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APHTHOUS ULCERS

Introduction:

Aphthous stomatitis is a common condition characterized by the repeated formation of benign and non-contagious mouth ulcers (aphthae) in otherwise healthy individuals. The informal term canker sores is also used, mainly in North America, although this may also refer to any mouth ulcers.

Signs and Symptoms:


These ulcers occur periodically and heal completely between attacks. In the majority of cases, the individual ulcers last about 7–10 days, and ulceration episodes occur 3–6 times per year. Most appear on the non-keratinizing epithelial surfaces in the mouth – i.e. anywhere except the attached gingiva, the hard palate and the dorsum of the tongue – although the more severe forms, which are less common, may also involve keratinizing epithelial surfaces. Symptoms range from a minor nuisance to interfering with eating and drinking. The severe forms may be debilitating, even causing weight loss due to malnutrition.



Pathogenesis:


The cause is not completely understood, but involves a T cell-mediated immune response triggered by a variety of factors. Different individuals have different triggers, which may include nutritional deficiencies, local trauma, stress, hormonal influences, allergies, or genetic predisposition.



Epidemiology:


The condition is very common, affecting about 20% of the general population to some degree. The onset is often during childhood or adolescence, and the condition usually lasts for several years before gradually disappearing. 

Treatment:

There is no cure, and treatments such as corticosteroids aim to manage pain, reduce healing time and reduce the frequency of episodes of ulceration. 



Prognosis:

By definition, there is no serious underlying medical condition, and most importantly, the ulcers do not represent oral cancer nor are they infectious. However, aphthae are capable of causing significant discomfort. There is a spectrum of severity, with symptoms ranging from a minor nuisance to disabling. Due to pain during eating, weight loss may develop as a result of not eating in severe cases of aphthous stomatitis. Usually, the condition lasts for several years before spontaneously disappearing in later life.


Top UK Dermatologists Online Consultation
Source: https://en.wikipedia.org/wiki/Aphthous_stomatitis

For more information on this topic please click on the links below

Link to DermNet NZ article on dermatology from DermUK
Link to Medscape dermatology article from DermUK
Link to NICE clinical knowledge summary on dermatology from DermUK

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