 weeks, test should be conducted to rule out the possibility of malignancy.
  • 1. Mirowski GW, James WD. Aphthous Stomatitis. In: Aphthous Stomatitis. New York, NY: WebMD. http://emedicine.medscape.com/article/1075570. Updated March 21, 2017. Accessed May 27, 2017.
  • 2. Goldstein BG, Goldstein AO, Dellavalle RP, Deschler DG, Corona R. Oral Lesions. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/oral-lesions. Last updated January 30, 2017. Accessed June 24, 2017.
  • 3. Scully C, Meyers AD. Aphthous Ulcers. In: Aphthous Ulcers. New York, NY: WebMD. http://emedicine.medscape.com/article/867080-overview. Updated January 20, 2017. Accessed June 24, 2017.
  • 4. Eichenfield LF, Frieden IJ, Zaenglein A, Mathes E. Neonatal and Infant Dermatology E-Book. Elsevier Health Sciences; 2014.
last updated 12/10/2018
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